Lessons Learned from the HIV Outbreak In Indiana

In March 2015, the governor of Indiana declared a state of emergency in order to authorize a needle exchange program. 

This was done as part of a state health department effort to control an alarming HIV outbreak in a rural southeastern county. Before this outbreak, fewer than five HIV cases were reported annually in the county.^1,2

“We have now identified over 150 HIV positive cases. The number of positives is slowing down. I would not say we have it completely under control yet. You can’t just draw a line around it,” state health commissioner Jerome Adams, MD said in an interview in May. “We were able to identify the pattern early. This could have been much worse.”

This is the first outbreak of HIV associated with injection of a prescription painkiller. ^{2, 3} 

More than 90% of people infected in the outbreak and interviewed by the Centers for Disease Control and Prevention (CDC) reported dissolving and injecting the prescription opioid Opana as well as sharing drug preparation equipment. 

More than 80% of those infected with HIV were also infected with HCV. 

In April, the CDC issued a health advisory for primary care providers and state health departments all over the country to be on the alert for HIV and HCV infections in persons who inject drugs (PWID). ¹

The Growing Link Between HIV and Prescription Drug Abuse

“Prescription opioid use and opioid overdose is increasing everywhere. These drugs are not coming from robbing pharmacies or from the Internet. Over 80% of these drugs start out as a prescription from a primary care provider. Over 80% of abusers say they got opioids from a friend or family member,” said Joan Duwve, MD, chief medical consultant for Indiana’s state health department.