You probably remember the headlines from last year: Nearly 200 people in rural Scott County, Indiana, contracted HIV, the result of people sharing needles while injecting opioids. A recently published study looks at the outbreak and concludes that it could have been avoided, reports the Courier-Journal. What’s more, other communities are vulnerable to similar outbreaks, including hepatitis C.

The study, published in The New England Journal of Medicine, recommends that rural states focus on preventive measures such as implementing HIV testing, identifying networks of injection drug users, increasing access to treatment and allowing syringe-exchange programs.

William Cooke, a doctor from the town at the center of the outbreak, noted that indicators of an outbreak were present: poverty, high unemployment, adverse childhood experiences, high hepatitis C rates and the presence of opioids.

Meanwhile, Brittany Combs, a public health nurse in Scott County and an author of the study, tells the newspaper that the county has seen “great success” with its needle exchange program. “We know that we have pretty much stopped the spread of HIV.… We know it has helped get people into rehab, we’ve linked them to [treatment]. I know it’s working because I see it every day.”

In related news, to learn about the latest work of HIV advocates in Indiana, read the POZ exclusive “New Group Tackles Laws That Make HIV a Crime.”