Objectives. To demonstrate how we applied the capture?recapture method for population estimation directly in a rural Appalachian county (Cabell County, WV) to estimate the number of people who inject drugs (PWID).Methods. We conducted 2 separate 2-week periods of data collection in June (?capture?) and July (?recapture?) 2018. We recruited PWID from a syringe services program and in community locations where PWID were known to congregate. Participants completed a survey that included measures related to sociodemographics, substance use, and HIV and hepatitis C virus prevention.Results. In total, 797 surveys were completed; of these surveys, 49.6% (n?=?395) reflected PWID who reported injection drug use in the past 6 months and Cabell County residence. We estimated that there were 1857 (95% confidence interval?=?1147, 2567) PWID in Cabell County. Among these individuals, most reported being White (83.4%), younger than 40 years (70.9%), and male (59.5%). The majority reported injecting heroin (82.0%), methamphetamine (71.0%), and fentanyl (56.3%) in the past 6 months.Conclusions. Capture?recapture methods can be applied in rural settings to estimate the size of PWID populations.
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