People who inject drugs and HIV crisis in Pence's Indiana: A media analysis using two policymaking theories.

BACKGROUND: In 2015, Scott County, Indiana was the center of an HIV outbreak related to injection drug use. Critiques of the government response exist; however, none examine the response through policymaking theories. This paper examines policy changes affecting people who use drugs (PWID) in Indiana through two theories: the social construction of target populations and punctuated equilibrium.

METHODS: A media analysis was performed to examine the prevailing image of PWID in Indiana ten years prior to the outbreak and two years after the crisis emerged. Article tone was assessed to examine the social construction of PWID, and how this construction related to incremental, then punctuated policy making.

RESULTS: A total of 372 news articles were examined. Media tone towards PWID was significantly more negative in the 10 years before the outbreak. Most articles regarding PWID pre-outbreak were crime-related, while during crisis, articles types varied and reframed PWID.

CONCLUSION: News article tone changed significantly, allowing new approaches to health related to PWID to be considered. This paper demonstrates the utility of these policy frameworks and analysis of target populations through media depictions. Implications for public health practitioners are discussed.