In early 2015, southeastern Indiana was in crisis. A surge of Hepatitis C and HIV cases in rural Austin, Ind., pointed to considerable intravenous drug use among the generally low-income population. Needle sharing was suspected in an area where everyone knew everyone and money was tight. In March, Indiana Gov. Mike Pence declared the outbreak a public health emergency, the worst in state history, and authorized a needle exchange program.


When the Indiana State Department of Health contacted Hirons for communications support, confirmed HIV cases topped 80 in Scott County, where such diagnoses had been rare. Few medical and social support services were available, and many residents were uninsured, further hampering efforts to reach individuals most at risk.

State health officials descended on the area to help local health departments, health care providers and others contain the spread of HIV, and the needle-exchange program was put in place. Disease intervention specialists from the Centers for Disease Control also arrived, interviewing each newly identified HIV-positive individual to obtain information about needle sharing and sex partners, as well as to recommend care coordination services, medical care and HIV prevention information.

Hirons was tasked with spreading the word throughout Scott County and nearby Washington, Perry, Jackson and Clark counties. Radio and TV spots were developed and produced targeting the poor, rural population. The target audience was men and women ages 20-35 with relatively low education levels. Messaging focused on the availability of free medical services and needle exchanges, with information on where to find those services. Language was easy to comprehend with clear calls to action:  Visit or call 866.588.4948 to learn more.

Although Scott County confirmed a total of 170 HIV cases, new cases fell considerably by June and trailed off even more by end of the year. Dr. Jerome Adams, state health commissioner, said vigilance will continue because of the high-risk lifestyles of much of the population.

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