Indiana governor extends needle-exchange program to curb HIV

AP News
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Posted: Apr 20, 2015 5:31 PM

INDIANAPOLIS (AP) — Indiana Gov. Mike Pence on Monday extended a needle exchange program in a rural, southern Indiana county to help combat an HIV outbreak, even though he generally opposes such programs.

Pence approved the 30-day extension of a March 26 executive order that declared a public health emergency in Scott County, about 30 miles north of Louisville, Kentucky. Republican Pence opposes such programs as part of a statewide anti-drug policy but said the efforts to fight the outbreak must continue.

"While we've made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it," Pence said in a statement Monday.

Scott County, which has a population of about 23,700, would normally see about five new HIV cases in a typical year. The Indiana State Department of Health officials reported Friday that there are now 120 confirmed HIV cases and 10 preliminary positive cases tied to the county — about one confirmed case for every 200 people living there. The cases have all been linked to needle-sharing among intravenous drug users.

Health officials say they expect the number of cases to increase as more people are tested, putting pressure on Pence and lawmakers to consider more long-term options.

Lawmakers heard testimony Monday on a proposal that would legalize needle exchange programs, which allow drug users to turn in used hypodermic needles in return for sterile ones in an effort to contain the spread of diseases.

If passed, the top 23 Indiana counties with the highest rate per population of hepatitis C would be able to establish their own exchange program. Health officials say high rates of hepatitis C are a key indicator of needle sharing and a potential HIV outbreak.

Other counties with lower rates could establish programs pending approval from county officials.

Opponents of the measure expressed concerns about handing out paraphernalia to drug users, and questioned whether the programs would be effective in rural areas such as Scott County that don't have adequate testing and health care resources available.

"It's just too early to tell what's going to be successful down there," said David Powell, executive director of the Indiana Prosecuting Attorneys Council. "There's a huge public health issue here. I get that, but we must also incorporate public safety aspects of this."

Dr. Beth Meyerson, an assistant professor of public health policy and administration at Indiana University in Bloomington said the spread of disease should be a first priority, and treatment programs and health resources can be established concurrently.

"If someone is drowning, you throw a buoy and that needle exchange is the buoy," she said. "We want to have a stronger system and we will...ultimately it's still that life buoy that's critical for those users at the time."

Senate Health Committee Chairwoman Patricia Miller, a Republican, said she is normally "not a fan" of needle exchange programs but is open to the proposal given the circumstances.

"Health officials are telling us potentially we'll see this in other counties so I'm concerned about that," she said. "We need to address it."

Miller said she is also considering a provision that would set a two-year expiration date on the programs.