Pence extends HIV emergency order in Scott Co., lawmakers debate expanding needle exchanges

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INDIANAPOLIS, Ind. (April 20, 2015) – Indiana Gov. Mike Pence extended an emergency order Monday, aimed at stopping an HIV outbreak in Scott County that health officials are calling an epidemic.

The order will allow a needle exchange program to continue in the county through the end of May. The outbreak, now at 130 new cases since January according to the Indiana Department of Health, is linked to drug use.

“While we’ve made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it,” Pence said in a statement.

As Pence signed the extension Monday, a legislative conference committee debated whether to expand needle exchange programs beyond Scott County.

“As opposed to questions about whether this has spread beyond the borders of Scott County? There’s no doubt in my mind,” Dr. Shane Avery said, a family physician in Scott County. “It’s here to stay. In fact we’ve not quarantined it. They travel in and out of the county, and it’s the governor’s refusal to address this situation that I believe will result in Indiana’s most historic failure in public health.”

The measure before lawmakers would allow counties with high rates of Hepatitis C to begin needle exchanges. Health officials say Hepatitis C is a good indicator for HIV.

“This is new territory for us,” Joe Fox said, legislative director for the Indiana State Department of Health. “And we need to go slow. We need to be deliberate while addressing the crisis as hand.”

An earlier version of the bill would have expanded needle exchange programs to all Indiana counties, but pushback from opponents and Pence’s administration quashed that.

“Based on Hepatitis C, we have a number of other counties that share characteristics with Scott County and could become the site of an outbreak,” State Rep. Ed Clere (R-New Albany) said.

Fox told lawmakers the health department is considering HIV testing in emergency rooms in counties surrounding Scott County.

But other health advocates testified that’s not enough, urging lawmakers to act fast and allow new needle exchange programs to begin immediately.

“We have zero evidence to that effect that it would put more needles on the street,” Dr. Beth Meyerson said, with the IU School of Public Health and co-director of the Rural Center for AIDS/STD prevention. “Primarily we do needle exchanges because we want to reduce HIV and Hepatitis C. That’s the primary reason we do this.”

Opponents, though, fear the potential consequences of an expansion.

“We don’t want the government to endorse handing out needles and saying it’s OK for drug addicts to get free needles,” David Powell said, executive director of the Indiana Prosecuting Attorneys Council.

Lawmakers have a narrow window to implement change. Different versions of this measure have passed the House and Senate. It will be up to the conference committee to vote on any changes before the end of the session next week.

“It looks like we have a lot of work to do,” State Sen. Patricia Miller (R-Indianapolis) said, who chairs the conference committee. “I’ve talked to people to keep an open mind.”

The fear, for lawmakers and health advocates alike, is the HIV epidemic will expand statewide.

“You heard the testimony that one prostitute said she had six with 70 truck drivers after she was HIV/AIDS positive,” Miller said. “That’s an enormous problem.”

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