Syringe exchange programs meant to slow HIV's alarming spread in West Virginia limited by political resistance

Photo by R. Konkathi, Unsplash

Despite federal recommendations and community efforts to stem HIV infections among opioid or methamphetamine users in central Appalachia, the disease continues to spread. Harm-reduction advocates and medical providers cite resistance to syringe exchange programs as the primary obstacle, reports Taylor Sisk of KFF Health News. "The situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use."

In 2021, West Virginia's HIV outbreak was particularly concerning to officials from the Centers for Disease Control and Prevention. Sisk writes, "The CDC’s HIV intervention chief called it 'the most concerning HIV outbreak in the United States and warned that the number of reported diagnoses could be just 'the tip of the iceberg.'" 

Rural areas without substance disorder treatment or disease education present a ripe breeding ground where HIV can spread undetected. Ryan White HIV/AIDS Program Director Christine Teague "is concerned for West Virginia’s rural counties, most of which don’t have a syringe service program," Sisk adds. "Tasha Withrow, a harm reduction advocate in rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that with little testing and heightened stigma in a rural community, it’s difficult to know."

Robin Pollini, a West Virginia University epidemiologist who conducts community-based research on injection drug use, told Sisk, “You would think that in a state that had the worst HIV outbreak in the country, we would have a statewide testing strategy." Sisk reports, "Teague would like every rural county to have a mobile unit. . . offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more."

While disease prevention through syringe exchange programs is well documented, the CDC's health warnings and recommendations for improved access to syringe exchanges have been largely ignored. Sisk reports, "In April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID."

A made in the USA bicycle is in the works; maker hopes tariffs on Chinese imports will spur American production.

Guardian's USA-made children's bike is
still evolving. (Guardian graphic via WSJ)

Children’s bike maker Guardian Bikes moved its production from China to the U.S. intending to build its bikes with as many American-made parts as possible, reports Natasha Khan of The Wall Street Journal. The company's founder, Brian Riley, hopes "steep tariffs" on Chinese imports pledged by President-elect Donald Trump will make American-made bikes and parts more competitive.

Moving bicycle component production to the United States will still be tough partially because China has dominated the sector for decades. Riley knows the challenges and is still moving in that direction. Khan explains, "For now, components from China represent about 90% of the total cost of Guardian’s parts. By the end of next year, Riley hopes that figure will be about 20%. Guardian is starting production of its own bike frames. . . . As a result of Guardian’s new manufacturing, American-made parts could represent about 60% of the cost."

One of the reasons Riley moved his company to the United States was to build a "safer bike that could prevent the kind of head-over-heels braking accident that had injured his grandfather years earlier," Khan reports. "Many bikes sold at retailers such as Walmart or Target aren’t fully assembled when they are shipped to the retailers from overseas, so manufacturers don’t have oversight on the final assembly. Riley told Khan, "By controlling every aspect of production, we can guarantee the quality of every bike that rolls off our assembly line."

Riley admits that opening a U.S. factory was expensive and time-consuming. "At first, workers were slow to build the bikes, putting together 100 a day. It took time and constant tweaking of the assembly line to improve their speed and efficiency," Khan writes. Riley told her, "We had to bite the bullet. We had to be willing to lose money for a while to get to the other side of the strategy.”

The creation of Guardian's USA-made bike is evolving. "Guardian plans to begin making bike frames at the factory this year, using American steel. . . . Guardian is also considering making rims itself," Khan reports. "The bike maker has approached U.S. suppliers that could provide grips and reflectors."

Riley told Khan, "Everyone says making bikes here is impossible." Kahn adds, "His factory shows it isn’t."

Opinion: U.S. Postal Service should deliver mail, not profits. Privatization 'would be a nightmare for rural Americans.'

U.S. Postal Service history dates back to 1775. Its goal
was to deliver mail. (Photo by Joel Moysuh, Unsplash)

Postmaster General Louis DeJoy deployed plans to make the U.S. Postal Service profitable. But turning a profit isn't the point of mail delivery, write Tribune Phonograph editorial members Kris O’Leary and Brian Wilson. Service is the heart of the USPS, and its lack significantly impacts rural areas.

