In a small Indiana town, a combination of poverty and lack of social services has had heartbreaking consequences. In Austin, Indiana, there have been 190 people diagnosed with HIV.

Austin used to be better off than it is now. There were low skilled jobs at a local soup processing company, but those were lost due to automation, or replacement by higher skilled positions. In a town where fewer than 10-percent of the population have a college degree, that’s devastating.

Fewer jobs meant less money, which meant more businesses leaving the area. Restaurants closed, as did the grocery store. Social services went away. Head start, early childhood care, workforce training, all left. So not only were there fewer jobs, there were also fewer resources to help those looking for work. Without affordable childcare, parents can’t work.

Also, in 2013, the only testing facility in the county, Planned Parenthood, was closed.

Without workforce training, people couldn’t gain skills to get other jobs. Not knowing what else to do for money, kids graduating from high school would go to the only doctor in town to try and get on disability.

As people lost hope, they started turning to drugs. Intravenous drug abuse became rampant. OxyContin was the drug of choice, ground up and injected. Until a change in the pills made them too difficult to grind.

Then people switched to Opana. Opana tried to change the formula in the same way OxyContin had, but it made no difference. If those weren’t available people would just switch to meth.

As people started sinking further in to drug use, they shrank back from the public. No one saw them, which made it easier to forget the problem existed. No one knew how severe everything had become.

It was 2014 when a health worker in a neighboring county first noticed the rise in HIV cases. When an HIV case is confirmed, there is a period of investigation in which the object is to try and find out who else might have been affected. During this time, health officials realized every one of the new cases was an intravenous drug user.

As the number of cases increased, Scott County needed help. They turned to New York state. New York had weathered a hepatitis-C outbreak in a rural area, so surely they would have some advice. Scott County was told that the only real option was a needle exchange. Unfortunately, needle exchanges aren’t allowed in Indiana.

By March 2015, Governor Mike Pence had no choice. He declared a state of emergency and allowed a needle exchange.

Indiana realized there needed to be more than just the needle exchange. That dealt with one part of a major problem. They had to find a solution to the drug use. In response they opened a center to help with all sides of the issue. Most of those affected didn’t have health insurance, several didn’t even have an ID.

This new facility helped people get birth certificates and file for Medicaid. They offered HIV testing and immunizations along with substance abuse and counseling referrals.

There are fewer new cases now, thanks to these changes. There is also some real recovery. Shonita Fink, a LifeSpring therapist said:

“What I have found is that people will go to the needle-exchange program, and then after a period of time — we’re not the first visit, we’re not the second visit, but after a period of time — they will get the courage to walk across the hall and come over to us and say, ‘Hi, I have had enough.’ ”

Even though there is positive change, the underlying issue of poverty still needs to be addressed. People still have trouble paying for basic needs. Brittany Combs, of the Scott County Health Department, had an issue finding some of her clients. They weren’t at the addresses she had on file. She found 20 individuals huddled in one house, the house with power.

This goes to show that the proper way to treat addiction is to offer help, and that when you close down testing facilities, outbreaks are sure to follow.

Featured image by Pixabay, available under a Creative Commons Attribution-Public Domain Dedication 1.0 Universal license.

 

 

 

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