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Scott County HIV Problem Changing Minds On Needle Exchanges

Barbara Harrington
/
http://indianapublicmedia.org/news/

 

Needle exchanges are controversial. Critics say handing out clean needles enables drug use, while others point to evidence, showing that exchanges reduce the spread of disease.

For the past several weeks, Scott County, Indiana has been operating a needle exchange, to combat an outbreak of HIV linked to injection drug abuse. It’s the first of its kind in Indiana, and it recently received approval from the state to run for a year. But getting the community to accept the idea was a process -- and in some ways, one that’s ongoing.

On a recent afternoon, Scott County’s mobile needle exchange unit rolled through the northern part of the small town of Austin. Brittany Combs, the county’s public health nurse, stopped the SUV at a run-down two-story house, one she had been to before. One of the users was media shy, so I stayed inside while she opened up the back of the of the vehicle to hand out needles to three different people.

The program seems to be gaining momentum. Governor Mike Pence first authorized the exchange in late March, but when it got up and running in early April, business was slow. Only four people came by in the first couple days. Now, more than 170 people have signed up. Drug users aren’t the only ones who had to warm up to the idea.

Many people in Scott County--including Combs herself--feared that handing out needles would enable drug use.

"A lot of people in our community are conservative, and they really didn't understand how it worked... [until I explained it] then they agree to it, and that's been really helpful," Combs says.

Combs changed her mind when she really looked at the research, which shows that needle exchanges reduce the spread of infectious diseases like hepatitis C and HIV.

The needle exchange does not strictly adhere to best practices generally accepted by national experts. Needle exchanges typically hand out more needles than one person needs, so a user can pass them on to their friends. But Scott County’s program requires each individual to register, and they only get enough needles to last a week -- which keeps them in regular contact with health workers. Combs says this setup helps connect users to treatment options. That was important to get the community on board.

One of the converts was Austin’s Chief of Police, Don Spicer.

Before the exchange, Spicer arrested anyone he caught with a syringe. Now, he lets them go, as long as they have a card to prove they’re participating in the program.

"In the beginning, I was not for it at all, because I felt like we're enabling," Spicer says. "But [identifying] those positive people, and medicating those positive people...reducing the viral loads in the bloodstreams...then I have to accept that's a good thing. I can't not support that side of it. But if I didn't have that knowledge, I'd still be against it."

At a recent public hearing to discuss extending the needle exchange, no one spoke out against it.

But even though it sailed through the hearing, not everyone is sold on the idea. Riding around with Spicer and Combs, multiple people expressed their dissatisfaction with the exchange. And Combs says health workers have seen a lot of comments on Facebook from people who are against it. But for her, the benefits are obvious.

"And now, doing the program, I know it works. Seeing the people, I know we're helping... I know of 5 people that were HIV negative in the needle program, that just got retested, and they're still negative. So, I know we saved five people from getting HIV," she says.

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