Document Type


Publication Date



rural, public health, infectious diseases, HIV, hepatitis C, qualitative research, MRHRC

Publication Title

Journal of Health and Human Services Administration, Symposium on Rural Health Challenges


Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity of rural areas included inadequate funding, insufficient staffing, and limited healthcare infrastructure. Promising strategies for providing prevention, disease surveillance, and treatment services in rural areas included the use of mobile treatment units, telemedicine approaches, and community education initiatives to overcome resistance to evidence-based harm reduction programs.

This qualitative research is a companion study to a quantitative analysis that categorized 20 states as potentially at risk for an HIV or HCV outbreak based on a composite burden of opioid use, and HIV and HCV indicators (Lendardson et al., 2021).


(e-pub ahead of print. Online version August 15, 2021)

A webinar on this study was held on April 21, 2020.

Funding Organization

HRSA-Federal Office of Rural Health Policy

Grant Number




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