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ding the need for an additional hand radiograph. Following many years of decline, HIV diagnoses attributed to injection drug use (IDU) in the United States increased in 2015, the year of a large outbreak among persons who inject drugs (PWID) in Indiana. We assessed trends in HIV diagnoses among PWID across the urban-rural continuum. We conducted national and county-level analyses of diagnoses among persons aged ≥13 years with HIV attributed to IDU only and reported to the National HIV Surveillance System through December 2019; county of residence

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