My home state of Indiana has been in the news a lot lately, and most of the news coverage has portrayed it in a pretty unflattering light. This is due almost entirely to the actions of our elected officials, who appear to be out of touch with the views of everyday Hoosiers and with the scientific community on matters of sexuality and sexual health. Much has been said and written in recent weeks about passage of the Religious Freedom Restoration Act (RFRA) and the concern that its original wording was intended to license discrimination against gay, lesbian, and bisexual persons. This is a prime example of how the State government’s actions are out of step with the public, who overwhelmingly oppose discrimination against sexual minorities. Our elected officials’ disregard for science has not generated quite the same level of national attention as the RFRA law, but it is nonetheless just as concerning. In this article, I would like to take a look at the disconnect between our State government’s actions and the science, and consider its potential impact on the sexual health of Indiana residents.
First, earlier this year, the Indiana House voted down a measure that sought to increase rates of vaccination against the human papilloma virus (HPV), one of the most common sexually transmitted infections. HPV can cause genital warts and is also linked to a range of cancers, including cancers of the cervix, anus, and throat. The HPV vaccine can provide protection against these health problems and is safe for use in both men and women.
The law that was voted down would not have mandated the vaccine; rather, it simple sought to establish a statewide program that would have increased awareness of the vaccine, with the goal of achieving an 80% vaccination rate among Indiana teens by 2020.
Why would our legislature reject a bill that would do nothing other than raise awareness of a vaccine that has the ability to prevent people from contracting a cancer-causing virus? Because a vocal minority continues to spread rumors about the nature of the vaccine, such as the idea that it gives teens a “license” to become promiscuous and that it can potentially cause negative side effects. Neither of these are true, by the way. For a look at what the research on the HPV vaccine has actually found, check out this video in which an Indiana University physician breaks it down for us.
By derailing this bill, our State legislature has let us down. There is no doubt that, without this bill, far fewer teens will end up getting the vaccine and more will end up contracting and spreading HPV, as well as suffering its ill effects.
Indiana doesn’t just have an HPV problem, though—it has a growing HIV problem, and our government is not taking the measures it needs to in order to address this issue either.
Consider this: in the small town of Austin, Indiana, 135 cases of HIV have been reported since the beginning of 2015. Let me put that number in perspective for you: Austin is a small town of 4,200 residents. One hundred thirty-five people translates to 3.2% of the population. Also, consider that the entire state of Indiana averages about 500 new cases of HIV per year. To have so many cases emerge in one small town in just four months is thus extremely concerning.
The rapid spread of HIV in this community stems from needles being shared among injection drug users who are injecting Opana, an opioid painkiller that is more potent than OxyContin and is highly addictive. Of course, HIV is also being spread by persons having unprotected sex with those who are sharing needles.
To reduce the spread of HIV and other infections caused by sharing needles (e.g., Hepatitis-C), needle exchange programs are sometimes used. Such programs allow drug users to trade in dirty needles for clean ones (these programs often provide free condoms too). Longitudinal studies have found that in cities without needle exchange programs, HIV rates tend to climb, whereas in cities that introduce such programs, HIV rates tend to drop . A large body of research dating back more than 20 years finds that these programs are related to numerous positive outcomes, with no negative effects (for a review of the research, see here). These programs do not encourage more people to use drugs, nor do they decrease public safety.
Moreover, researchers have found that needle exchange programs are cost-effective too . Syringes are cheap, while HIV drugs are not. Indeed, the cost of one year’s worth of HIV medication for a single HIV+ person can be $12,000 or more in the United States! Even a small number of cases of HIV can thus have an enormous public health cost.
Adopting needle exchange programs in a state with a major HIV epidemic should be a no-brainer, right? Not exactly. Needle exchange programs are actually illegal in Indiana, with one exception: current Governor Mike Pence has authorized a temporary needle exchange program for 60 days in Scott County, where the city of Austin is located. While adopting some program—any program—to combat this HIV crisis is certainly a step in the right direction, such an effort falls well short of what the state actually needs to be doing. A one- or two-month program in one city will not make this problem go away.
Why is Pence only taking a half-measure (or, perhaps more accurately, only a quarter-measure)? Because he is either ignoring the science about the effectiveness of needle exchange programs or is actively choosing not to believe it. In his own words:
"I don't believe that effective anti-drug policy involves handing out paraphernalia to drug users by government officials," he says. "I reject that."
By not allowing needle exchange programs to expand and by imposing such major restrictions on the only program that’s in place, the HIV epidemic will continue to spread. Indeed, it has already begun to spread to nearby Jackson county.
People’s health and lives are at stake here, and our elected officials simply do not seem to be acting with that in mind. I try to avoid getting too political on this website, but action after action taken during this legislative session has shown that it is time for both our Governor and legislative leaders to go. The health of the people of our state depends upon having elected officials who govern based upon evidence, not based upon their own personal beliefs.
If you share the sentiment, a friend of mine has organized a “Pence Must Go” campaign. If you make a donation, you can get your very own “Pence Must Go” sign. Although this campaign originally stemmed from Pence's support of the RFRA law, this article should make it clear that there are multiple reasons our state needs new leadership. Click here to learn more.
Want to learn more about Sex and Psychology ? Click here for previous articles or follow the blog on Facebook (facebook.com/psychologyofsex), Twitter (@JustinLehmiller), or Reddit (reddit.com/r/psychologyofsex) to receive updates.
 Hurley, S. F., Jolley, D. J., & Kaldor, J. M. (1997). Effectiveness of needle-exchange programmes for prevention of HIV infection. The Lancet, 349(9068), 1797-1800.
. Jacobs, P., Calder, P., Taylor, M., Houston, S., Saunders, L. D., & Albert, T. (1998). Cost effectiveness of Streetworks' needle exchange program of Edmonton. Canadian Journal of Public Health, 90(3), 168-171.
Image Source: 123RF.com
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