Republicans are having to face a reality in which HIV is no longer just affecting gay people and drug users in big cities, and it’s exposing some uncomfortable realities that were already glaringly obvious, but which people still like to pretend don’t exist.

It wasn’t supposed to happen here. Not in Austin, a one-doctor-and-an-ice-cream-shop town of 4,200 in southeastern Indiana, nestled off Interstate 65 on the road from Indianapolis to Louisville, where dusty storefronts sit vacant and many residents, lacking cars, walk to the local market. Not in rural, impoverished Scott County, which had reported fewer than five new cases of HIV infection each year, and just three cases in the past six years. Not in a state where, of the 500 new cases reported annually, only 3 percent are linked to injection drug use.

But it did. And it could happen in many more backwoods towns just as unprepared as Austin.

As the largest HIV/AIDS outbreak in Indiana’s history roils this Hoosier hamlet, it reflects the changing face of the epidemic in the U.S., as a disease that once primarily afflicted gays and minorities in deep-blue cities rises in rural red states. This new evolution of HIV is also forcing a new generation of Republican policymakers to confront its orthodox opposition to remedies such as government-funded needle-exchange programs.

I’m hung up on that first sentence, “It wasn’t supposed to happen here.”

I can’t tell if the author of this article is using this sentence with any sense of irony at all. Continue reading →