# The effect of opioids, stimulants, and the simultaneous use of both on the hepatitis C virus (HCV) cascade of care in rural communities in the United States

> **NIH NIH F31** · OHIO STATE UNIVERSITY · 2022 · $40,593

## Abstract

PROJECT SUMMARY
The number of acute hepatitis C virus (HCV) infections has risen steadily in the U.S. due to increased injection
drug use (IDU). The growth of IDU has disproportionately contributed to acute HCV infections in rural
communities as their incidence rates are more than twice those of urban areas. HCV management is described
using the HCV cascade of care (CoC) and includes testing and treatment completion. There is a critical need
to increase HCV testing among people who inject drugs (PWID). The annual HCV testing rate is only 7.7%
among those clinically identified as PWID in the U.S. Among rural PWID who tested positive for HCV, 59%
contacted a healthcare provider within 18 months of their results, 14% reported seeking HCV treatment, and
only 8% reported receiving HCV treatment. Further, stimulant use, defined as methamphetamine,
amphetamine, or cocaine use, is resurging. Polysubstance use of opioids and stimulants is increasing among
rural PWID and is associated with increased factors for HCV transmission, such as syringe sharing. Yet, the
effect of stimulant and polysubstance use on HCV testing and treatment remains unclear. The proposed
research aims to reduce the morbidity and mortality associated with HCV among PWID in rural communities.
The proposed project will leverage data collected in eight NIH-funded studies of the Rural Opioid Initiative
(ROI) (NIDA U24DA048538). We will use this comprehensive collection of data and the integration of
epidemiological and spatial methods to determine the effect of opioids, stimulants (methamphetamine,
amphetamine, cocaine), and their simultaneous and concurrent use on HCV infection, testing, and treatment
completion in rural communities included in the ROI infrastructure. Aim 1 will estimate the association of opioid
use, stimulant use, and polysubstance use of opioids and stimulants with the presence of HCV infection among
PWID. Aim 2 will measure the association of opioid, stimulant, and polysubstance (opioid and stimulant) use
on HCV testing and treatment completion. Aim 3 will identify high-priority locations to target HCV testing and
treatment among PWID communities within the ROI infrastructure. The results from this project will identify
rural communities that require HCV testing and treatment support to curtail the spread of HCV and associated
mortalities among PWID. This project will enhance the applicant’s expertise and application of epidemiological
methods to solve public health issues in the fields of substance use and infectious diseases. The applicant will
gain research, collaboration, and dissemination experience to prepare her for an independent epidemiological
investigator career. This project and applicant are supported by distinguished faculty in epidemiology,
substance use, infectious diseases, behavioral health, geography, population health, and public health
informatics.

## Key facts

- **NIH application ID:** 10459753
- **Project number:** 1F31DA054752-01A1
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Angela T Estadt
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $40,593
- **Award type:** 1
- **Project period:** 2022-05-03 → 2025-05-02

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10459753

## Citation

> US National Institutes of Health, RePORTER application 10459753, The effect of opioids, stimulants, and the simultaneous use of both on the hepatitis C virus (HCV) cascade of care in rural communities in the United States (1F31DA054752-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10459753. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*