On Thursday March 26, Indiana Governor Mike Pence made an official announcement, declaring a public health emergency in a rural community in Indiana where 79 new HIV cases have been identified in the last few months.
Most of the cases were identified in Scott County, about 30 minutes north of Louisville, having a population of approximately 25,000.
It might seem unusual that such a small community be affected by an HIV outbreak but there is a logical reason behind this phenomenon – the ever increasing use of heroin and other injectable drugs in rural areas such as this one.
Many states in the Midwest have been struggling with a recent increase in drug and needle use and Indiana has seen the biggest rise. Another factor that led to the outbreak in Indiana is the use of strong painkillers such as Opana that can be modified so that it can be injected. Indiana State Department of Health stated that since 2002, the number of deaths caused by Opana overdose has risen from 200 to 700 in 2012.
In such rural communities, public health infrastructure is inconsistent thus inefficient in preventing infections such as HIV from spreading. Beth Meyerson, a professor of health at Indiana University and co-director of the Rural Center for AIDS/STD Prevention explained that Scott County, together with other four counties are serviced by a single clinic that can test for HIV. This is another reason why the virus can spread so easily. As there is only one clinic, it is clear that the public health system in this area is dysfunctional and weak.
A study conducted in 2013 by the Trust for America’s Health organization found that Indiana had the weakest federal funding per person from the Centers for Disease Control (CDC). The average spent per capita nationally was $19.54 while in Indiana $13.72 were allocated per person.
But HIV is not the only concern in rural communities. According to Meyerson, there has been an increase in Hepatitis C which is actually another sign that the HIV outbreak is spreading. The U.S. Department of Health & Human Services found that about a quarter of the people infected with HIV in the United States are also suffering from Hepatitis C.
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