HIV outbreak: Know the facts

Indiana is facing an unprecedented outbreak of HIV due to injection drug use in the southeastern region of the state.

Since December of last year, 142 new HIV cases have been reported in this region, with new cases still being reported each day. This is easily the largest outbreak of HIV among injection drug users in recent memory in the United States.

In response to this, Gov. Mike Pence declared a public health emergency in Scott County at the end of March, authorizing additional resources and temporarily suspending Indiana Code banning needle-exchanges in the county. The 30-day executive order has been extended for an additional 30 days.

As of April 24, the number of HIV cases related to the outbreak has reached 142 (136 confirmed and 6 preliminary positive cases). The large majority of the cases are due to injection drug use and sharing of needles. Based on our predictive modeling, we haven’t hit the peak yet, meaning we fully expect more cases due to increased testing and contacting high-risk individuals.

The area’s drug of choice is oxymorphone (trade name Opana), a prescription painkiller that can be crushed and injected. Its popularity has increased after the painkiller OxyContin was changed to become more difficult to abuse.

The age range of the individuals who have tested positive for HIV ranges froom about 18 to 64. Besides living in the same area in southeastern Indiana and being addicted to Opana, most have something else in common – a litany of misinformation about HIV. Having correct information is critical to understanding and preventing HIV.

Through the “You Are Not Alone” public education awareness campaign, community forums and visits to the One-Stop Shop (a community outreach center in Austin made possible by Pence’s executive order that is offering a variety of services to residents, all free of charge), we have been able to disseminate helpful, factual and lifesaving information.

We have also heard many of the myths about HIV that have been circulating since late 1984 when Indiana resident Ryan White was diagnosed with AIDS. You may remember the discrimination Ryan and his family faced due to misinformation or lack of information. Families threatened to remove their children from the school Ryan attended in Kokomo, fearing their children would catch HIV from a school water fountain or from just sitting in the same classroom as Ryan.

So what HIV/AIDS myths are we still hearing? Let’s debunk some of the common ones:

If I had HIV I would feel sick. Not true. People can have HIV for years without symptoms. Even if a person feels OK, the virus is still reproducing in the body.

I don’t need to start HIV treatment until I start feeling sick. Not true. Treatment needs to start once a person has tested HIV positive. By the time a person starts feeling sick, HIV has already damaged the immune system. Getting those infected with HIV promptly treated is essential to lowering their infectivity and slowing and or stopping the spread of this outbreak. Those with HIV should keep in mind, though, that receiving HIV treatment does not mean they can’t infect others, only that they are less likely to.

HIV only affects certain groups of people. Not true. Anyone can get HIV and people can get infected the first time they are exposed. HIV is most commonly passed through unprotected sexual intercourse or oral sex, through blood or by sharing needles. A mother can pass HIV to her baby during pregnancy, during labor or through breastfeeding.

An HIV diagnosis is a death sentence. Not necessarily. While there is currently no cure for HIV, people can now live longer, healthier lives due to early detection and compliance with effective treatments.

People can catch HIV from everyday activities like sharing a phone or shaking hands. Not true. HIV cannot be caught from everyday activities or casual contact like shaking hands or touching ordinary objects. The virus does not live long outside the body, so people can’t get HIV from things like doorknobs or toilet seats.

HIV is the same as AIDS. Not true. HIV is the virus that leads to AIDS, but a person can have HIV for years without having AIDS. Having HIV does not mean you have AIDS.

HIV drug therapy is available only for rich people. Not true. Treatment programs and support services are available through Medicaid-the nation’s largest source of public funding for AIDS and HIV care-and 350,000 uninsured Hoosiers can now get health care coverage, which includes HIV treatment and mental health services through Gov. Pence’s newly approved Medicaid reform program, HIP 2.0. Hospitals across the state have navigators to help people get signed up for HIP 2.0 coverage, and those who come to our one-stop shop in Austin can get everything they need to get signed up for HIP 2.0 in one visit. Lack of coverage is no longer a reason for lack of hope.

For more information about HIV and the outbreak response, visit the Indiana State Department of Health at

Jerome Adams is Indiana state health commissioner. Send comments to