There was concerning news out of Indiana Saturday, with a serious public health situation unfolding in an Indiana county, and continuing to trend downwards. As detailed by The New York Times, the ongoing HIV outbreak in Scott County, Indiana is getting worse, and it could put Republican Governor Mike Pence in a somewhat awkward situation. According to state officials, there have been 14 new confirmed cases of HIV in the relatively small rural county over the last week, with an additional ten more "preliminary positives" bringing the anticipated total to 130.
The outbreak was first observed in March, and has been blamed on a slew of different factors – as Dr. William Cooke told the Chicago Tribune at the time, Scott County posses "a recipe for disaster, all the bad ingredients — unemployment, high dropout, high teen pregnancy rate, high drug abuse rate." It was a major enough problem that it forced Pence to approve a 30-day emergency needle exchange program for the county, aimed at easing the re-use of contaminated syringes by drug users, a major means of HIV transmission. Making that move was out-of-step enough on its own for Pence, who (like many Republicans) opposes the very concept of needles exchanges.
As the Times notes, it's not entirely unexpected that the HIV rate would still be increasing, as any public health response aims by design to get more people tested, diagnosed and informed. But with the needle exchange program set to expire on April 25, Pence's willingness to embrace a policy he doesn't support in a a time of crisis could be put even further to the test.
Considered a potential presidential candidate in 2016 (although the high-profile controversy surrounding Indiana's Religious Freedom Restoration Act didn't helped matters), Pence may feel the pressure to extend the program out further still – especially considering that approving it in the first place sort of concedes its importance. And as far as any national office ambitions go, he's kind of in a bad spot either way – whatever he ends up deciding could make a crisp attack ad from either the left or right alike.
Of course, the real urgency here isn't wondering what the political implications might be, it's getting the outbreak under control. According to the Centers for Disease Control, approximately 1,201,100 Americans were infected with the Human Immunodeficiency Virus at the end of 2011, with 26,688 estimated to be suffering from AIDS. The Scott County outbreak is already the largest in the state's history, but hopefully it starts to get better as the public health response has more time to work.
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