Racialized environments and syringe services program implementation: County-level factors.

Autor: Bluthenthal RN; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: rbluthen@usc.edu., Humphrey JL; RTI International, USA., Strack CN; RTI International, USA., Wenger LD; RTI International, USA., LaKosky P; North American Syringe Exchange Network, Tacoma, WA, USA., Patel SV; RTI International, USA., Kral AH; RTI International, USA., Lambdin B; RTI International, USA.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2024 Oct 01; Vol. 263, pp. 112430. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1016/j.drugalcdep.2024.112430
Abstrakt: Objective: Racialized health inequities in substance use-related harms might emerge from differential access to syringe service programs (SSPs). To explore this, we examined the association between county-level racialized environments, other factors, and (1) SSP presence, and (2) per capita syringe and (3) naloxone distribution.
Methods: 2021 US National Survey of SSP data (n=295/412;72 % response rate) was used to identify SSP presence and the sum of syringes and naloxone doses distributed in 2020 by county. Study measures included racial residential segregation (RRS; i.e., divergence and dissimilarity indexes for Black:Non-Hispanic White & Hispanic:Non-Hispanic White) and covariates (i.e., demographic proportions, urban/suburban/rural classifications, 2020 US presidential Republican vote share, and overdose mortality from 2019). We used logit Generalized Estimating Equations to determine factors associated with county-level SSP presence, and zero inflated negative binomial regression models to determine factors associated with per capita syringe and naloxone distribution.
Results: SSPs were reported in 9 % (283/3106) of US counties. SSP presence was associated with higher divergence and dissimilarity indexes, urban and suburban counties, higher opioid overdose mortality, and lower 2020 Republican presidential vote share. Per capita syringes distributed was associated with lower RRS (divergence and Hispanic:White dissimilarity), lower racially minoritized population proportions and rural counties, while per capita naloxone distribution was associated with lower Hispanic and "other" population proportions, and rural counties.
Conclusions: Racialized environments are associated with SSP presence but not the scope of those programs. Preventing HIV and HCV outbreaks, and overdose deaths requires addressing community level factors that influence SSP implementation and accessibility.
Competing Interests: Declaration of Competing Interest No conflict declared.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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