Public health officials warn that rural Appalachia might be just a few dirty needles away from an HIV catastrophe, as the region is gripped by an epidemic of injection drug abuse and hepatitis C.
Dr. Jennifer Havens, an epidemiologist at the University of Kentucky's Center on Drug and Alcohol Research, says a single person could become the "Typhoid Mary of HIV."
The Centers for Disease Control and Prevention reported last month that the rate of hepatitis C has increased by 364 percent in Kentucky, Tennessee, West Virginia and Virginia.
Kentucky's biggest cities are opening syringe exchange programs this summer to confront the looming threat of HIV. But rural communities have been slower to embrace such plans, citing logistical complications and concerns over whether the programs facilitate rather than prevent drug use.