At least 160 people have been infected with HIV in Southern Indiana as part of an unprecedented outbreak. While experts say the outbreak has likely been contained and the number of new cases is beginning to plateau, local doctors say there’s more to be done.

The State Health Commissioner approved Scott County’s request Thursday to extend its needle exchange program for at least the next year.

“One sharing or one use of a pre-used needle puts you at risk,” says Dr. Jennifer Walthall, Deputy State Health Commissioner. “Especially in a community where the viral load of HIV is very high and very infective, we want to make sure that we’re protecting people with this powerful tool.”

Walthall says law enforcement has been a primary supporter and partner in this outbreak response. Shifting the focus from the illegality of drug use to the underlying mental health factors in addiction has been important to gain the trust of residents and treat the causes of the outbreak.

The Scott County Health Department’s needle exchange program has been coupled with resources for addiction treatment services, infectious disease testing, health insurance and job training.

Despite the progress being made, Dr. Beth Meyerson, co-director of the Rural Center for AIDS/STD Prevention at the IU School of Public Health, says the outbreak has exposed deficiencies in the public health sector in regard to drug addiction and infectious disease testing and treatment. Out of 92 counties in Indiana, 37 counties have HIV test sites sponsored by the state Department of Health.

“When you have an outbreak like what’s happening in Scott, it shows the belly of the beast. It’s not just about HIV — it’s about our primary public health system not working well together,” Meyerson says. “So in essence it means our next step, beyond outbreak response, is how do we build that community resilience, that public health infrastructure together?”

The Centers for Disease Control and Prevention recommends universal HIV testing for people between the ages of 13 and 64. But Dr. Diane Janowicz, infectious disease specialist at IU Health Physicians, says it hasn’t been adopted in most areas.

“Universal testing has been recommended because 16 percent of people who are in infected with HIV here in the United States don’t know it,” Janowicz says. “By offering this universal testing, ideally we can capture more and more people who don’t know they’re HIV infected and then subsequently link them to care where they can see a physician and get effective treatment.”

She says the Scott County outbreak can be an impetus for other communities throughout the country who take notice and realize this can happen anywhere.