Bridging the Hepatitis C Treatment Gap in Rural America

April 27, 2026
Rural town with one road, few houses, changing leaf colors outside

Over the past decade, major medical advancements have transformed the landscape of hepatitis C treatment. Today’s treatments are safe, simple, and highly effective—curing more than 95 percent of those treated.1 Yet despite this progress, access to hepatitis C testing and care remains a significant challenge, particularly in rural America, where communities face long-standing barriers to health services.

About Hepatitis C

  • Hepatitis C is a viral infection caused by the hepatitis C virus (HCV).
  • HCV is most often spread through blood-to-blood contact.
  • For some people, hepatitis C is a short-term illness, but about half of those infected with HCV develop long-term, chronic infection.2
  • Without treatment, chronic hepatitis C can lead to serious liver problems, including liver cancer and death from liver-related disease.

People living in rural communities experience unique social, economic, and structural challenges that increase their vulnerability to hepatitis C and hinder their access to prevention and treatment services. Higher poverty rates, economic instability, and increased rates of injection drug use—one of the primary modes of hepatitis C transmission—contribute to elevated risk in rural communities. These challenges are compounded by barriers to accessing health services, including limited public transportation, greater distances to healthcare facilities, and a higher likelihood of being underinsured or uninsured.3

Rural healthcare systems themselves are often under strain. Many rural areas experience ongoing shortages of healthcare providers, limited access to specialty care, and under-resourced facilities, which can make hepatitis C diagnosis and care more difficult. As a result, many healthcare sites—particularly in resource-limited rural communities—do not offer hepatitis C testing or treatment services.4 Infectious disease prevention services are also less available, making it challenging to curb the spread of the virus.3

Stigma further complicates access to hepatitis C care. In small, close-knit rural communities, concerns about privacy and confidentiality can deter people from seeking testing or treatment. Stigma from healthcare providers, such as use of judgmental language or assumptions that patients are unlikely to adhere to treatment, can also discourage individuals from accessing services. This can be particularly problematic in areas where healthcare options are already limited.

These barriers coincide with a steep rise in hepatitis C infections. Over the last decade, the annual number of new infections has more than doubled,5 with rural communities disproportionately affected. In fact, rural areas are experiencing twice the number of new hepatitis C infections as urban areas.6

With targeted investments and evidence-based strategies, however, reversing this trend is not just possible—it’s within reach. Several promising approaches are already demonstrating success:

  • Telehealth—including mobile interventions—has expanded access to treatment in rural areas and has shown to be particularly effective when paired with peer support.7
  • Co-located hepatitis C treatment within existing healthcare service settings can meet people where they are and reduce missed opportunities for care.
  • Advancements in rapid “test and treat” models allow patients to begin curative therapy in a single visit, reducing the likelihood of patients falling through the cracks.

The tools to eliminate hepatitis C exist, but a cure will only become reality with a sustained commitment to making care more accessible in rural communities. Recognizing and understanding the social, economic, and structural challenges rural residents face is a critical step toward addressing the disproportionate burden of hepatitis C in those communities and ensuring that progress in treatment translates to meaningful population-level impact. Achieving hepatitis C elimination in rural America is not only possible, but a public health imperative.

References

  1. Centers for Disease Control and Prevention. (2025, January 31). Clinical care of hepatitis C. https://www.cdc.gov/hepatitis-c/hcp/clinical-care/index.html 
  2. Centers for Disease Control and Prevention. (2023, August 7). Hepatitis C surveillance. https://www.cdc.gov/hepatitis-surveillance-2021/hepatitis-c/ 
  3. Walters, S. M., et al. (2023). How the rural risk environment underpins hepatitis C risk. The International Journal on Drug Policy, 112, 103930. https://doi.org/10.1016/j.drugpo.2022.103930 
  4. Awan, O. (2024, January 16). What the hepatitis C crisis says about the U.S. healthcare system. Forbes. https://www.forbes.com/sites/omerawan/2024/01/16/the-hepatitis-c-crisis-epitomizes-the-problems-with-us-healthcare/ 
  5. Lewis, K. C., et al. (2023). Clinical Infectious Diseases, 77(10), 1413–1415. https://doi.org/10.1093/cid/ciad411 
  6. Gordon, S. C. (2018). Gastroenterology & Hepatology, 14(12), 720–722. https://pmc.ncbi.nlm.nih.gov/articles/PMC6383161/ 

  7. Seaman, A., et al. (2025). Clinical Infectious Diseases, 80(3), 501–508. https://doi.org/10.1093/cid/ciae520 

     

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