ArticleJournal of acquired immune deficiency syndromes (1999)2016
County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 280 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
280 citing papers in PubMed, 2 syntheses or guidelines pooled it, 451 citations in OpenAlex.
- Insights into the spatial epidemiology of hepatitis C infection: systematic synthesis of area-level determinants and spatiotemporal analyses.BMC public health · 2025Pooled it
- The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases.Substance abuse · 2020Pooled it
- Can a participant-referred 'study buddy' increase retention of rural people who use drugs in research? A multi-site, randomized trial.Addiction (Abingdon, England) · 2026Trial
- Convenience, rapport and skill: effective rural hepatitis C treatment, qualitative findings from a mobile harm reduction-informed tele-medicine intervention in Northern New England, 2022-2024.Harm reduction journal · 2026Trial
- Peer-assisted telemedicine hepatitis-C treatment for people who use drugs in rural communities: a mixed methods study.Addiction science & clinical practice · 2025Trial
- Association of skin infections with sharing of injection drug preparation equipment among people who inject drugs.The International journal on drug policy · 2021Trial
- Promoting Safe Injection Practices, Substance Use Reduction, Hepatitis C Testing, and Overdose Prevention Among Syringe Service Program Clients Using a Computer-Tailored Intervention: Pilot Randomized Controlled Trial.Journal of medical Internet research · 2020Trial
- Hepatitis C screening strategies and linkage-to-care approaches in U.S. emergency departments: A systematic review and meta-analysis.Preventive medicine reports · 2026Review
- Review
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- Characterizing the Geography of Drug Use Networks and Behaviors Among People Who Inject Drugs in the Baltimore Metropolitan Region.AIDS and behavior · 2026Article
- Frequent police contact and nonfatal overdose among people who use drugs in rural Appalachia.Drug and alcohol dependence · 2026Article
- Drug Use and Social Connectivity Related to Hepatitis C Infection Among Rural People Who Use Drugs.Journal of viral hepatitis · 2026Article
- What We Owe: A Liberatory Ethics of Harm Reduction.Nursing inquiry · 2026Article
- Recent hydromorphone injection and risk of incident infective endocarditis among people who inject drugs in Toronto, Canada: a cohort study.Harm reduction journal · 2026Article
- Identifying communities at elevated risk of hepatitis C infection in Los Angeles County: an ecological study using machine learning.BMC public health · 2026Article
- Psychosocial correlates of awareness of HIV pre-exposure prophylaxis (PrEP) among persons who inject drugs in Northeast Georgia.AIDS care · 2026Article
- Gender and power dynamics in three types of injection partnerships among young women in rural Appalachia.Harm reduction journal · 2026Article
- Impact of a pharmacist-led hepatitis C clinic on hepatitis A and B vaccination rates and treatment outcomes: A retrospective cohort study.Journal of managed care & specialty pharmacy · 2026Article
- Burden of Injection Drug Use-Related Infection Hospitalizations in Tennessee, 2016-2023.Open forum infectious diseases · 2026Article
220 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on byReply.2017
Authors and funding
16 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveA recent HIV outbreak in a rural network of persons who inject drugs (PWID) underscored the intersection of the expanding epidemics of opioid abuse, unsterile injection drug use (IDU), and associated increases in hepatitis C virus (HCV) infections. We sought to identify US communities potentially vulnerable to rapid spread of HIV, if introduced, and new or continuing high rates of HCV infections among PWID.
designWe conducted a multistep analysis to identify indicator variables highly associated with IDU. We then used these indicator values to calculate vulnerability scores for each county to identify which were most vulnerable.
methodsWe used confirmed cases of acute HCV infection reported to the National Notifiable Disease Surveillance System, 2012-2013, as a proxy outcome for IDU, and 15 county-level indicators available nationally in Poisson regression models to identify indicators associated with higher county acute HCV infection rates. Using these indicators, we calculated composite index scores to rank each county's vulnerability.
resultsA parsimonious set of 6 indicators were associated with acute HCV infection rates (proxy for IDU): drug-overdose deaths, prescription opioid sales, per capita income, white, non-Hispanic race/ethnicity, unemployment, and buprenorphine prescribing potential by waiver. Based on these indicators, we identified 220 counties in 26 states within the 95th percentile of most vulnerable.
conclusionsOur analysis highlights US counties potentially vulnerable to HIV and HCV infections among PWID in the context of the national opioid epidemic. State and local health departments will need to further explore vulnerability and target interventions to prevent transmission.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.