Mike Pence's Defining Moment As Governor? Enabling An HIV Outbreak.

Here's what to do if you want to create a public health crisis.

One of Vice President Mike Pence’s defining moments during his one term as Indiana governor? Lackluster public health efforts, which led to a massive HIV outbreak. The failure was spurred by public health funding cuts and Pence’s moralistic stance against needle exchanges.

A timeline of the HIV outbreak, the worst in state history, reads like a roadmap of what to do if you want to create a public health crisis.

Pence slashed state health spending.

Pence first laid the groundwork for Indiana’s HIV outbreak as a member of Congress back in 2011, when the House passed his amendment to defund Planned Parenthood. Then, in 2013, Pence’s first year as governor of Indiana, Scott County’s one Planned Parenthood closed in the wake of public health spending cuts. Since that particular Planned Parenthood was also the county’s only HIV testing center, there was no longer a place for the county’s 24,000 residents to get tested.

Nearly 20% of Scott County residents lived below the poverty line. Injection drug use there was a major problem, increasing the risk of HIV outbreak.

Fast-forward to 2015. Local health officials began to report HIV cases linked to intravenous prescription opioid use in Scott County. Scott County residents were sharing needles to inject their opioids, and nobody was getting tested. 

The situation quickly spiraled out of control. At the height of the outbreak, 20 new cases of HIV were being diagnosed each week, reaching a total of nearly 200 cases by the time the outbreak was finally under control.

Pence was dangerously wrong about needle exchanges.

During that time, Pence dragged his feet. Although the outbreak was identified in late January of 2015, it took Pence until April of that year to allow a temporary needle exchange in Scott County. It was a big shift for the governor, who was morally opposed to needle exchanges and believed they promoted drug use.

This position is dead wrong, according to health experts.

“People think that if you give someone a syringe, it means they’re going to go out and inject drugs, and if don’t give them syringes, they won’t inject drugs,” Robert Childs, executive director of the North Carolina Harm Reduction Coalition, told HuffPost in 2015.

“But the thing is that if you don’t give them syringes, they share them, and then people will start getting HIV and viral hepatitis C.”

And beyond humanitarian or public health reasons, opposing harm reduction isn’t a fiscally sound policy. “These are extremely costly diseases, and there’s no reason to get them if people can get access to clean syringes — an incredibly cheap product,” Childs said.  

Pence reversed his needle exchange stance — for now.

After Pence finally reversed his stance and instituted Scott County’s temporary exchange, four other Indiana counties followed suit, according to the Indianapolis Star.

The program has largely been a success. “Over the past year, the syringe exchange program in Scott County has had a tremendously positive and dramatic impact,” Dr. R. Kevin Rogers, Scott County’s health officer, told the Star.

But a temporary needle exchange focuses too much on solving this specific outbreak, instead of instituting a permanent public health fix for those who are going to use drugs, Hannah Cooper, an associate professor at Rollins School of Public Health at Emory University, told HuffPost in 2015. Instead, she said, the county needs a permanent program.

“This is not a closed environment,” Cooper said of Scott County. “People can move freely. New infections will come in, and people need to be able to protect themselves.”

Pence’s public health record in Indiana often seems to be overlooked nowadays ― a frustrating oversight, considering nearly 200 people contracted HIV while Pence twiddled his thumbs over harm reduction and de-emphasized public health spending.

So the question remains: Do we really want to see Pence’s public health judgement replicated? Our collective health may depend on that answer.

This article has been updated from its original publication in October 2016.

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Before You Go

6 Reasons Mike Pence Is Terrible For LGBTQ People
He has supported LGBT discrimination under the banner of "religious freedom."(01 of06)
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In March 2015, Pence signed Indiana's Religious Freedom Restoration Act (or RFRA) into law, effectively legalizing discrimination against LGBT people across the state. The bill, which Vox called "one of the biggest political crises" of Pence's career, allowed business owners to cite their religious beliefs as justification for turning away LGBT customers.

The bill's passage sparked national controversy, and in the end, was reported to have set the state back $250 million. In April 2015, Pence signed a revised version of the bill into law that included language that explicitly barred businesses from denying services to customers on the basis of categories that include sexual orientation and gender identity. Many LGBT rights advocates remained critical of the revisions, saying that Indiana should have repealed the measure altogether.
(credit:CHRIS KEANE / Reuters)
He REALLY opposes same-sex marriage.(02 of06)
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Pence has long been an outspoken opponent of marriage equality, and in floor speeches during his time in Congress, described marriage as being “ordained by God.”

Of the Supreme Court’s 2015 ruling that granted same-sex couples the right to tie the knot nationwide, he reportedly said that he said he was disappointed that SCOTUS had “failed to recognize the historic role of the states in setting marriage policy,” but nonetheless noted that he believed “in the rule of law.”
(credit:Jonathan Ernst / Reuters)
He's opposed hate crime protections for LGBT people.(03 of06)
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In 2009, Pence was an outspoken opponent of the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act, which officially expanded federal hate crime legislation to include violence directed at members of the LGBT community.

At the time, Pence blasted President Barack Obama for using the measure to “advance a radical social agenda,” according to USA Today, and argued that the law could be used to curb free speech rights.
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He didn't want "Don't Ask, Don't Tell" repealed.(04 of06)
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Pence was no fan of President Obama's decision to repeal "don't ask, don't tell," which banned gay and lesbian people from serving in the armed forces.

In 2010 he told CNN he did not want to see the military become “a backdrop for social experimentation," and said, "We ought to put their interests and the interests of our national security first."
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He opposed Obama's 2016 transgender bathroom directive.(05 of06)
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In May, Pence spoke out against the Obama administration's directive advising public schools to allow trans students to use the bathroom that best corresponds with their gender identity or risk losing federal funding.

“The federal government has not business getting involved in issues of this nature,” Pence said.
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His stance on HIV/AIDS prevention is questionable at best.(06 of06)
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In 2000, Pence suggested that money from a program to help those with HIV/AIDS should be repurposed toward organizations that “provide assistance to those seeking to change their sexual behavior,” BuzzFeed reports.

He's also suggested that needle exchange programs, which can be used to help prevent the spread of HIV, encouraged drug use.

Last year, Pence reluctantly allowed for a short-term needle exchange program to be put into place in Indiana following a spike in HIV infections across the state.

"I do not enter into this lightly," he told The Indianapolis Star. "In response to a public health emergency, I'm prepared to make an exception to my long-standing opposition to needle exchange programs."
(credit:Andrew Kelly / Reuters)

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