Rural counties may be potentially vulnerable to an HIV or hepatitis C outbreak among persons who inject drugs. How well equipped are these counties to handle an outbreak should one occur? Using mixed methods, we provided a deeper understanding of rural counties at risk of an outbreak based on their characteristics and an assessment of their public health infrastructure. The project's purposes were to: (1) identify states at risk of an HIV or hepatitis C outbreak using indicators of opioid use and (2) understand the ability and resources of rural counties to address an outbreak. With secondary data sources, we selected 10-15 states for high rates of problem opioid use for further analysis of county health professionals and facilities, sociodemographic and economic characteristics that could impact clinical outcomes, and rural proximity to urban resources and providers. Additionally, we conducted interviews with local stakeholders about their clinical capacity to respond to an outbreak.

Publications

• Capacity of Rural Counties to Address an HIV or Hepatitis C Outbreak
  Policy Brief
  Maine Rural Health Research Center
  Date: 02/2021
  This study examines rural-urban differences in state and local health department capacity to prevent, prepare for, and respond to an HIV or hepatitis C outbreak.
• Voices From the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C
  Journal Article
  Maine Rural Health Research Center
  Date: 05/2021
  Interviewing public health professionals from six rural states, researchers examined the challenges involving HIV, HCV, and serving rural people who inject drugs and determined strategies to address those challenges.