Indiana NeedleAustin, Indiana, once a hub of manufacturing jobs and small businesses, is today the site of the worst HIV outbreak in the state of Indiana, and possibly the entire nation. This outbreak is happening amongst the backdrop of the social and economic decline of a rural Indiana town. This epidemic is symptomatic of the destructive tendencies of the capitalist system in general, as it stumbles along through continual economic crises whose effects are felt hardest by workers and the poor.

Founded in 1853 as a station for railroads connecting Louisville, Kentucky to Indianapolis, Indiana, the once-thriving town had several factories providing jobs for the town’s workers. Austin’s downtown area used to be a center of culture for the area, having several restaurants and small shops to meet the community’s daily, cultural, and recreational needs. This was made possible by the post-WWII economic boom, when capitalism was reinvigorated with the demand of postwar construction, as well as increased state guidance, investment, and planning over the economy, which stimulated growth.

This wartime destruction and government-stimulated years of upswing was not to last, however. By the 1970s, the world capitalist system fell back into its pre-war norm: an epoch of deepening recessions and crises. In response, the capitalists deindustrialized entire swathes of the nation, shutting down factories and businesses, moving production overseas in search of cheaper labor, and putting American workers out of jobs. This devastated working-class towns like Austin. Austin became a microcosm of the destructive effects that declining capitalism wrought on society as a whole.

Today, one in five of all Scott County adults live below the poverty line, have not completed high school, or are on disability. The county and town have very high teen birth rates and twice Indiana’s average rate of cases of child abuse and neglect. It is also one of the lowest-ranking Indiana counties when it comes to overall health. In addition, Austin has seen a widespread rise in drug addiction and an increase in prostitution.

It is in these conditions that, as of April 24, nearly 150 cases of HIV have been identified among residents of this poor, rural town. The disease has been spread primarily due to the practice of needle-sharing among users of the drug Opana, a particularly powerful brand of the painkiller oxymorphone. Users typically share needles because they are expensive and hard to obtain. As a result, this practice is conducive to the spread of infectious diseases like HIV.

As a result of this alarming outbreak, Indiana Governor Mike Pence reluctantly allowed for a temporary 30-day needle exchange program for Scott County, which he has since extended. However, despite high records of success in many such situations, the governor and the Austin Police Department are stuck in a law-and-order mindset, concerned that the practice will provide free paraphernalia to drug users. As such, they have expressed themselves as determined to stop the program as soon as things begin to improve. In fact, needle exchange programs have proven to be very effective in poor areas plagued by chronic drug usage.

Bobbie Joe Spencer, an Austin resident who lives on $200 a week doing lawn care and cleaning jobs, is an Opana user who tested negative for HIV. Her statement to the Courier Journal, the newspaper for the nearby city of Louisville, Kentucky, highlights the chronic social problems that gave rise to this epidemic in the first place: “I do it (Opana) to escape from my reality. I don’t like my reality. I’ve been wanting to get off this crap. But rehab is so expensive. I wish I had my life back.”

To eradicate HIV and the threat it poses to Austin, to Indiana, the nation, and the world, proactive solutions like needle-exchange programs must be allowed to work, despite of the prejudices of the Indiana state government, police departments, and those like them. But even needle exchange programs can only serve as a bandage. The reality that Bobbie Joe referred to, a reality created by the social effects of a capitalist system wracked with inevitable and worsening economic crises, must be scrapped for a new reality that can provide all workers with affordable healthcare, productive jobs, and a positive social environment that can provide for people’s physical and mental health, as well as their daily, cultural, and recreational needs. It will take a mass struggle, based on the working class, to place the economy and state under real democratic control.

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