Austin mayor: ‘Be patient’ — fighting HIV epidemic a multipronged approach

Medical waste containers are stored in preparation for Scott County residents that are looking to exchange used needles at the Community Outreach Center in Austin as part of the needle-exchange program authorized by Gov. Pence. "The goal is a clean syringe for each injection use," said Brittany Combs, Scott County Public Health Nurse.

AUSTIN — Gov. Mike Pence’s public health emergency provisions to extinguish an unprecedented HIV outbreak in Scott County expire after 30 days.

But Austin Mayor Douglas Campbell stressed that combating the HIV-borne drug abuse problem rooted in his southeastern Indiana city will take much longer.

“I just think that people need to be patient and understanding,” Campbell said Tuesday. “ ... This is not something that happened fast. This has been a long, ongoing process to get to the point that we are now, so I hope people don’t expect it to be taken away or cured fast.”

The attack against the worst HIV outbreak in Indiana’s history — sourced from intravenous drug use — is taking shape on several fronts. State and local health officials are visiting residents door-to-door, sending mailers and posting fliers to inform them of the program. Legislation is making its way through the Statehouse that could establish precedent for needle-sharing programs in high-risk communities statewide.

Scott County Health Department Public Health Nurse Brittany Combs said during a news conference Tuesday at Austin City Hall that word of mouth is the most important method for spreading information and dispelling rumors.

“We have heard that some people don’t trust, that the cops are there waiting to arrest them as soon as they walk in the door, or that we’re going to track them and as soon as the 30 days is over we’re going to arrest them,” Combs said. “None of that is true.”

ACTION AT THE STATEHOUSE

A needle exchange program began Saturday as one leg of Pence’s executive order, allowing Scott County-only residents to trade in dirty needles for clean ones, and it expires April 25.

But a longer-term solution could be could be in the works.

On Tuesday the Indiana House passed a bill that would allow local health officials in high-risk communities to give needles to intravenous drug users without having to get an emergency declaration from the governor.

The measure, which passed 53-39, could apply to Indiana counties that have high rates of Hepatitis C, a potentially lethal blood-borne virus that, like HIV, is commonly transmitted through sharing of contaminated needles and through sexual contact.

Public health officials have warned that high Hepatitis C rates, now present in half of Indiana’s 92 counties, are a marker that a community is at-risk for an HIV outbreak like the one in Scott County.

But the measure, authored by Rep. Ed Clere, R-New Albany, faces opposition. It must get approval from a conference committee of Senate and House members before getting a full vote in the Senate. If approved, it’s on to Pence, who has threatened to veto legislation that expands needle exchange outside of Scott County. Pence has declared his long-standing opposition to such programs and has made clear that he allowed the program in Scott County only because the community faced a public health emergency.

By Monday morning, four people had exchanged 300 needles in Scott County and received 168 in return.

“I think 168 is low, compared to what I thought we’d have,” said Campbell, who cut his Florida vacation short after the Centers for Disease Control arrived in Scott County two weeks ago.

Eighty-nine people have tested positive — a 1,680 percent increase from an average of five per year — with 84 confirmed and five preliminarily positive. Campbell said it may appear that the virus is spreading rapidly but the numbers are spiking because more residents are being tested than ever before. Before the outbreak, Scott County didn’t have any HIV testing centers.

“Once we get our testing substantially completed, we know our numbers will level out,” he said.

ESTABLISHING TRUST

Education and trust are key in weathering the epidemic, Campbell said.

“So as mayor, that’s one of the things I’m trying to communicate to people: Let’s not be afraid through this process,” he said. “This is not something that all of a sudden we’ve said, “Hey, we’ve got a major problem.’ That’s not the deal. The deal is that we are trying to correct a lot of years of wrongs.”

He said he’s not too concerned that the epidemic will affect the business climate in Austin. The city has historic partnerships with companies such as Morgan Foods, a canned good supplier, which is the biggest employer in the county.

“And [the outbreak isn’t] going to affect that,” Campbell said. “ ... If we can get a healthier community, that’s going to help us.”

Residents aren’t required to bring dirty needles to their initial visits. They’re given starter packs — a week’s supply of clean needles, “sharps boxes” or biohazard receptacles — based on their individual use habits.

Combs said she had one woman report using 10 to 12 needles daily to feed her current level of addiction.

“The number is a lot higher than I thought on some of these,” Combs said.

Residents wanting to help clear the streets of dirty needles can also pick up sharps boxes at the state-organized resource center, called the One-Stop Shop, at 2277 W. Frontage Road, Austin. The One-Stop Shop provides other resources, such as Hepatitis A and B and Tetanus vaccinations.

Reel said trained volunteers will be participating in a community cleanup April 11.

However, health officials are advising that those who participate in community-wide cleanups are properly trained and equipped to handle dirty needles.

“When it rains, these needles come up to ground level from the gutters,” Indiana State Department of Health spokeswoman Amy Reel said. “We’re getting reports of children being stuck by needles, plating in the yard. And the community is very concerned about this.”

Some are wary of a breach of privacy, worried they will be identified as HIV positive or addicts simply by visiting the One-Stop Shop.

“Nothing’s foolproof,” Austin Police Chief Donald Spicer said. “But the reward outweighs the risk for these people.”

Officials expect more to visit the One Stop-Shop as word spreads

“For any new problem,” Deputy State Health Commissioner Jennifer Walthall said, “that requires a culture change.”

Beilman writes for the Jefferson (Ind.) News and Tribune. CNHI state reporter Maureen Hayden contributed to this report.