There is “trouble, folks right here in river city” (Ok, Scott County),
“Trouble with a capital T and that rhymes with” HIV ….
The song from Meredith Wilson’s The Music Man, which was set in Indiana, heralded a pool problem in fictional River City, but one area really in the state, Scott County, has a bigger problem right now – an HIV epidemic.
Fueled by needle-sharing drug addicts, approximately 72 people in the area, located in southern Indiana, have tested positive for HIV since the first of the year. Another 7 people are awaiting confirmation that they too contracted the virus. The rapid spread has forced the governor and U.S. Centers for Disease Control and Prevention (CDC) to declare a public health emergency in the region.
The CDC has deployed investigators to test residents and try to stem further spread of the virus. CDC officials “traveled to the community … an epidemic ‘aid team,'” Gov. Mike Pence told reporters, who also acknowledge that the CDC has confirmed the existence of “an epidemic in Scott County.”
This epidemic is very different from those on the early days of HIV and AIDS experienced in large metropolises like New York City, Paris, San Francisco and Los Angeles. As recounted in Philadelphia, And The Band Played On, The Normal Heart, and other entertainment outlets as well as thousands of articles, the initial epidemics were in gay communities. While HIV continues to be spread as a sexually transmitted disease, this epidemic is attributed to injections of opiates, largely reported to be Opana, with dirty needles.
In the short term, the governor, healthcare workers, disease-intervention specialists, public health officials and others are trying to hammer out a strategy to deal with the crisis in Indiana. In the long term, the issue has resurrected legislative debates on needle and syringe exchange programs that would allow drug users to trade their used drug paraphernalia for new ones.
To track the current Indiana virus’ spread, experts are tracing all known contacts any of those who tested positive for HIV in the county. They have determined that the epidemic’s epicenter was Austin, a town in the northwestern county area, where opiate abuse has been a growing problem. According to reports, used syringes litter roadsides, ditches and yards.
According to Dr. William Cooke, who is medical director at an Austin health clinic, the Family Foundations Medicine, acknowledged the area have all the bad ingredients that make a recipe for disaster, like high unemployment, school dropout and teen pregnancy rates. He noted increased numbers of overdoses and most drug users now testing positive for Hepatitis-C. “We knew it was a only matter of time until HIV set in,” Cooke said.
Still, the recent HIV spread has been exceptionable. During 2014, only 420 new HIV cases were reportedly identified in Indiana, a state with a population of about 6.6 million. Compare this to the nearly 80 cases during the past three months in a town of 4,200.
The state’s House Public Health Committee heard testimony Wednesday about creating a needle-sharing program. Health officials and concerned citizens who testified stressed the time sensitive nature of the issue. Cooke was one of the people who lobbied the lawmakers to offer fresh needles and safe places to dispose of dirty needles along with a means to connect residents with addiction therapists. The goal is to quell the HIV epidemic in Indiana with a long-term solution to get rid of the “trouble in river city” and Scott County.
By Dyanne Weiss