The HIV outbreak in southeastern Indiana has reached its peak and is now on a downward trend.
Most of the 175 positive cases have been traced back to Scott County – but that's not stopping other communities from taking action.
As residents of Scott County learn to cope with the aftermath of the epidemic, the list of counties considering implementing needle exchange programs to prevent the spread of HIV in their communities keeps growing.
An Addict's Story
Kevin Polly points to a mark on his left arm.
"This track mark runs from here all the way down," he says, tracing the length of his arm.
The mark is reminder of where he's been – and how far he's come.
"I don't know how my neck looks now, but at the end that's the only place I would hit is my neck."
I don't know how my neck looks now, but at the end that's the only place I would hit is my neck.
-Kevin Polly, recovering addict
Most of Polly's life has revolved around addiction. He was living in the small, rural community of Austin and began using drugs when he was only 13. It started with marijuana and alcohol. It wasn't until about eight years ago that Polly started using needles.
"I succumbed to peer pressure at the age of 41," he says. "Once you do it that way, you won't do it another way."
His drug of choice eventually became a prescription pain killer called Opana. Most days Polly would shoot up four to five times.
With no jobs, no money, nothing else to do, it's how a lot of people in Austin were spending their time.
"I was to the point that's all I cared about," he says. "From the time I was awake to the time I went to bed, I was either using or trying to find something to use."
That vicious cycle came to a screeching halt a few months ago, when an HIV outbreak hit Southeastern Indiana. With so many IV drug users sharing needles, Austin was ground zero.
"I got a letter in the mail and I believe it was February saying it come from the Clark County Health Department stating that someone had tested positive for a communicable disease and turned my name in," Polly says.
Polly went to the health department to have a mouth swab done. The test came back positive.
"It was devastating. At the time I thought my life was over."
Turns out, it wasn't.
"The very last thing I did before I left my house one last time was shot up an Opana," he says. "And, that's been the last time. April the 17th."
Polly checked himself into a treatment program in Jeffersonville, made it through the 35 day program and is now living in a halfway house.
"Feels good," Polly says. "I just celebrated 90 days clean and sober. I didn't think I'd celebrate nine days clean and sober."
And things are looking up back home, too.
Change Slowly Coming To Austin
Brittany Combs walks proudly through a brick building sitting on Highway 31 in Austin, right across the street from the police department.
"We have them come through here," she says pointing to a doorway in the lobby. "We offer the same things that we offered at the other place."
This is the Scott County Health Department's new satellite office. It sits in the middle of the neighborhood hit hardest by the outbreak.
Here they offer immunizations, HIV testing, insurance sign up and the needle exchange program. Life Spring Mental Health Services will soon set up shop in the building, too.
"They're really wanting the sterile water a lot," Combs says. "That's what they're asking extra for because a lot of them don't even have running water."
In the few weeks it's been open, this has become a popular place. We're at the office outside of normal business hours, but with the health department car parked out front, people keep stopping by for fresh needles.
There's a lot of people that never would have signed up on insurance that we signed up on insurance that can now go to the doctor because they have that insurance and they have that coverage.
-Brittany Combs, Scott County Public Health Nurse
The needle exchange has connected the health department to a population that's been under-served in this community. When they come in to get needles, they show the nurse an unusual bump or tell her about breathing trouble. And many of those people are finally getting help.
"There's a lot of people that never would have signed up on insurance that we signed up on insurance that can now go to the doctor because they have that insurance and they have that coverage," Combs says.
While the outlook for Austin wasn't good when the outbreak started, there's a renewed sense of hope on the streets.
It seems the small town that felt left behind is now serving as a model for other communities throughout the state.
"We've got in contact with several other counties," Combs says. "Some have come and actually toured the program to see how we ran it and things like that."
List Of Counties Considering Needle Exchanges Keep Growing
Several other counties have sought approval for needle exchange programs or are considering doing so.
An exchange in Madison County will go into effect in August. Fayette County has also requested an exchange. But it's unclear how the state will judge the success of the programs.
"The Indiana State Department of Health is working very closely with the Centers for Disease Control and Prevention to develop measures to use to evaluate the needle exchange programs to identify data points and a way to track data over time," says State Epidemiologist Pam Pontones.
Clark County will hold a hearing next week to see what the public thinks about starting an exchange there, where the Hepatitis C and HIV rates are 25 to 30 percent higher than the state average.
That's worrisome to Kevin Polly, who's seen firsthand how quickly the disease can spread.
He wants to settle down in Clark County – and he doesn't want to be living in another community consumed by an outbreak.
"A year from now I hope to have my own place here in Jeffersonville," he says. "There is just so much more to offer here."
