Late last year, the CDC released a vulnerability index which identified six indicators associated with the HIV/Hepatitis C virus (HCV) outbreak among people who inject drugs (PWID) in Scott County, Indiana in 2015. Recognizing that this issue extended beyond one locality, CDC assessed the same indicators in 3,143 rural counties across the U.S. to detect jurisdictions that may be at risk for a similar drug user health emergency.
Subsequently, CDC published “County Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States,” a report highlighting 220 counties in the nation that are most vulnerable (top 5%) to an HIV/HCV outbreak similar to that in Scott County. CDC recently released a supplemental appendix, which thoroughly explains the vulnerability assessment’s research methodology and contains county-level vulnerability data. The data may be used to assist jurisdictions with vulnerable counties in advancing preparedness activities such as emergency response planning and targeted HIV/HCV testing to PWID.
As a note, it is neither epidemiologically nor scientifically correct to compare or rank vulnerability scores across the most vulnerable counties and states, since their values are essentially considered equivalent. Further, it is important to note that the identification of vulnerability does not mean that an HIV or HCV outbreak is inevitable or that there is a current problem. State and local public health officials can better assess actual vulnerability by examining more detailed data that is available locally and not reported nationally.