County-Level Vulnerability to HIV and Hepatitis C Outbreaks Due to Injection Drug Use – Tennessee, 2021 Update



Rising drug overdose deaths in Tennessee may be a sign of changing drug-related behaviors, such as increases in injection drug use and/or the types of drugs being injected. This raises the potential for rapid transmission of certain infections that could result in an HIV or HCV outbreak among persons who inject drugs.

To evaluate county-level vulnerability to an outbreak, the Tennessee Department of Health examined socio-economic factors, indicators of opioid-related drug use, access to heathcare, and health outcomes in Tennessee.

Ten measures were used to assess the vulnerability of each county in Tennessee:

Socioeconomic Factors

  • Non-Hispanic white percentage: % of the population of a county that is not Hispanic or Latino and were of white race alone
  • Percentage of population with a disability: % of the population of a county that has a disability
  • High unemployment rate: Was the unemployment rate above TN’s median, 2.7%?

Opioid Use

  • High intensity drug trafficking area: Was the county identified as a 'drug trafficking hot zone' by the department of justice?
  • Buprenorphine prescription rate: The number of people per county filing buprenorphine prescriptions, per 1,000 residents
  • Drug death rate: The rate of deaths related to all drugs, per 100,000 residents

Access to Healthcare

  • Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) Opioid Treatment and Recovery services: Percent of individuals aged 12 years or older receiving TDMHSAS funded substance abuse treatment and recovery services for any opioid abuse
  • Behavioral Health services: Rate of uninsured individuals receiving Behavioral Health Safety Net Services, per 1,000 residents

Health Outcomes

  • Years of potential life lost: Years of potential life lost before age 75 per 100,000 population (age-adjusted)
  • Rate of injury related deaths: Injury related deaths, per 100,000 residents

What this means: Socioeconomic status, health outcomes, treatment access, and opioid prescribing may be driving Tennessee’s vulnerability to HIV or hepatitis C virus (HCV) outbreaks. By sharing this information with local stakeholders, policymakers, and program planners, additional resources can be committed to provide the evidence-based services to prevent HIV and HCV transmission.

Select below to see the public health region profiles

Contact Us:

Syringe Services Programs, HIV prevention, or HIV care: HIVSTI.info@tn.gov

Viral Hepatitis Case Navigation or Harm Reduction Resource Teams: VH.Health@tn.gov

Overdose prevention, substance use disorder treatment, or recovery services: health.opioidresponse@tn.gov