HIV

Another southern Indiana county might declare a state of emergency over increasing rates of HIV and hepatitis C.

Clark County, which is just across the Ohio River from Louisville, is considering the move in light of the recent outbreak in neighboring Scott County.

Scott County, Indiana, has received national attention recently following a spike in HIV and hep-C, blamed on the use of dirty needles used by addicts who are injecting heroin and the painkiller opana.

The Courier-Journal reports Clark County public health officer Kevin Burke is considering declaring a public emergency after it was discovered that a current HIV case in his county was linked to the Scott County outbreak. A public emergency would allow the creation of a needle exchange program, something proponents say is necessary to slow the spread of disease and offer treatment options to addicts.

U.S. Centers for Disease Control and Prevention director Tom Frieden says the 4,200 person town of Austin, in Scott County, has a higher per-capita rate of HIV infection than any country in sub-saharan Africa.

Indiana state health officials say they’re working to transfer more responsibility to local officials dealing with the response to the HIV outbreak in the southeastern part of the state. Indiana State Health Commissioner Dr. Jerome Adams and Deputy State Health Commissioner Jennifer Walthall  outlined the transition and long-term sustainability efforts in a news conference Wednesday.

Adams said he wants to make it clear that the Indiana health department is not leaving Scott County, where 170 people have been newly-diagnosed with HIV since December.

“This is a transition to more local control, more local empowerment. But the state will remain partners with Scott County. We’ll continue to be involved with and go down to Scott County for the foreseeable future,” he said.

There are now 170 confirmed HIV cases related to the outbreak. Adam said that 86 percent of those with HIV also have Hepatitis C.

Indiana health officials say more than 100 people have tested positive for HIV in an outbreak of the virus among intravenous drug users in southeastern Indiana.

The state’s Joint Information Center said Friday that as of Thursday there had been 95 confirmed HIV cases and 11 preliminary positive cases tied to the outbreak.

All of the HIV cases have been linked to needle-sharing among intravenous drug users.

Scott County — about 30 miles north of Louisville, Kentucky — is the epicenter of Indiana’s largest-ever HIV outbreak.

Gov. Mike Pence declared a public health emergency in the county on March 26 that allowed the creation of a limited needle-exchange program that aims to stem the spread of the virus.

On the first day of its new HIV clinic, the Community Outreach Center in Austin, Ind., is quiet.

Rows of chairs line the lobby. Health care providers walk in and out of  doors that lead to private testing areas, treatment resources and other services. The makeshift center is dubbed a One- Stop Shop, sanctioned and overseen by the Indiana State Department of Health.

State and local health officials have begun a needle-exchange program in a southern Indiana county where an HIV outbreak among intravenous drug users has grown to nearly 90 cases.

Scott County’s needle-exchange program started Saturday morning under an emergency executive order signed last week by Gov. Mike Pence.

That 30-day order temporarily suspended Indiana’s ban on such programs, but only for the southern Indiana county about 30 miles north of Louisville.

The program is open only to Scott County residents through the Community Outreach Center in the city of Austin that’s at the epicenter of the epidemic. That region now has  84 confirmed HIV cases and five preliminary positive cases.

Each participant will initially receive enough needles for one week to help combat needle-sharing that’s caused the epidemic.

Indiana is launching a needle exchange program in Scott County to combat an outbreak of HIV related to intravenous drug use.

Disease intervention specialists from nearby counties and states, including Kentucky, have been called upon to assist.

Louisville is about 40 miles south of Scott County, and Kentucky officials are battling this state’s own issues with intravenous drug use—specifically, with a spike in heroin use.

But Kentucky health officials have not seen a surge in new HIV cases despite the Indiana outbreak, said Dr. Kraig Humbaugh, director of the division of epidemiology and health planning for Kentucky.

He said he expects Louisville physicians to see an increase in the number of people seeking treatment for HIV from Southern Indiana.

He said it’s too early to tell whether the Indiana HIV outbreak will also lead to an increase in Kentucky.

In 2013, there were 392 newly diagnosed HIV cases in Kentucky, according to the 2014 HIV/AIDS Surveillance Report.

Dr. William Cooke knew he wanted to practice medicine in a rural town. He’s been a physician in Austin, Indiana, for 10 years—and he’s the only physician in town.

“I went there specifically to bring access to care,” he said.

Austin is in  Scott County, which is at the center of national focus because of an HIV outbreak attributed to intravenous drug use.

To meet the crisis, Cooke is providing a much-needed free HIV clinic for the small city of about 4,300 people. So far, more than 80 people Scott County have tested positive for HIV since the end of the year.

On Tuesday, Cooke and his team at Foundations Family Medicine opened an HIV clinic in their existing office in Austin, about 40 miles north of Louisville.  They were joined by representatives from the Indiana State Department of Health, the Centers for Disease Control and Prevention, the Indiana Family and Social Service Administration and local health departments.

On its first day, about 30 people stopped by the HIV clinic either for testing or to initiate HIV treatment, he said. All of the services and care were provided free of charge.

“The people of Austin deserve to have their own clinic to get treatment from and not require them to travel to Louisville or Indianapolis,” he said.

One of the state’s foremost HIV/AIDS public health officials has told a panel of state lawmakers Wednesday that the state’s health insurance exchange under the Affordable Care Act, Kynect, is helping patients who have the virus.

Despite gains in treating the virus, it still disproportionately affects African-Americans and Hispanics.

According to data from the Kentucky Department for Public Health, African-Americans make up 38 percent of newly diagnosed HIV cases despite representing only eight percent of the state population.

Kraig Humbaugh, senior deputy commissioner for the department, told members of the Joint Committee on Health and Welfare that those figures mirror a national trend. His only explanation for the difference lies in the risk factors listed by the data.

The University of Louisville

HIV vaccine research being conducted in Owensboro is getting a boost from a federal grant. The National Institutes of Health Monday announced a five-year, $14.7 million dollar grant for a project being led by the Owensboro Cancer Research program.

The goal is to create a gel-based vaccine that involves tobacco plants.

Researchers in Daviess County have been extracting a protein found in red algae, injecting it into tobacco plants, growing the tobacco on a massive scale, and then extracting the protein for use in a gel. Lab tests show the protein blocks HIV cells from entering uninfected cells.

Researchers have developed a gel using the protein that they hope can be used to stop the spread of HIV during sexual intercourse.

Owensboro Cancer Research program director Kenneth Palmer says the irony of using tobacco plants to possibly create a medical breakthrough isn’t lost on him.

Experts who watch HIV and AIDS cases in Kentucky say the rate of infection may see a rise thanks to complacency and the rise of heroin abuse in the state.

In spite of ongoing education and prevention efforts, the rate of infection in the state has remained constant over the past decade in Kentucky.

Mark Royse, executive director of AVOL, told the Lexington Herald-Leader that the infection rate may be on the rise. AVOL serves HIV and AIDS patients in 72 Kentucky counties.

Royse says people believe the disease is a problem in poorer countries, but not the U.S.

He says as heroin use increases in the state, so too do infection problems that arise from sharing needles.

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