needle exchange

Shane Avery practices family medicine in Scott County, Ind. In December, a patient came to his office who was pregnant, and an injection drug user.

After running some routine tests, Avery found out that she was positive for HIV. She was the second case he had seen in just a few weeks.

"Right then, I kind of realized, 'Wow, are we on the tip of something?' " Avery says. "But you just put it away. ... It's statistically an oddity when you're just one little doctor, you know?"

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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.

On Friday afternoons, several dozen people line up in the narrow hallway of Prevention Point Philadelphia. The men and women, all ages, hold paper and plastic bags full of used syringes.

"We obviously have a space challenge, but people come in, they drop off their used syringes and they ask for what they need," says Silvana Mazzella, the director of programs at the service center for injection drug users.

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