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Kentucky's Appalachian hills are a shared drug needle away from the next big HIV outbreak


Kentucky leads the nation in vulnerable counties ... the rolling green landscape is dotted by a mix of dilapidated single-wide mobile homes, sagging old houses and well-kept homes, with a tiny commercial strip and about a dozen churches.


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Updated: December 16, 2017 @ 10:56 pm Full Forecast Sign Up Log In Dashboard Logout My Account Dashboard Profile Saved items Logout .follow-links-1463822 li { margin-right:1px; padding:0; } .follow-links-1463822 li a, .follow-links-1463822 li a:focus, .follow-links-1463822 li a:active {font-size: 18px; margin-right: 10px;padding: 0; opacity: .8; padding:0; box-shadow: none; } .follow-links-1463822 li a:hover { text-decoration: none; opacity: 1; }.follow-links-1463822 li a.fb,.follow-links-1463822 li a.fb:hover {color: #3A59A5;}.follow-links-1463822 li a.tw,.follow-links-1463822 li a.tw:hover {color: #46C8F9;}.follow-links-1463822 li a.tb,.follow-links-1463822 li a.tb:hover {color: #4A6988;}.follow-links-1463822 li a.email,.follow-links-1463822 li a.email:hover {color: #4A6988;}.follow-links-1463822 li a.sms,.follow-links-1463822 li a.sms:hover {color: #4A6988;} jQuery(document).ready(function(){ $('.follow-links-1463822 li a').tooltip({ placement:'bottom' }); }); Search $('#site-search-1463821-btn').on(__tnt.client.clickEvent, function(){ $('#site-search-1463821').submit(); return false; }); $('#site-search-1463821').on('submit', function(){ // Filter query var sQueryFiltered = $("#site-search-1463821 input[name=q]").val().replace(/\?/g, '); $("#site-search-1463821 input[name=q]").val( sQueryFiltered ); if( $('#site-search-1463821-term').val() ){ $('#site-search-1463821-btn .fa').removeClass('fa-search').addClass('fa-spinner fa-spin'); return true; }else{ return false; } }); Toggle navigation Home About Us Contact Us / Forms Staff Directory Advertise With Us Subscriber Services Local Elected Representatives Newcomers Information Partners in Education Academic All Stars Text Alerts Contest and Special Sections Press Pass Local Business Card Directory Kentucky New Era on vacation Search Warm The Children Chamber Directory Survey News Alerts Crime Courts Crime Stoppers Accidents Restaurant Reports Photo Galleries Disaster Preparedness Top Stories Technology News Election Sports Submit NCAA Chris Jung Outdoors Photo Galleries Titans Hoppers Horse Racing Nascar NFL Opinion Voice of the People KNE Editorial Submit Living Pets of the Week Out 'N About Slice of Life That's the Ticket Weddings Engagements Anniversaries Cradle Roll Food Photo Galleries Community Calendar Submit Obituaries Guide Classifieds Place an Ad Real Estate Sales Real Estate Rentals Announcements Help Wanted Merchandise Pets Wheels Service Directory Public Notice Ads Job Network Showcase Of Homes e-Edition Subscribe/Renew Alerts Submit Help .asset-paging .direction { color: #680c0a; } jQuery(document).ready(function($){ function asset_prevNextContent(oAsset, sPos){ var sPosTitle = (sPos === 'prev') ? 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'next' : 'previous'; __tnt.trackEvent({'category':'tnt-prev-next','action':sAction, 'label':'article', 'value':'1'}); return true; }); } }, function(){ __tnt.log('Error: '+ sStatus); });var bPrevNextScroll = false; $(window).on('scroll mousewheel', function(){ if( !bPrevNextScroll && $('.asset-body').length > 0 && !$('body').hasClass('trigger-disabled') && !__tnt.elementOnScreen('#asset-photo-carousel') ){ bPrevNextScroll = true; var sNextTrigger = 'trigger-next'; setTimeout(function(){ if( __tnt.elementOnScreen('.asset-body', 250) ){ $('body').removeClass(sNextTrigger); } else { $('body').addClass(sNextTrigger); } bPrevNextScroll = false; }, 200); } });$(window).on("load resize", function(){ var sCondTrigger = 'trigger-condensed'; if( window.innerWidth > 991 && window.innerWidth – Andiria Tipton figured it was her job, as the older kid, to crawl around under a bed and pick up dirty drug needles.She’s matter-of-fact about why: “I had to keep them from my little sister.”Andiria has learned a lot about the hellish world of addiction in her short 10 yearsBut she’s also found refuge from it as one of eight kids being raised by Lisa Lacy-Helterbrand, who takes in children of people struggling with addictionAll but one began life in drug withdrawal. Addiction is endemic in these Appalachian hillsIt’s gained so much ground that the nation’s foremost health experts fear one plague will spawn another, that rampant intravenous opioid use will lead to a drug-fueled HIV outbreak like the one that struck Austin, Indiana in 2015That outbreak was the largest to hit rural America in