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Rural Towns Lack Resources To Combat, Prevent HIV Outbreak

Rural health departments located near the center of Southeastern Indiana's growing HIV outbreak are struggling to meet the demand for services.

As we first reported last week, the HIV outbreak that originated in Scott County is expanding to its neighboring counties. And, the state is facing mounting criticism for not doing more to help communities at risk.

Local Departments Lack Resources To Provide HIV-related Services

The Jackson County Health Department sits in a small building in Seymour. It serves as a resource for residents to get information about public health risks in their community.

But, the one they're facing now caught the folks working here off guard.

"HIV was not necessarily on the radar at the time," says Public Health Coordinator Lin Montgomery. "We knew we had drug users. The use of Opana and the sharing of needles was something that was in the back of our minds, but we were not expecting the HIV turnout that we've had."

The State Department of Health says five people have tested positive for HIV in Jackson County – a big threat in a small, rural community.

But, the local health department can only do so much to help combat the problem.

It costs a lot of money to setup a clinic and provide services to that population.

-Lin Montgomery, Jackson County Public Health Coordinator

They don't even have the resources to test people for HIV.

"It costs a lot of money to setup a clinic and provide services to that population," Montgomery says.

She will undergo a state testing course, which will allow the department to access state resources to start HIV testing in the community.

Health officials say most of the HIV cases are still being traced back to the sharing of dirty needles. In Jackson County, police say addiction is especially bad in the small town Crothersville.

It sits right across the county line from Austin, which is the epicenter of the outbreak.

"Right now, we are having a problem with IV drug use and probably reuse of needles, sharing needles and that has been a problem with the Scott County events," says Jackson County Sheriff Mike Carothers. "It's kind of been a carry over into our county."

But, police departments, too, are struggling to combat the root of the problem.

Many are staffed at levels lower than what's suggested by the federal government.

"Money would probably help for one so we could have more overtime, more manpower," Carothers says.

As HIV Cases Increase, State Expands Its Efforts To Stop Outbreak

The state is expanding its efforts to quell the outbreak by providing resources for HIV testing to any community that wants them.

Until now, their efforts have focused solely on Scott County, where they've setup a one-stop-shop that offers free testing and clean needles.

Health officials still have to complete contact tracing for at least 120 people. And, they say the outbreak still hasn't reached its peak.

"As you've seen from our report from last week to this week, we've started to see a decreasing in that slope," says Deputy State Health Commissioner Jennifer Walthall. "And, that is with our additional services on the ground. So, we are very encouraged by those."

While they're focusing much of their attention on ways to stop the outbreak, the state is looking ahead to what its long-term response could look like.

The Department of Health is working with doctors from the Centers for Disease Control and Prevention to determine what needs the HIV positive population will have years from now and what resources small communities like Austin will need to address them.

When we call at the state level or maybe even the federal level and say, 'Hey, we need help, we're from Austin', I think they're going to hear us.

-Donald Spicer, Austin Police Chief

"It will have to include providing care for people with HIV and Hepatitis, helping people recover from drug addiction and ultimately looking and trying to improve on some of the social determinants that caused the drug problem," says Dr. Jonathan Mermin, Director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

In order for the state and local health departments to truly get a handle on the HIV and Hepatitis C problem, more long-term health providers will have to come to the community. In Austin, there are few resources for substance abuse or mental health treatment.

The people living in Austin are hopeful all of the attention their community is getting will only make it stronger.


"The biggest fear is the negative response that the public sees it as a negative thing, that other people around the world are seeing it as a negative thing," says Austin Police Chief Donald Spicer. "But, there's going to be so much positive come out of this. People know where Austin is now and those resources are going to be made available. And, when we call at the state level or maybe even the federal level and say, 'Hey, we need help, we're from Austin,' I think they're going to hear us and I think they're going to provide that help."

Legislators approved a bill earlier this week that allows communities to ask for authority to setup needle exchange programs similar to the temporary exchange in Scott County. But, the language is extremely restrictive. Communities must meet certain criteria in order to qualify for an exchange program.

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