Mike Pence’s Response to H.I.V. Outbreak: Prayer, Then a Change of Heart

On the evening of March 24, 2015, Sheriff Dan McClain got an unexpected voice mail: “This is Gov. Mike Pence calling. I would welcome the opportunity to get your counsel on what’s going on in Scott County.”

What was going on was unprecedented in Indiana and rare in the United States: H.I.V. was spreading with terrifying speed among intravenous drug users in this rural community near the Kentucky border. Local, state and federal health officials were urging the governor to allow clean needles to be distributed to slow the outbreak.

But Indiana law made it illegal to possess a syringe without a prescription. And Mr. Pence, a steadfast conservative, was morally opposed to needle exchanges on the grounds that they supported drug abuse.

As Sheriff McClain called the governor back, the pressure was mounting. The number of new H.I.V. cases in the county was nearing 90.

“Don’t give me any political views, I want to know your opinion,” the sheriff recalled the governor saying.

The sheriff, who was not a fan of needle exchanges, was quick to reply. “I believe the only thing we can do to stop or slow this thing is to get clean needles out there,” he said.

As the Republican vice-presidential candidate, Mr. Pence brings a long record of social and fiscal conservatism that serves as a counterweight to Donald J. Trump’s frequently shifting views. But rarely have the governor’s principles been tested like they were during Indiana’s worst public health crisis in years.

Much as his Democratic counterpart, Tim Kaine, had to wrestle with his deeply felt opposition to capital punishment in a death penalty state, allowing 11 executions when he was Virginia’s governor, the H.I.V. outbreak forced Mr. Pence to balance strong beliefs against ground-level reality: an epidemic that was growing more dire by the day.

Tens of thousands of them were handed out over the following months. And the program, along with drug therapy and aggressive outreach, slowed the flood of new H.I.V. cases to a trickle.

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