Indiana officials hopeful HIV outbreak may be subsiding

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INDIANAPOLIS (AP) — After months of mounting HIV cases, a rural county that's facing Indiana's worst-ever HIV outbreak is seeing a dwindling number of new infections, possibly signaling that the outbreak is winding down, a state health official said Thursday.

Deputy State Health Commissioner Jennifer Walthall said there have been 149 confirmed HIV cases and one preliminary positive case in Scott County and adjacent areas since December, but only about 15 new cases during the past two weeks.

She said health officials "are very relieved" by the recent drop in new HIV cases amid the outbreak fueled largely by needle-sharing among intravenous drug users.

"We feel that we've really started to get a handle on where we are in the outbreak and we might be seeing its conclusion," Walthall said during a weekly update on the outbreak.

Scott County, about 30 miles north of Louisville, Kentucky, normally sees only about five new HIV cases annually, but since the outbreak was detected in December it's seen 30 times that number.

Those cases in Scott County, as well as a handful in adjacent Jackson County and other parts of southeastern Indiana, are tied largely to needle sharing among people who injected a liquefied form of the painkiller Opana. But some of those cases have spread through unprotected sex, which is the primary way the virus that causes AIDS is transmitted in the U.S.

Because the epicenter of the outbreak — in the small Scott County city of Austin — is adjacent to busy Interstate 65, Indiana launched a public awareness campaign last week encouraging truck drivers and travelers along I-65 between Indianapolis and Louisville to avoid prostitutes, use condoms and limit their sex partners.

Gov. Mike Pence signed an order in March allowing a 30-day needle-exchange program for Scott County to prevent additional infections. He later reauthorized through May 24 that program, which has distributed more than 10,000 syringes to 250 participants.

A measure approved by lawmakers that Pence signed into law Tuesday allows Indiana communities to seek state approval to run needle exchanges if they can prove they're facing an HIV or hepatitis C epidemic fueled by IV drug use.

Scott County's public health nurse, Brittany Combs, said the county health department has signed off on requesting a one-year needle-exchange under that law and the county's commissioners will meet soon to consider that request. A public hearing is also needed before the county can seek the state health department's approval for that program.

"As soon as the governor signed it, we were ready to go," Combs said during Thursday's outbreak update at a command center in Austin where state and local officials run the needle-exchange and also offer free HIV screening, drug treatment referrals and other services.

Any Indiana needle-exchange programs arising from that new law would join nearly 200 other such programs in 33 states, the District of Columbia, Puerto Rico and other U.S. territories, said Greg Millett, vice president and director of public policy for amfAR, The Foundation for AIDS Research.

Millett said Scott County is only a short drive from Louisville, where the city council last month approved a needle-exchange program to help combat Kentucky's heroin epidemic and soaring hepatitis C cases.

More than 80 percent of those infected in Indiana's HIV outbreak also have hepatitis C.

"In many ways, what's taking place in Scott County is probably a harbinger of what we might be seeing in rural parts of Kentucky and other rural areas. That's why this issue is so pressing," he said.

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