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1.
Harm Reduct J ; 20(1): 157, 2023 10 26.
Article in English | MEDLINE | ID: mdl-37880724

ABSTRACT

BACKGROUND: Research 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. METHODS: PWID 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. RESULTS: Among 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]). CONCLUSION: This 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.


Subject(s)
Drug Users , HIV Infections , Substance Abuse, Intravenous , Humans , Substance Abuse, Intravenous/epidemiology , Needle-Exchange Programs , Cross-Sectional Studies , Data Collection
2.
Health Educ Behav ; 50(4): 473-476, 2023 08.
Article in English | MEDLINE | ID: mdl-37088985

ABSTRACT

Racism impedes the health of communities of color and, more recently, has been declared a public health crisis. Social uprisings in response to the police brutalities in the summer of 2020 have further pushed public health as a discipline to recognize racism as a public health issue. We argue that, as a discipline, we must challenge ourselves to move toward radical public health to achieve health equity. Radical public health requires future and current public health practitioners to discuss the root of health inequities, which we identify as racial capitalism. We (a) discuss racial capitalism and its intersection with public health and (b) critique current anti-racist pedagogy with recommendations on how to move forward. Future public health practitioners must acquaint themselves with racial capitalism and use it as a lens to see all public health problems if they are to dismantle structural racism that perpetuates health inequities.


Subject(s)
Health Equity , Racism , Humans , Public Health , Capitalism , Health Status Disparities , Racial Groups
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