The impact of the opioid epidemic on infectious disease transmission is an important public health issue. The problem came dramatically to light in 2015 when an outbreak of new human immunodeficiency virus (HIV) infections occurred in rural Scott County, Indiana.
This qualitative study explores the experiences of community health centers (CHC) in caring for people with opioid use disorder (OUD) and preventing HIV and hepatitis C (HCV) based on semi-structured discussions held with staff in eight CHCs located in the Appalachian region, the West, and the Northeast.
Key results from talking to CHC staff include a variety of administrative, social, and financial challenges they face in providing prevention and treatment of OUD and reduction in risk. These challenges include gaps in state and county systems for monitoring prescriptions of opioid medications; staffing, particularly for behavioral health providers; stigma that attaches to drug use, drug use treatment, and infectious diseases; and integration of primary care can behavioral health care. The most significant financial challenge is sustainably providing screening and treatment for HCV.
All of the CHCs are very active in pursuing collaborations with community-based organizations and local governments to provide prevention and treatment services. Many of the CHCs use telehealth technologies to collaborate with specialists in behavioral health and other opioid use and infectious disease issues.
CHCs are engaged in a wide range of activities that aim to provide information to the public about OUD and its connection to infectious diseases. Most of the CHCs have been involved in public events, such as health fairs, that focus on public education. CHC staff are also actively involved in training local providers and writing opinion pieces in local newspapers.