More than 100 people in southeastern Indiana have tested positive for HIV in an outbreak linked to the sharing of intravenous needles, and officials said Friday they're trying to combat unfounded fears among drug users that they could be arrested if they take part in a needle-exchange program created to stem the spread of the virus.
The state's Joint Information Center said there had been 95 confirmed HIV cases and 11 preliminary positive cases tied to the outbreak as of Thursday. That's up from last week's 84 confirmed HIV cases and five preliminary positive cases.
All of those cases have been linked to needle-sharing among intravenous drug users, most of whom injected a liquefied form of the prescription painkiller Opana.
Indiana's largest-ever HIV outbreak has hit Scott County, a rural, economically-struggling area about 30 miles north of Louisville, Kentucky. Health officials say all of those infected either live in the county or have ties to it. In a typical year, that county would see only about five new HIV cases, but it's seen 20 times that number since December.
Republican Gov. Mike Pence declared a public health emergency in the county March 26 that temporarily waived the state's ban on needle-exchange programs, although solely for that county in hopes of stemming the virus' spread.
That program began last Saturday in Austin — a city of about 4,500 residents that's the epicenter of the outbreak, but as of Monday only four people had joined the needle-exchange. Those four had exchanged 300 used needles and received 168 new, clean ones in return.
State health officials said Friday they did not have an update on the total number of participants.
But Brittany Combs, the public health nurse for the Scott County Health Department, said a total of 11 people had become part of the program by late Wednesday and several others followed on Thursday. She did not have a tally on those additional participants.
Combs said that after some initial apprehension among IV drug users who feared arrest if they showed up to get clean needles, it now appears that officials have made progress allaying their fears.
"Some people were scared to come to the needle-exchange because they were afraid that either the cops were there waiting to arrest them or that we had video cameras to videotape them for later," she said. "Others thought we were going to be able to track them — and none of that is true."
Combs said the program is confidential because participants receive laminated cards with only their date of birth, sex, two letters from their first name and two letters from their last name.
She said volunteers have been canvassing certain neighborhoods handing out fliers on the needle-exchange program and trying to "calm any fears they might have." Some local users who are "vocal in the community" have come into the center and registered for the needle-exchange, proving to other users "that nothing happened to them," Combs said.
"It's a slow process to get people's trust," she said. "The word is kind of getting out that we're not here to harm people, we're here to help them."
Pence's emergency order, which runs for 30 days and can be extended in 30-day increments, directed state health officials to open the command center in Austin to coordinate HIV and substance-abuse treatment and bring in a mobile unit to enroll people in a state-run health program to get HIV testing and treatment.
Austin Mayor Douglas Campbell said Friday that while the needle-exchange program had not yet been embraced by local drug users, officials had expected it would face a slow start.
"It's going to take some time for the people to understand that we want this program to work because we want to make our community healthier and better," he said.