The Indiana General Assembly took action Wednesday on a bill that would allow needle exchanges in some counties. Needle exchanges allow drug users to trade dirty syringes for clean ones, in order to reduce transmission of infections such as HIV. The number of people infected with HIV has continued to grow in rural Scott County, Indiana since the state health department declared an outbreak there in late February. In late March, Governor Pence issued an executive order establishing a temporary needle exchange for Scott County. Earlier this week, more than 140 people had tested positive.
The original proposal would have allowed needle exchanges statewide. But the compromise that passed Wednesday requires that a local health official to determine if there’s an HIV or hepatitis C epidemic in a county before an exchange can be established.
If needle sharing is determined to be responsible for the epidemic, a county government can ask the state health commissioner to declare a public health emergency, which would allow for a syringe exchange to operate locally.
Governor Mike Pence supports the legislation. "I believe this gives both our public health community and our public safety community the legal framework to continue to address this public health emergency in Scott County and to be able to address, in medically appropriate ways, any future emergencies,” Pence says.
Dr. Beth Meyerson, co-director for the Rural Center for AIDS/STD Prevention at Indiana Unviersity, welcomes the bill’s passage, but she says it’s just a first step. “Now the rest of the marathon is going on, and we’re at mile 13," Meyerson says.
Because of the design of the request process, Meyerson says that there are many ways a needle exchange could be held up. County officials might worry about a possible stigma associated with a declared public health emergency, a local health official might be ideologically opposed to exchanges, or it could get stopped at the state level.
“The science is there, I guess that’s the easy part," she says. "So I think the case could probably be made fairly easily. The question is whether…there’s a political will locally to make it and move through those hoops.”
Meyerson said she and many others in the public health community are eager to advise decision-makers throughout the process, both at the state and local levels.
