State health officials reported on March 27, 2015 a total of 81 HIV positive tests, which includes 74 confirmed and 7 preliminary cases related to the outbreak in southeastern Indiana. Oral fluid HIV tests (swab in the mouth to collect saliva), which are being utilized, are very accurate and all of the preliminary positives in the outbreak have so far become confirmed positives. All positive cases have been linked to injection drug abuse, with some individuals also reporting sexual intercourse as a possible mode of transmission.
Governor Mike Pence has declared a public health emergency in Scott County due to the outbreak reaching epidemic proportions.
"Scott County is facing an epidemic of HIV, but this is not a Scott County problem; this is an Indiana problem," said Governor Pence. "I am confident that together, we will stop this HIV outbreak in its tracks."
The public health emergency declaration was issued in Executive Order 15-05, which orders the state to coordinate a multi-agency response and provides additional resources and tools to tackle the outbreak.
"The order issued yesterday gives local officials the authorization and tools needed to help stop this tragic epidemic," said State Health Commissioner Jerome Adams, M.D., M.P.H. "Stopping this outbreak will take the full collaboration and partnership of federal, state and local resources. I am encouraged by the compassion and collaboration by those at both the state and local level to stem the tide of the outbreak."
The Indiana State Department of Health is working closely with local health officials, the Centers for Disease Control and Prevention (CDC), drug treatment facilities, academic and local medical providers, other State agencies and other partners to contain the outbreak and get HIV positive individuals treatment. This includes:
- Providing free HIV testing to individuals.
- Utilizing a rapid HIV screening test that takes 20 minutes to process. If that test is reactive, or indicates the likely presence of disease, blood is being drawn to send to the State Lab for confirmatory testing, which produces results within a week.
- Interviewing newly identified HIV positive individuals to obtain sex and needle sharing partner information by Disease Intervention Specialists (DIS). Individuals are also referred to medical care and HIV Care Coordination services.
- Setting up an incident command center in Scott County to coordinate HIV treatment and substance abuse treatment.
- Launching a medical clinic to assist with individual care.
- Providing resources and support to help individuals sign up for the Healthy Indiana Plan (HIP 2.0), gain access to substance abuse treatment and other needs as determined.
- Creation and implementation of a public education awareness campaign called You Are Not Alone, which focuses on substance abuse treatment, safe sex, needle disposal and HIV testing and treatment. Viewers are encouraged to contact the HIV services hotline or addiction hotline for local treatment and care resources.
The Executive Order issued by the Governor authorizes the Scott County local officials to take the actions they deem necessary, including a targeted, short-term needle exchange program for the sole purpose of containing the epidemic. Needle exchange programs are illegal in Indiana.
The Scott County Board of Health met Thursday evening to discuss and vote on a request for a needle exchange program. The request was approved by officials and sent to the Indiana State Department of Health. State health officials are working closely with local officials to coordinate the program.
"All members of the Board of Health voted unanimously to approve the needle-exchange program request," said Scott County Health Officer R. Kevin Rogers, M.D. "We appreciate the opportunity that Governor Pence is giving us to authorize this intervention."
All cases so far related to the outbreak have originated in Scott County but health officials continue to investigate contacts in Scott, Clark, Perry, Washington and Jackson counties.
State health officials recommend that all Hoosiers know their HIV status. The best way for an individual to learn their HIV status is by getting tested by a health care professional. Hoosiers in the southeastern portion of the state, especially individuals who have engaged in high-risk behavior such as needle sharing and unprotected sex, are advised to get tested and then re-tested after about two to three months because HIV can take up to three months to appear in a person's system.
To help reduce risk of HIV infection, avoid:
- injection drug use;
- sharing or re-using needles and other drug paraphernalia;
- engaging in unprotected sex; and,
- engaging in sex with commercial sex workers.
For HIV testing locations and information about HIV Care Coordination, individuals are encouraged to call the ISDH HIV Services Hotline at (866) 588-4948.
Individuals seeking help with substance abuse should call the national 24-hour addiction hotline at 1-800-662-HELP (4357). This hotline provides confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental health and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
To learn more about the link between HIV infection and drug abuse, visit the National Institute on Drug Abuse at