Health Affairs   |  August 23, 2021

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In early 2015, Scott County, Indiana, was in the midst of one of the worst drug-related HIV outbreaks in US history. As HIV surged in southeastern Indiana, the county’s response was inhibited due to Indiana’s prohibition of syringe services programs (SSPs). State lawmakers eventually reversed course and legalized a local SSP. The results were remarkable. The county’s drug-related overdose deaths plunged 20 percent in 2019, and its HIV transmission rate plummeted to just a single case in 2020. Research models further suggest that Indiana may have mitigated—and even prevented—its HIV outbreak had it implemented an evidence-based response that included a syringe services program before the county’s transmission rate skyrocketed.

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