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Indiana Governor Pence Authorizes A Needle Exchange To Contain HIV Outbreak In Rural Indiana

A health worker draws blood for an HIV test.

Indiana Gov. Mike Pence issued an executive order today declaring a public health emergency in Scott County in response to a growing outbreak of HIV. His order includes authorization for a "targeted" clean needle exchange.

Clean needle exchanges are illegal in Indiana and the governor has said he opposes them as an addiction-fighting strategy, but is making an exception in the case of Scott County. The number of cases has now grown to 79 since the outbreak was first identified in January.

Pence included the needle exchange on the recommendation of the Centers for Disease Control. A team from the CDC arrived in Scott County on Monday to work with local and state health officials.

In addition to authorizing Scott County public health officials to establish a needle exchange program, the governor also ordered the Indiana State Department of Health to set up an incident command center to coordinate HIV treatment and substance abuse treatment, and requires state and local health, law enforcement and emergency response agencies, as well as health-care providers and hospitals to cooperate and assist in disaster response.  In addition, the state will set up a mobile one-stop shop to assist individuals in enrolling in Medicaid, offering vaccinations, and providing identification information.

It also authorizes Scott County health officials to take whatever steps they deem necessary to contain the outbreak, including a needle exchange. These give addicts access to clean syringes to prevent the sharing of dirty needles.

The state health department is also launching a public awareness campaign, which focuses on drug treatment, infection protection, safe sex, needle disposal and HIV testing and treatment. The three-month campaign will include digital and social media ads, billboards along the Interstate 65 corridor, radio, and will be featured in the free local paper, The Giveaway.

As Pence declared the health emergency, the legislature may soon be taking its own steps to help mitigate the problem.

On Wednesday, Rep. Ed Clere (R-New Albany) introduced a measure that would allow needle exchanges to operate in Indiana. Both the American Medical Association and the Centers for Disease Control say allowing drug users access to clean needles through exchanges is effective in reducing the spread of HIV among IV drug users.

Clere and other supporters of the amendment stressed that they want to be proactive in addressing the spread of HIV in the state. 

“This is something that has been around in the United States for more than two decades, and I think there are more than 200 programs operating around the country," Clere says. "So we’re not doing something new. We are trying to take some o the best practices from other places."

The amendment is still being debated in committee, but if it were to pass as it’s currently written, operators of a needle exchange would be required to register with state and local health departments. An exchange would also be required to deliver information on drug treatment options in the area, in hopes of getting users off of drugs.

Dr. Kevin Burke is a health officer for Clark County and he oversees the HIV testing in the southeastern part of the state. He says that while treating HIV is expensive, a needle exchange actually helps curb spending.

"You have tremendous savings to the state and federal government. So actually if you prevent HIV in one person, you’ve paid for your needle exchange program. Definitely if you prevent it in two," says Burke. "That would give you $40,000 a year that you would be spending on healthcare that could be earmarked for a program.”

Dr. Jennifer Walthall of the Indiana State Department of Health, told the committee that Governor Pence is open to needle exchange as part of his emergency response in Scott County, but he opposes legalizing needle exchanges long term, or in any other part of the state.

Clere said the Public Health Committee will vote on the amendment next week.

Jake Harper is an investigative reporter for Side Effects Public Media, and he is a co-host of the Sick podcast. He can be reached at