recent history, with a rate comparable to countries in Africa.Lee County, where Lacy-Helterbrand’s family lives, is one of 54 in Kentucky and 220 nationwide identified by the U.SCenters for Disease Control and Prevention as the most vulnerable to a similar outbreakNeighboring Wolfe County tops the list as the most likely place to become the next Austin.Kentucky leads the nation in vulnerable counties, with most clustered in an Appalachian region marred by drugs, doctor shortages, economic ruin and hopelessnessOne drug needle shared by someone with HIV could easily be the match to this powder keg.Yet only 33 of the 220 vulnerable counties have working exchanges where addicts can trade dirty needles for clean ones, Courier Journal foundOf Kentucky's 54 vulnerable counties, 33 lack needle exchangesAmong them is Wolfe, which approved an exchange but is still trying to come up with money for the needles.Experts say forsaking these places could lead to the resurgence of a disease many Americans consider an old threatDrug-related HIV infections are already creeping up across the nationEven now, an outbreak may be quietly brewing.“People have forgotten about HIV… But it’s becoming clear you have the stage set for a major increase in these infections (in places) we’ve basically ignored,” said DrPaul Volberding, director of the University of California, San Francisco AIDS Research Institute“Whenever we have an infectious disease and we turn our back, it bites us.”Many believe the solution begins with fighting addiction in each family, school and communityBut the sheer scope of the drug scourge dwarfs grassroots efforts – even by dedicated residents like Lacy-Helterbrand, who not only takes in children but also directs an organization that helps other needy Appalachian kids.On a recent afternoon, she surveyed towering stacks of boxes filled with donated holiday gifts at the Appalachian Ministries headquarters atop winding Shoemaker Ridge RoadAndiria trailed behind her, balancing baby Gabe, Lacy-Helterbrand’s youngest, on her hip.Soon after, Lacy-Helterbrand stopped in on Priscilla Spears, 27, who got presents from the ministry when she was youngerAn unleashed dog hopped between them on a driveway as Spears described struggling with pills and watching her toddler endure the pain of withdrawal at birthShe’s clean now, she told her friend, and hopes to stay that way, given what's at stake.She cast her eyes down, rubbing her pregnant belly.Appalachia jumps out from a national map of vulnerable counties.CDC researchers searched for places like Austin, Indiana, a tiny city with scarce medical resources where HIV sickened more than 200 people out of a population of 4,200Before the outbreak, Austin never saw more than a handful of casesBut a combustible mixture of poverty and drug abuse hinted at the plague to come.To find the next such place, researchers looked at statistics tied to injecting drugs, such as overdose deaths, prescription opioid sales, low income and unemploymentTheir analysis, published in the Journal of AIDS last November, izdentified vulnerable counties in 26 statesA US Department of Health and Human Services presentation in October showed drug-related HIV infections – one in 11 new HIV cases overall – rose 4 percent nationally in 2015 after a decade-long, 63 percent decline.Wolfe County, about 2 ½ hours east of Louisville, fared badly on all the CDC measuresHome to just 7,159 people, it lost 14 to drug overdoses in five yearsPer-person income stands at $13,901, less than half the national averageAnd more than 30 percent of residents live in poverty, compared with about 13 percent nationally.Surrounding the 1-square-mile county seat of Campton, the rolling green landscape is dotted by a mix of dilapidated single-wide mobile homes, sagging old houses and well-kept homes, with a tiny commercial strip and about a dozen churchesDense sloping forest is shot through with a maze of ATV trails.Stacy Usher rides those trails, sometimes finding spent needles in clearingsShe once discovered a bundle of needles and drug “works” in a daycare parking lot while dropping off a childShe figures they fell out of another parent’s car.Usher works as a service corps coordinator for the Eastern Kentucky anti-drug group Operation UNITE, teaching kids at Campton Elementary School how to avoid drugsShe asks each class: “How many of you know someone who is addicted or has been addicted?”All raise their handEvery time.