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Indiana looks to Canadian doctors for help with HIV outbreak

The HIV outbreak in Austin, Indiana, has been blamed on an epidemic of injectible opioid drug addiction.
By Stephen Feller   |   Jan. 12, 2016 at 4:04 PM

INDIANAPOLIS, Jan. 12 (UPI) -- Researchers at the University of Indiana announced they are working with doctors from Canada to address the HIV epidemic in the small town of Austin, Ind., where nearly 200 people have been diagnosed since early 2015.

The BC Center for Excellence in HIV/AIDS is working with the university to institute the HIV Treatment as Prevention model the organization has used to maintain decreases in new HIV diagnoses in Canada since 1996.

Austin, a town of about 4,200 in Scott County, has had 184 new HIV infections since the beginning of 2015. About 10 percent of the town injects opioid drugs on a daily basis, which officials there have pointed to as the cause of the outbreak.

In April 2015, Indiana Gov. Mike Pence approved a temporary needle exchange program to slow the epidemic, which stood at 130 positive HIV tests at that time. In just the first two weeks of the program, more than 5,000 clean syringes were given out and 1,400 used syringes were collected.

The university is using a two-year, $200,000 grant from the National Institute of Drug Abuse to fund part of the program, which employs a combination of treatment for people with HIV and rigorous outreach campaigns to prevent its spread.

The program has been credited with a 60 percent decrease in new HIV and AIDS cases in Canada, and is hoped to do the same in Indiana. The program also has been instituted in other American cities, including San Francisco, New York City, and Washington, D.C.

"We have a chance to reverse the course of this HIV epidemic by implementing fast-acting and effective evidence-based strategies," said Dr. Kara Wools-Kaloustian, an associate professor of medicine at the University of Indiana, in a press release. "Using innovations in science and technology, as well as targeted and compassionate approaches to reach those affected by this outbreak, this has the potential to decrease HIV transmission and help save lives within the state of Indiana."

The HIV Treatment as Prevention program was put into effect in Canada in 1996, using highly active antiretroviral therapy, or HAART, to treat people with HIV. HAART is a combination of HIV drugs that lowers viral loads so much the disease cannot be detected. This allows the immune system to rebuild itself, which significantly reduces the chance of transmitting HIV, either by sharing a needle or through unprotected sex.

Doctors and researchers in Indiana will identify factors affecting whether people start and continue treatment, and track and assess risk factors for transmission. They also plan to map problem areas and determine whether there is a clustering of HIV transmission events.

Additionally, researchers will explore ideas to discourage injection drug use and implement or expand programs to decrease use.

"The situation in Indiana marks a critical need for implementing best practices in harm reduction and HIV prevention," said Dr. Julio Montaner, director of the BC Center, told The Georgia Straight. "Treatment as Prevention is a model for opening up access to early HIV treatment and care, for reducing stigma, and for targeted disease elimination. Providing sustained, consistent treatment and care ensures that an individual's viral load decreases, dramatically reducing the likelihood of disease progression and secondarily stopping HIV transmission."

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Topics: Mike Pence, HIV
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