Assessment of Tennessee’s county-level vulnerability to hepatitis C virus and HIV outbreaks using socioeconomic, healthcare, and substance use indicators

• DOI: 10.1371/journal.pone.0270891
• Publication Date: 2022-08-04T17:44:16Z
• Authors: Jessica Vakili; Lindsey Sizemore; Peter F. Rebeiro; Ben Tyndall; Pamela Talley; Kristyn Whaley; Meredith Brantley
• Keywords: Hepatitis C

Background Human immunodeficiency virus (HIV), hepatitis C (HCV), and injection drug use are syndemic in the central Appalachian states. In Tennessee (TN), declines HIV among persons who inject drugs (PWID) stalled, HCV infection rates increased significantly from 2013–2017. To better target strategies to address syndemic, county-level socioeconomic, opioid use, access healthcare, health factors were modeled identify indicators predictive of vulnerability an HIV/HCV outbreak PWID TN. Methods Newly reported chronic cases aged 13–39 years 2016–2017 used as a proxy for TN’s 95 counties. Seventy-five publicly available measures collected reduced through multiple dimension reduction techniques. Negative binomial regression identified associated with which calculate local outbreak. Results Thirteen strongly statistically significant being percentage population 20–44 years, per capita income, teen birth rate, clients TDMHSAS-funded treatment recovery, syphilis case homes at least one vehicle. Based on 13 indicators, we distribution Eleven high counties identified, preponderance located east middle Conclusion This analysis most These results, alongside routine surveillance, will guide targeted prevention linkage care efforts vulnerable communities.