Small Indiana town with the worst drug and HIV problem in the country

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In Austin, Indiana, widespread drug use led to the single largest outbreak of HIV in the USA.

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It’s a tiny place, covering just two and a half square miles of the sliver of land that comprises Scott County. An incredible proportion of its 4,100 population — up to an estimated 500 people — are shooting up. It was here, starting in December 2014, that the single largest HIV outbreak in US history took place. Austin went from having no more than three cases per year to 180 in 2015, a prevalence rate close to that seen in sub-Saharan Africa.

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Jessica, 30, and Darren, 24, were children when they started using drugs. Darren smoked his first joint when he was 12 and quickly moved on to snorting pills. “By the time I was 13, I was a full-blown pill addict, and I have been ever since,” he said. By age 14, he’d quit school. When I asked where his caregivers were when he started using drugs, he laughed. “They’re the ones that was giving them to me,” he alleged. “They’re pill addicts, too.”

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“Some of these kids around here just did not have a chance,” said Darren, who has seen parents selling drugs in front of their five- and six-year-olds. Barney Rushkoff, an HIV-positive 57-year-old who lives in a mobile home without electricity or heat, told me about seeing a child playing in the street. The little boy had a towel wrapped around his arm and was shouting “shoot me, shoot me”, mimicking his parents injecting.

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Jackie McClintock, the nurse who started working with Combs when the outbreak made headlines, told me about a couple she met who’d recently moved to Austin. “They shared one needle for a month,” she said. “They would shoot up at least ten times a day.”

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“There’s not a whole lot of hope for nobody,” said Kristy Madden, 37, a recovered addict with two children and two grandchildren. “Nobody doesn’t really have anything to look forward to.” She said she has relatives with HIV, some of whom are still using drugs. An Austin man named Cecil, who has HIV, told me he’d recently spent $3,500 on Opana pills in less than five hours. “My days is numbered,” he told me, “so why stop now?”

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