"The U.S Postal Service should focus on delivering the mail, not delivering a profit," they write. "Privatization of the postal service has been a dream for some who see the opportunity for profit, but it would be a nightmare for rural Americans who would see service cuts, additional delays and increasing costs. These would disproportionally impact rural residents simply due to the economics of having fewer potential customers over a wider area."

In many business ventures, privatization "can be a wonderful thing. . . . . It can bring about innovation. . . and the adoption of new efficiencies," O'Leary and Wilson add. "In a recent interview, President-elect Donald Trump broached the idea of revisiting privatization of the postal service as a potential goal. . . . Trump’s comments come at the same time that Postal Service leadership is under increased bipartisan scrutiny for spiraling increases in rates and ever-diminishing service standards."

In a December congressional hearing, members berated DeJoy for failing to meet service benchmarks and repeated upgrade delays. "Georgia Rep. Rich McCormick, a Republican, lambasted DeJoy," the editorial board writes, "leading to DeJoy covering his ears during the hearing." DeJoy defended his optimization strategies and said lawmaker interference could "end" the Postal Service.

However, profit-margin goals have little to do with the Postal Service's actual purpose. O'Leary and Wilson write, "DeJoy and other postal leadership have lost sight, if they ever had it, of the service that is at the core of the Postal Service. If DeJoy’s version of operational leadership and strategy were applied to highways, we would see interstates being turned into gravel roads."

If the U.S. postal service is privatized, its goal will become profits above all. "It will funnel off large city metro areas that can make money and drop rural areas that cover more land miles than people," O'Leary and Wilson add. "This is most of the U.S. population not living on either population-dense coast. The Midwest could lose any mail or package service if this becomes a reality. . ."

A historic first in Alaska may mean drilling in an untouched national refuge; Native Alaskans want a 'seat at the table.'

Map by Sarah Melotte, The Daily Yonder, from Bureau of Land
Management data. Click on map to enlarge.

Alaska’s Arctic National Wildlife Refuge is big, beautiful, and rich in natural resources and biodiversity. It has also been the "focal point of more than six decades of drilling controversy," which will come to a tentative resolution when tracts within the region's 19-million-acre expanse open for oil and gas leases this month, reports Sarah Melotte of The Daily Yonder. Native Alaskan communities want to be among the decision-makers for the coastal land that "is estimated to contain 11.8 billion barrels of recoverable oil."

Drilling in ANWR has never been done before. The region is home to "charismatic species like polar bears, wolves, and the caribou that are sacred to the Gwich’in, a Northwestern Alaska tribe," Melotte writes. "Oil and gas operations elicit mixed responses from Alaskan Natives. . . Some worry that drilling activity will hurt vulnerable wildlife and subsistence living, others say the oil and gas industry funds important infrastructure for their communities."

The coastal region, also known as the North Slope Borough, receives 95% of its total budget from oil and gas development taxation. Reservation members also depend on shareholder income regional corporations generate and pay out to Alaskan Natives. The Artic Slope Regional Corporation serves as an example. The company "has over 13,000 shareholders who receive dividends," Melotte notes. "Since its establishment in 1972, the ASRC has distributed more than $1 billion in dividends."

"Many leaders of the Iñupiat, an indigenous people native to Alaska’s North Slope Borough, say that oil and gas operations can be good for native communities if conducted responsibly," Melotte reports. Nagruk Harcharek, president of the Voice of the Arctic Iñupiat, a nonprofit organization that advocates for Alaska’s Iñupiat people, told Melotte, "Before oil and gas, you couldn't graduate high school and stay in the North Slope. Now there are K-12 schools in every North Slope village."

Harcharek used a past North Slope drilling project to help explain how Native Alaskans want to be included in drilling activity and practices. Melotte writes, "He said they were consulted 'early and often' in the decision-making process. . . . He said they want to be included before decisions are announced publicly."

