{"id":1084,"date":"2015-04-20T16:19:19","date_gmt":"2015-04-20T16:19:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=1084"},"modified":"2015-04-20T16:19:19","modified_gmt":"2015-04-20T16:19:19","slug":"indiana-state-ban-on-needle-share-programmes-faces-challenge-of-an-idu-fuelled-hiv-spike","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2015\/04\/20\/indiana-state-ban-on-needle-share-programmes-faces-challenge-of-an-idu-fuelled-hiv-spike\/","title":{"rendered":"Indiana State ban on Needle Share programmes faces challenge of an IDU-fuelled HIV spike"},"content":{"rendered":"<p>In 2011 18.5% of HIV infections in the US were attributable to intravenous drug-use (IDU) &#8211; a significant proportion (<a href=\"http:\/\/sti.bmj.com\/content\/87\/Suppl_1\/A16.1.abstract?sid=d7308c47-a781-41c4-8833-2200c0a01e4e\">Lansky &amp; Wejnert (STIs)<\/a>).\u00a0 The issue of IDU fuelled HIV transmission has been brought forcibly to the attention of Americans in the last few weeks by the recent HIV outbreak in Scott County, Indiana, US. \u00a0This local epidemic appears to have been the result of the recreational use of the opiate, Opala. The number of infections has continued to rise, reaching a new peak of 130 this last week (<a href=\"http:\/\/www.indystar.com\/story\/news\/2015\/03\/30\/indiana-house-committee-adopts-needle-exchange-measure\/70689832\/\">Indystar\/needle exchange<\/a>; <a href=\"http:\/\/www.npr.org\/blogs\/health\/2015\/03\/28\/395821345\/indianas-hiv-spike-prompts-new-calls-for-needle-exchanges-statewide\">npr\/Indiana&#8217;s HIV spike<\/a>).<\/p>\n<p>The effectiveness of public health interventions amongst IDU, including needle exchange programmes is well-established. Recent studies in Russia and East-European contexts (<a href=\"http:\/\/sti.bmj.com\/content\/89\/Suppl_1\/A257.2.abstract?sid=153d33bf-ae55-4200-9a7c-1d4e67184504\">Vagaitseva &amp; Demyanenko (STIs)<\/a>; <a href=\"http:\/\/sti.bmj.com\/content\/89\/Suppl_1\/A177.2.abstract?sid=153d33bf-ae55-4200-9a7c-1d4e67184504\">Boci &amp; Bani (STIs)<\/a>), where IDU accounts for greatest proportion of infections, \u00a0have also come to very positive conclusions about their cost-effectiveness (<a href=\"http:\/\/sti.bmj.com\/content\/89\/Suppl_1\/A385.1.abstract?sid=153d33bf-ae55-4200-9a7c-1d4e67184504\">Demyanenko &amp; Vagaitseva (STIs)<\/a>. \u00a0They\u00a0have also considered ways of improving uptake among drug-users (<a href=\"http:\/\/sti.bmj.com\/content\/89\/Suppl_1\/A319.3.abstract?sid=153d33bf-ae55-4200-9a7c-1d4e67184504\">Boci &amp; Hallkaj (STIs)<\/a>. \u00a0Sadly, in 23 states of the US &#8211; as in Russia and some East-European countries &#8211; traditional legal restrictions on needle exchange programmes remain in force (<a href=\"http:\/\/lawatlas.org\/query?dataset=syringe-policies-laws-regulating-non-retail-distribution-of-drug-paraphernalia\">LawAtlas\/US<\/a>).\u00a0 Indiana just happens to be one of these US states. \u00a0Its governor, who has had to authorize a short-term moratorium on the legal restriction of needle exchange in response to the outbreak, just happens to be Mike Pence, a republican who is known for his especially hawkish views on social issues (see <a href=\"https:\/\/blogs.bmj.com\/sti\/2011\/06\/05\/us-republicans-prepared-to-put-the-poor-at-risk-in-order-to-make-a-political-stand-on-abortion\/?preview=true&amp;preview_id=390&amp;preview_nonce=f12931af6d\">&#8220;US Republicans prepared to put the poor at risk&#8221; (STI\/blogs)<\/a>) and favours continuation of the ban.<\/p>\n<p>Needless to say, an order authorizing the temporary suspension of the restrictions on needle exchange was issued last month. \u00a0A needle-exchange programme has distributed 5,300 clean needles to drug-users since 8<sup>th<\/sup> April when it began its activities.<\/p>\n<p>Unfortunately, however, the temporary suspension is due to expire on 25<sup>th<\/sup> April. \u00a0It also applies only to Scott County. Health experts are pushing legislators to allow needle exchange in neighbouring counties of Indiana, where high levels of HCV indicate a high risk of similar outbreaks. \u00a0On Monday, a joint Senate and House Legislative Committee will consider a measure, authored by Ed Clere, a representative from a neighbouring county, to authorize local public health and law enforcement authorities to work together to start their own need exchange programmes. But Governor Pence has threatened to veto the measure.\u00a0 He declines to explain his position in public, but is said by Senate President, David Long, to believe that needle exchange programmes lead to greater drug use (<a href=\"http:\/\/www.newsandtribune.com\/news\/health-experts-push-for-indiana-s-needle-exchange-bill-to\/article_a0b36f88-e560-11e4-be2c-7f20d51646ad.html\">News &amp; Tribune\/Indiana&#8217;s needle exchange bill<\/a>).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In 2011 18.5% of HIV infections in the US were attributable to intravenous drug-use (IDU) &#8211; a significant proportion (Lansky &amp; Wejnert (STIs)).\u00a0 The issue of IDU fuelled HIV transmission has been brought forcibly to the attention of Americans in the last few weeks by the recent HIV outbreak in Scott County, Indiana, US. \u00a0This [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/sti\/2015\/04\/20\/indiana-state-ban-on-needle-share-programmes-faces-challenge-of-an-idu-fuelled-hiv-spike\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2789,4363,2795,4354],"tags":[],"class_list":["post-1084","post","type-post","status-publish","format-standard","hentry","category-hiv-the-law","category-hiv-and-drugs","category-international-report","category-intravenous-drug-use"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Indiana State ban on Needle Share programmes faces challenge of an IDU-fuelled HIV spike - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2015\/04\/20\/indiana-state-ban-on-needle-share-programmes-faces-challenge-of-an-idu-fuelled-hiv-spike\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Indiana State ban on Needle Share programmes faces challenge of an IDU-fuelled HIV spike - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"In 2011 18.5% of HIV infections in the US were attributable to intravenous drug-use (IDU) &#8211; 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