Study: Indiana HIV outbreak could have been avoided

NEW HAVEN, Conn. — The 2014 HIV outbreak in Scott County, Ind., could have been avoided with a quicker public health response, according to a new study published in The Lancet today.

The study reported that the state government responded to the outbreak after new HIV infections had already peaked in the rural county.

“Initiation of a response on Jan 1, 2013, could have suppressed the number of infections to 56 or fewer, averting at least 127 infections; whereas an intervention on April 1, 2011, could have reduced the number of infections to ten or fewer, averting at least 173 infections,” the summary of the study stated.

The study authors stated that early and robust surveillance efforts and case finding alone could reduce future outbreaks. Ensuring access to HIV services and harm-reduction interventions could further reduce the likelihood of outbreaks, and substantially mitigate their severity and scope.

“We used publicly available data on the outbreak to recreate it in a computer simulation,” Gregg S. Gonsalves, assistant professor of epidemiology and the study’s first author, told science news website EurekAlert. “Once we had recreated the events in Scott County, we could examine what would have happened if a response to the threat had been initiated earlier.”

The study pointed out that rapidly growing opioid use in Indiana and a hepatitis C outbreak spurred local public health leaders to recommend establishment of syringe exchange and other programs to prevent HIV transmission several years before the Scott County outbreak, although their recommendations were rejected by the state, the website reported.

“Our findings suggest that with earlier action the actual number of infections recorded in Scott County — 215 — might have been brought down to fewer than 56, if the state had acted in 2013, or to fewer than 10 infections, if they had responded to the HCV outbreak in 2010-2011. Instead they cut funding for the last HIV testing provider in the county,” Forrest W. Crawford, associate professor of biostatistics and of ecology and evolutionary biology, and the paper’s senior author, told EurekAlert.

In 2013, then-Gov. Mike Pence cut funding to Planned Parenthood in Indiana. In many parts of the state, Planned Parenthood is the only provider of HIV testing. The clinic in Scott County was one of those that were forced to close.

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