Using mathematical modeling, the researchers estimate that the HIV infections had been rising since 2011 and had actually peaked in January 2015, “over 2 months before the Governor of Indiana declared a public health emergency.”
Pence had been failing to deal with HIV in his state for years. Gonsalves and Crawford’s models estimate that instead of 215 infections in 2015, “a response on Jan 1, 2013, could have suppressed the number of infections to 56 or fewer, averting at least 127 infections”.
This was years before Indiana knew there was an HIV epidemic underway. Because of funding cuts, the only HIV testing provider in southeastern Indian had closed in 2013. This, according to the study, “could have delayed the diagnosis of the initial case of HIV infection in Scott County.”
The disaster in Scott County was not just a failure of clean needles or even just Indiana’s long-time “abstinence stressed” sexual education. It was a disaster born of a total abdication of Indiana’s public-health responsibility—and it’s the kind of health disaster we could see nationally. Pence is now vice president in an administration that is gutting HIV/AIDS resources and further criminalizing drug use—two paths that will increase HIV prevalence across the country. Meanwhile, the twin crises of deindustrialization and rising opioid usage mean that the conditions for localized HIV epidemics are not unique to Scott County. Gonsalves and Crawford write that the CDC believes there are “220 counties across the USA at risk of outbreaks of HIV” and hepatitis C.
As conditions favorable to epidemics spread across the country, the ability for public-health agencies to respond to such crises are being throttled. As NPR reported in 2016, 40 percent of health departments have reduced services, with one CDC official saying, “More than half of state and local STD programs have experienced budget cuts. In 2012, 20 health departments reported having to close their STD clinics.” And, as local governments are turning away from STD and overdose-prevention efforts, they are also incarcerating more people on charges related to drug addiction and sex work—and even prosecuting individuals for harm-reduction work.
The epidemiology of HIV flourishes amid drug stigma, homophobia, poverty, and racism; in turn, government approaches that allow HIV to thrive also breed homophobia, racism, classism, and drug panic. Much of US society often doesn’t care about HIV infections or AIDS deaths—or about hepatitis infections or overdose deaths—when they are perceived to be happening to people who are black, queer, and/or immigrant. Gonsalves and Crawford’s study of Scott County shows that preventable epidemics can happen anywhere where austerity is combined with theocratic, anti-science policies. As public-health approaches are abandoned throughout the United States, that applies to increasingly large swaths of the country.
Mike Pence Is Still to Blame for an HIV Outbreak in Indiana—but for New Reasons
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