“It’s not pretty out here,” she said“Every single student that I have, every person I know, has been negatively impacted by drugs in this county.”That includes herGrowing up in rural Wisconsin, Usher got hooked on oxycodone after blowing out her knee playing high school soccerShe managed to get through college while addicted, but stopped cold turkey with the help of a friend after her 5-year-old brother on graduation day asked: “Why do you take so much medicine?”Usher and her husband moved to Eastern Kentucky in 2014 to give their three boys the country upbringing she hadBut “after we got here, we realized this was actually the worst place to move” because of drugsThough she loves the people, she worries for her kids every day.Cyndi Tapley does tooShe grew up here and watched poverty deepen as employers, like a computer board factory where her mom and sister once worked, closed their doorsFor many, hope disappeared with the jobs, and opioid abuse took rootNeedles turned up in Campton’s playgroundTapley’s 10-year-old son Clayton walked by them on roadsides.“Three out of every five people I would say have a drug problem, so you see it all the time,” said Tapley, who also has a 13-year-old daughter“A lot of times kids are strung out and in jail.”Even promising lives are derailedJonathon Terrill, a 32-year-old father of two in Wolfe County, was a high school salutatorianAfter taking painkillers for a sports injury, he cycled through addiction, treatment and relapse for years, once pawning his wife’s wedding ring to pay for drugsHe eventually sought help with an addiction medicine called Vivitrol and has stayed clean 18 months.Today, Terrill works long hours on a pipeline“I could’ve been behind a desk somewhere,” he said“Now I’m working physical labor to make ends meet.”Such stories are familiar to Ernest Childers, a 72-year-old former trucker and alcoholic who pastors the Lakeview Church of Truth in Rogers, KentuckySober 37 years, he has long run an addiction recovery program.“I’ve seen it all,” Childers said, standing near a pulpit displaying guitars, a quilt-covered piano and an American flag“This year, I’ve done three OD funeralsI’ve seen children crawling on the floor with uncapped needles … I had one man, a 30-year-old, whose mother stuck him with a needle at age 10All I could do was hug him.”As Childers spoke, neighbor Sam Spencer walked down the church aisle and settled into a pew.“This dope business, I’ll tell you what …” Spencer began, going on to describe how a thief stole more than $3,000 worth of tools from him just that day.The two men commiserated about rising drug crime, about carrying guns for protection.“It ain’t good, Sam, and it’s gonna get worse,” the pastor said, shaking his head“We’ve watched this grow into a festering sore.”It’s a festering sore that invites infectious disease, and the threat stretches far beyond Wolfe CountySeven other Eastern Kentucky counties also rank among the nation’s top 10 most vulnerable – including Perry, which is under particular scrutiny because some Austin, Indiana residents have relatives there.HIV has been found across Appalachia, though known rates so far are lower than in urban Kentucky, where testing is more commonApril Young, a University of Kentucky assistant professor of epidemiology, said less HIV testing in Eastern Kentucky means the disease could be spreading silently.An outbreak is almost inevitable, UK researcher Jennifer Havens said“It’s just a matter of time.”Researchers point to an explosion of HIV’s widely-accepted harbinger: the potentially deadly liver disease hepatitis C.Like HIV, “hep C” can be spread by sharing needlesAnd it’s easier to contract, so it’s not uncommon to have both diseasesMost Austin patients do.From 2008-2015, Kentucky had the nation's highest rate of new, acute hep C infections, with 1,089 casesAnother 38,000 Kentuckians livewith chronic hep CHavens’ long-term study of Eastern Kentucky drug users found that once they start shooting up, most get hep C within a year.At Hickory Hill Recovery Center, located atop a steep rural road near Hazard, the majority of clients arrive with the disease.Client Joshua Hatfield of Knox County, 34, contracted it more than a decade ago from sharing needles with a girlfriendAfter getting hooked on painkillers he was prescribed in high school, he went on to shoot up nearly every drug he could find – OxyContin, cocaine, meth and even fentanyl squeezed from a patchAs his life spiraled downward he twice tried suicide.Client Ryan Thaxton, 27, of Pulaski County, was diagnosed with hep C in 2015 after sharing a needle with a woman he knew had the diseaseYears of shooting up cocaine, heroin and other drugs made him too desperate to careAnd even after his diagnosis – which he brushed off as “normal” – he kept sharing needles, figuring most other users also had hep C.Many clients, such as Jordan Weddle, 25, of Pulaski County, don’t learn they have hep C until they get to Hickory Hill – meaning they could have been unknowingly transmitting the disease for yearsWeddle admi

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