Houselessness and syringe service program utilization among people who inject drugs in eight rural areas across the USA: a cross-sectional analysis

Harm Reduction Journal

Research

William C. Miller¹  April M. Young²  P. Todd Korthuis³  Mai T. Pho⁴  Vivian F. Go⁵  Peter D. Friedmann⁶  William A. Zule⁷  Hannah L. F. Cooper⁸  Paige Gugerty⁸  Dylan Falk⁸  Harris Greenwood⁸  April M. Ballard⁹  Ryan P. Westergaard^1,10  Wiley D. Jenkins^1,11  Thomas J. Stopka^1,12  Judith Feinberg^1,13  Gordon S. Smith^1,13  David W. Seal^1,14 

[1] College of Public Health, The Ohio State University, Columbus, OH, USA;College of Public Health, University of Kentucky, 111 Washington Avenue, 40536, Lexington, KY, USA;Department of Medicine, Oregon Health & Science University, Portland, OR, USA;Department of Medicine, University of Chicago, Chicago, IL, USA;Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Office of Research, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA;RTI International, Research Triangle Park, NC, USA;Rollins School of Public Health, Emory University, 1518 Clifton Road, 30322, Atlanta, GA, USA;Rollins School of Public Health, Emory University, 1518 Clifton Road, 30322, Atlanta, GA, USA;School of Public Health, Georgia State University, 140 Decatur Street SE, 30303, Atlanta, GA, USA;School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA;School of Medicine, Southern Illinois University, Carbondale, IL, USA;School of Medicine, Tufts University, Boston, MA, USA;School of Medicine, West Virginia University, Morgantown, WV, USA;School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA;

关键词: Houselessness;    Syringe service programs;    Harm reduction;    Rural areas;    Healthcare access;   

DOI  :  10.1186/s12954-023-00892-w

 received in 2023-09-14, accepted in 2023-10-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundResearch conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states.MethodsPWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic characteristics. Using binomial logistic regression, we examined the relationship between experiencing houselessness and any SSP use. To assess the relationship between houselessness and the frequency of SSP use, we conducted multinomial logistic regression analyses among participants reporting any past 30-day SSP use.ResultsAmong 2394 rural PWID, 56.5% had experienced houselessness in the prior 6 months, and 43.5% reported past 30-day SSP use. PWID who had experienced houselessness were more likely to report using an SSP compared to their housed counterparts (adjusted odds ratio [aOR] = 1.24 [95% confidence intervals [CI] 1.01, 1.52]). Among those who had used an SSP at least once (n = 972), those who experienced houselessness were just as likely to report SSP use two (aOR = 0.90 [95% CI 0.60, 1.36]) and three times (aOR = 1.18 [95% CI 0.77, 1.98]) compared to once. However, they were less likely to visit an SSP four or more times compared to once in the prior 30 days (aOR = 0.59 [95% CI 0.40, 0.85]).ConclusionThis study provides evidence that rural PWID who experience houselessness utilize SSPs at similar or higher rates as their housed counterparts. However, housing instability may pose barriers to more frequent SSP use. These findings are significant as people who experience houselessness are at increased risk for drug-related harms and encounter additional challenges when attempting to access SSPs.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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