Asher J Schranz1, Jessica Barrett2, Christopher B Hurt3, Carlos Malvestutto2, William C Miller4. 1. Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd. Bioinformatics Building CB# 7030, Chapel Hill, NC, 27599-7030, USA. Asher.Schranz@unchealth.unc.edu. 2. Division of Infectious Diseases, Ohio State University Wexner Medical Center, Columbus, OH, USA. 3. Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd. Bioinformatics Building CB# 7030, Chapel Hill, NC, 27599-7030, USA. 4. Division of Epidemiology, Ohio State University College of Public Health, 302 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43220, USA. miller.8332@osu.edu.
Abstract
PURPOSE OF REVIEW: This article reviews recent epidemiologic trends in HIV and hepatitis C virus (HCV) and strategies for treatment and prevention of these infections as they relate to the opioid epidemic. RECENT FINDINGS: Among people who inject drugs (PWID) in the United States (US), HIV diagnoses are decreasing, while HCV is increasing. Care for HIV and HCV relies heavily on specialist infrastructure, which is lacking in rural areas. Antiretrovirals for HIV and direct-acting antivirals for HCV are effective among PWID, yet multiple barriers make it difficult for rural injectors to access these treatments. Similarly, access to syringe service programs, medication-assisted therapy for opioid addiction, and pre-exposure prophylaxis for HIV are all limited in rural areas. Previous research on HIV and HCV among PWID has focused on urban or international populations, yet the US opioid epidemic is moving away from metropolitan centers. Increasing rurality of opioid injection brings unique challenges in treatment and prevention. Research into the care of HIV, HCV, and opioid use disorder among rural populations is urgently needed.
PURPOSE OF REVIEW: This article reviews recent epidemiologic trends in HIV and hepatitis C virus (HCV) and strategies for treatment and prevention of these infections as they relate to the opioid epidemic. RECENT FINDINGS: Among people who inject drugs (PWID) in the United States (US), HIV diagnoses are decreasing, while HCV is increasing. Care for HIV and HCV relies heavily on specialist infrastructure, which is lacking in rural areas. Antiretrovirals for HIV and direct-acting antivirals for HCV are effective among PWID, yet multiple barriers make it difficult for rural injectors to access these treatments. Similarly, access to syringe service programs, medication-assisted therapy for opioid addiction, and pre-exposure prophylaxis for HIV are all limited in rural areas. Previous research on HIV and HCV among PWID has focused on urban or international populations, yet the US opioid epidemic is moving away from metropolitan centers. Increasing rurality of opioid injection brings unique challenges in treatment and prevention. Research into the care of HIV, HCV, and opioid use disorder among rural populations is urgently needed.
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