[LINK] "Largest HIV outbreak in Indiana history hits tiny community"

[rfmcdonald]

The Toronto Star's Jennifer Yang describes a terrible epidemic of HIV in the United States, a drug-borne pandemic in Indiana's Scott County aggravated by public policy and poor public health.

Since December, 89 cases have been reported in Scott County, a region that typically sees five HIV cases a year. Most are in Austin, a crumbling city of about 4,300 located near the Kentucky border.

The crisis has triggered a state of emergency and urgent response measures, including a temporary needle exchange program, which is normally illegal under Indiana state law. But as public health officials scramble to contain the outbreak, a troubling question looms: how could this have happened?

Investigators say the HIV outbreak was caused by another epidemic that has long plagued Scott County: drug addiction. “One hundred per cent of cases have reported IV drug use so far,” Dr. Jerome Adams, Indiana’s health commissioner, told the Star.

While unsafe sex has helped spread the virus, Adams believes this is the “largest or first outbreak of its kind solely related to prescription drug abuse.” In Austin, where public parks are littered with syringes, police are pointing the finger at Opana, the area’s “drug of choice,” a prescription painkiller that can be crushed and injected. In 2012, Reuters reported that Opana was the “new scourge of America,” gaining popularity after the painkiller OxyContin was changed to become more difficult to abuse.

Scott County is one of Indiana’s poorest areas and 17 per cent of people live in poverty, with a median household income of $43,650. “Austin has historically been a poor community,” said Cpl. Carey Huls, a public information officer with Indiana State Police. “Over time, because of joblessness, the drugs crept in.”