Prior to 1992, HCV was commonly spread by blood and blood product transfusions. This is now rare as a result of improved blood-bank procedures. Injection drug use is the biggest risk factor for HCV transmission. Spread of HCV can be prevented using methods similar to preventing spread of HIV - using clean injection equipment and not sharing needles. Safer sex practices play a smaller role in prevention because sexual transmission is a minor route of spread.
Treatment has significant side effects.
Most infected people probably become infected from injection drug use. Most transmission likely occurred at least 10 years ago, prior to widespread outreach and education to injection drug users about safer injection practices. Multnomah County will monitor the CDC hepatitis budget, and keep you informed on its status as well as any focused program proposals.