In the wake of a devastating HIV outbreak in a rural Midwestern county, the tone of the news media toward people who use injection drugs changed significantly, according to a new analysis from a public health researcher at the University of Hawai‘i.

Moreover, this shift in the media's tone may have provided the momentum that was needed to change decades-old, outdated government policies, and allow public health agencies to start a syringe exchange program to prevent the further spread of HIV and other diseases, the analysis shows.

"The study showed that the media is really key to creating a frame around how populations are perceived by the public," said David Stupplebeen, the author of the study and a PhD student at the Office of Public Health Studies at the university.

The outbreak struck Scott County, Indiana, in 2015, and was linked to an increase in the use of opioids. In his analysis, Stupplebeen searched for news articles that focused on people who use injection drugs that were published up to 10 years before the outbreak was first reported to the Centers for Disease Control and Prevention. He compared those articles with articles that were published after the outbreak was reported. He examined a total of 372 articles, which were mainly from local newspapers' coverage of the outbreak.

Stupplebeen found that before the outbreak, news stories about people who use injection drugs tended to focus on the crimes that these people committed, painting a picture of them as immoral criminals. But during the outbreak, which ultimately resulted in nearly 200 new cases of HIV in the sparsely-populated county, the tone shifted. The news articles started to bring to light the heartbreaking effects that the opioid-use epidemic had on the people living in an area already plagued by high levels of unemployment and poverty.

"Negative framing of people who inject drugs helped reinforce a stable policy environment, which didn't support syringe exchange programs," Stupplebeen says. "The HIV crisis changed the framing." This change in framing opened the door to the state's decision to allow the county to begin a syringe exchange program, to offer clean needles to people who use injection drugs.

Much research has shown that syringe exchange programs reduce the impact of communicable diseases in the community. However, some policy makers are reluctant to allow such programs over misguided fears that the programs encourage drug use. (They don't.)

"After the outbreak became known, talk turned to getting people into treatment, preventing overdoses, and doing needle exchange," Stupplebeen says.

The analysis will appear in an upcoming issue of the International Journal of Drug Policy.