Challenges of the Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C. Previous research on HIV and hepatitis C (HCV) among people who inject drugs (PWID) has focused on urban or international populations, yet the US opioid epidemic is moving away from metropolitan centers. In this report, researchers examine the increasing rurality of opioid injection, the challenges to treatment and prevention that are unique to rural areas, and the public health interventions needed to address them.