To combat this significant problem, Governor Mike Pence authorized a short-term needle exchange program, which is underway at the Community Outreach Center.

The center, which opened March 30th, and kicked me out on Monday morning, serves as a one-stop shop for those in need of services, providing ways for members of the community to get State-issued ID cards and birth certificates, enroll in health insurance, get vaccinated for tetanus or hepatitis, as well as giving them job counseling and local training. However, perhaps most importantly, the center offers free HIV testing, a needle exchange service, and provides information about prevention, treatment, and substance abuse referrals. It’s also where I started my search for answers about how this outbreak came to be.

The center is tucked away on a side road in this small town. Still, you can’t miss it: two large roadside construction signs face the street from both directions, shouting the opening hours in flashing orange lights.

Inside, the building is spartan, with a bare waiting area decorated with two rows of chairs facing a table full of pamphlets. The entrance to the needle exchange is separate from the public entrance. Both are marked with copious signage. At first glance, it just looks like another yard, but you realize very soon that it’s something else entirely. It feels sleepy and quiet, but the stakes couldn’t be higher: if the outbreak is to be stopped, we must first at least find the scope of it. And the numbers tick higher every day.

We’re at a tenuous point. Over the last two decades, HIV infections related to intravenous drug use have been on the decline across the country, but this current outbreak has experts worried. Scott County is small, but it’s not unique; like many rural counties, it has high unemployment, a large percentage of adults who have not finished high school, and many in the community with limited access to healthcare. Add on powerful, shareable opiates and government initiatives to limit access to clean needles , and you, my friend, have the makings of a catastrofuck.

The question then, is why Scott County? Is it just bad luck? Or did decisions made along the way contribute to the outbreak at hand?

And how can we keep this from happening again? That’s what I’m here to find out.

Leigh Cowart is reporting live from Indiana all week. Leave a response to this post below, or use the tag HIVOutbreak on Medium or #HIVoutbreak on Twitter.

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