Despite Alaska's rich natural resources, many Alaskan Natives live in poverty and still hunt for food, and drilling activities could interfere with their reliance on wild game. "Hunting is more than just a hobby in many native villages with high poverty rates," Melotte writes. "Hunting is a method of survival, said Dr. A.L. Lovecraft, professor of Political Science and director of the Center for Arctic Policy Studies at the University of Alaska. '[Drilling] also comes with all of this other baggage... Problems related to health, indoor health, indoor air quality, outdoor air quality.'"

Quick hits: Wallet-draining breakfast prices; the 'Walmart effect;' rural short story winner; bird flu stats; shouses

Photo by E. Aceron, Unsplash

Budget-busting beef with eggs and coffee breakfasts won't be cheaper anytime soon. "While commodities such as beef and eggs have long been volatile, others such as coffee have jumped in price more recently," report Patrick Thomas, David Uberti and Elizaveta Galkina of The Wall Street Journal. "Average prices for food at home rose in November by the largest annual pace in a year. . . . Store-bought ground [coffee] roasts have jumped 11% in price over the past year to an all-time high." In slightly less of a buzzkill, pork prices have remained steady, and "the average price of white bread is down around 3% over the past year."

Walmart's motto is "save money, live better," but oftentimes, that's not what happens to places after Walmart moves in. "New research suggests that the company makes the communities it operates in poorer — even taking into account its famous low prices," reports Rogé Karma for The Atlantic. "Walmart’s many defenders argue that the company is a boon to poor and middle-class families, who save thousands of dollars every year shopping there. . . .Two new research papers challenge that view." Read the research here.

Haworth's character, Michael, decides to venture home.
(Photo by Julian Scholl, Unsplash)

When one season of life ends, another begins -- or does it? Jeremy Haworth's short story "Blood Brother" explores Michael Riordan's path from retirement boredom to the uncertainty of going home. Haworth writes, "The sudden thought of home occurred to him. . . . Years had elapsed since he had crossed the threshold of the old farmstead. But the twinge in his chest told him time was shortening. The thought of death. . . an instinct to finally lay the ghosts of the past to rest. . ." Hadworth's story is the winner of the second annual “Best in Rural Writing Contest” presented by the rural literary journal The Milk House with support from The Daily Yonder.

The spread of bird flu or H5N1 in dairy cows has put many dairy farmers and consumers on edge. To help measure and mitigate the virus in cow herds, the Department of Agriculture rolled out mandated milk testing in December. The USDA is sharing its testing results with up-to-date graphics of confirmed bird flu cases, also called HPAI, found in U.S. herds. Over the past 30 days, testing found 182 new cases in two states. See the details here.

Shouses don't have to be small. This shouse is located in Okeana, a small unincorporated
community in rural Ohio. (Morton Buildings photo)

Rural landscapes have made room for country-living architecture that goes beyond barn-shaped homes and wood cabins. "Barndominiums" and "shouses" are dotting the countryside in surprising numbers. "Look carefully the next time you’re driving on the back roads of America, and you’re bound to spot a shouse — a hulking rectangular structure. . . . It could easily be mistaken for a machine shed," reports Dionne Searcey of The New York Times. "From the outside, shouses look a lot like the better-known barndominiums, or barndos for short. . . . It’s difficult to trace the genesis of shouses. . ."

'Fancy mechanic' Brienna Hall works for a company few have heard of doing work vital to maintaining all the tech in our lives. "The piece of equipment that the entire world has come to rely on — and Hall is specially trained to handle — is called an extreme ultraviolet lithography machine," reports Ben Cohen of The Wall Street Journal. "It’s the machine that produces the most advanced microchips on the planet . . . maybe the most remarkable thing about these invaluable machines is that they’re all made by the same company: ASML. . . . This one Dutch company is responsible for all of the EUV lithography systems that help make the chips in so many of your devices. Like your phone. And your computer. And your tablet. And your TV. Maybe even your car, too."