Milton Engebretson starts his church’s van.
He’s in his third week of what has become a daily ritual: driving around Austin, Indiana, transporting people to the town’s Community Outreach Center.
The outreach center is the hub of the community's fight against a growing HIV epidemic, the severity of which has drawn national attention to the tiny town about 30 miles north of Louisville.
In the plain single-story center, residents in need find a fledgling needle exchange program, free HIV testing and counseling.
Engebretson has taken about 55 people to the center so far, including battered women, a homeless man and even a teenage boy.
He dispatches himself to pick up people with a phone call.
Some people call and hang up several times before asking for a ride, he says.
"The number will repeat a couple of times and finally they will say, 'Is this the ride for the one stop?' And I’ll say, 'Of course it is,'” he says.
In Scott County's battle against the HIV outbreak, some residents such as Engebretson take steps to help. Others watch in fear, or remind all who ask that the HIV outbreak is but one of the community's struggles.
One of those struggles in intravenous drug use—especially Opana.
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'Typical Town'
In the most drug-ravaged neighborhood of Austin (population of about 4,300), people walk the streets aimlessly. But, at about 11 a.m. Tuesday, it's still early for those walkers, he says.
Still, he shows me around the nucleus of where Austin's drug and prostitution problem resides.
“This is Mann Avenue. This is Rural and Mann. They’ll take this route all the way down to Factory, is where they would walk,” he says.
A church. A small grocery store. Dogs on lawns, people sitting on front porches.
"This is the typical town of Austin. Hard-working people," Engebretson says.
The smell of sauerkraut is in the air from Morgan Foods, a nearby canning company, as we continue our drive around town. Across the way people are lined up at the Dairy Queen on Highway 31. The Austin Police Department is a short drive down the highway.
And all of this is in walking distance to where drug dealers, addicts and prostitutes freely roam the streets looking for their next client or fix.
Jennifer Marquez, 26, moved to town six months ago from Southern California.
She'd never heard of Opana before arriving in Austin—and she had no idea the community was struggling with crime.
Now, the pregnant mother of two says she worries about the safety of her children.
"Having to check your yard just for needles or anything like that. It's horrible,” she says.
Marquez says she lives in the midst of the illegal activity. She describes the neighborhood as a nice community overrun with "the drug population."
But, as Engebretson drives back to his church, he says that many have forgotten that those issues are nothing new in the small city.
“It’s been like this for a while,” he says.
Austin Police Chief Donald Spicer agrees. He says many ingredients led to the city’s current state and the recent HIV outbreak.
“The Hep C, the drug use already, the types of drugs available—all that kind of made a recipe for what happened,” Spicer says.
Long-Standing Problems
Scott County, which includes Austin, and surrounding areas now have 136 confirmed HIV cases. Six other cases are preliminary.
Indiana Gov. Mike Pence recently extended his executive order temporarily legalizing a needle exchange program in Scott County.
So far, more than 4,300 needles have been provided to 95 people.
The extended executive order expires May 24.
But Austin native Leona says it’s taken the government too long to address the area’s long-standing problems.
Leona, who asked that her last name be withheld for privacy, uses a painkiller called Opana intravenously. She is HIV-negative.
“Now they’re wanting to give out free syringes … if they’d done that a long time ago we probably wouldn’t have had an outbreak, because people are gonna use regardless,” Leona says.