Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Sarah Wackerbarth, PhD

Committee Member

Richard Ingram, DrPH

Committee Member

Tyrone Borders, PhD


Needle sharing has become an important factor in the prevalence of HIV and viral hepatitis rates as injection drug use of illicit substances, such as heroin and prescription opioids, has increased across the United States. Kentucky, much like the rest of the nation, has also been devastated by the recent surge of injection drug use. In 2010, drug overdose rates ranked Kentucky as the third highest state in the nation. Hepatitis B (HBV) and Hepatitis C (HCV) rates within Kentucky have been consistently higher than the national rate since 2007 and 2003, respectively. Hospital discharge costs related to HCV infections have increased by $167 million. In response to this public health problem, the Commonwealth of Kentucky passed Senate Bill 192 (KY SB 192), a comprehensive drug policy with a goals to mitigate the spread of HIV and viral hepatitis. Provisions of the bill include harsher penalties for heroin trafficking, additional allocation of funds for addiction treatment, legal immunity for reporting a drug overdose victim, an increase in the availability of Naloxone, and authorization of needle and syringe exchange programs (NSEP). KY SB 192 is a multifaceted drug policy, the needle exchange provision was highly debated and embodies the four characteristics of a morality policy: marked by controversy, symbolic nature, the policy attracts a diverse policy community, and enduring controversy. The implementation of NSEP in the state of Kentucky carries the following projections: An average decrease of 1 to 6 HIV cases per year and an approximate annual decline in rate by 0.04 to 0.50 per 100,000 (or 1.8 – 22.1 cases per 100,000) for HCV. This amounts to approximately $2 million in cost savings for both HIV and HCV treatment.

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