IGNITe is a study about substance use and Hepatitis C (HCV) risk in young women based in Appalachia. The goal of IGNITe is to develop an understanding of HCV risk that young women in Appalachia are experiencing to then create an evidence-based harm reduction program for young women who inject drugs. Injection drug use and HCV among young women is dramatically rising in the rural United States. We hope to address this by developing harm reduction services (such as syringe exchange programs) specifically tailored for young women in rural Appalachia.