Scott County HIV 01

A syringe is found along West Main Street in downtown Austin in Scott County on in this March 2015 file photo. A recent outbreak of HIV infections in the county have been traced by health officials to intravenous drug use in the area, and a team with the Centers for Disease Control and Prevention is currently working with local officials to contain the outbreak.

INDIANAPOLIS — The HIV outbreak in Scott County that reached epidemic proportions in the middle part of this decade could have been reduced dramatically if state officials had acted sooner, says a study from the Yale School of Public Health.

One of the authors of the study, Gregg Gonsalves, assistant professor of epidemiology at Yale University, said the researchers reached their findings after using publicly available data from the outbreak to re-create it in a computer simulation.

“Once we had re-created the events in Scott County, we could examine what would have happened if a response to the threat had been initiated earlier,” Gonsalves said in a statement.

The study published in The Lancet HIV last week says there were warning signs as early as 2004 that an HIV outbreak could occur in the region because of an increasing number of cases of prescription drug abuses and opioid overdoses.

In 2008, local authorities were recommending that syringe-exchange programs be allowed to reduce the risk of HIV spreading, the study reports. But they were rejected by state officials.

The outbreak had already peaked when then-Gov. Mike Pence, now vice president, declared a public health emergency in late March 2015, according to The Lancet research. The Lancet is a weekly general medical journal founded in 1823 that publishes original research articles like the Scott County study.

After resistance from the Pence administration, the executive order the former governor signed only allowed Scott County to have a needle exchange for 30 days.

“The study should be a wake-up call to both state and local officials to invest in public health and to implement measures that have proven effective, including testing and syringe exchange,” said state Rep. Ed Clere, R-New Albany, who authored legislation overturning a law banning needle exchanges.

”More than three years after the HIV outbreak in Scott County, many counties with similar risk factors still haven’t approved syringe exchange. It stopped the spread of HIV in Scott County, and it could prevent another outbreak elsewhere. What happened in Scott County doesn’t have to happen again.”

The other author of the study, Forrest Crawford, associate professor of biostatistics, ecology and evolutionary biology, said they found the actual number of infections recorded in Scott County was 215 and could have been reduced dramatically if acted on sooner.

“[The number] might have been brought down to fewer than 56, if the state had acted in 2013, or to fewer than 10 infections, if they had responded to the HCV outbreak in 2010-2011,” Crawford said in a statement.

In 2011, the year HIV infections began growing, Scott County had 239 opioid prescriptions per 100 residents, which was more than double the state average of 107 prescriptions per 100 residents, according state data.

The Indiana State Department of Health when reached for comment said the agency does not comment on studies or research done by outside groups.

The Lancet study was funded by the National Institute on Drug Abuse, the National Institute of Mental Health and the NIH Director’s New Innovator Award Program.

James Polston is a reporter for, a news website powered by Franklin College journalism students.

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