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

Table 5 Adjusted multinomial logistic regression associations between houselessness and the frequency of SSP use in the prior 30 days among Rural Opioid Initiative PWID and used an SSP at least once in the prior 30 days (n = 972)

Characteristic	Frequency of SSP use^b
	Twice versus once		Three times versus once		Four or more times versus once
	aOR	(95% CI)	aOR	95% CI	aOR	95% CI
Experienced houselessness^a	0.90	(0.60, 1.36)	1.23	(0.77, 1.98)	0.59	(0.40, 0.85)
Drug Use^b
Heroin	2.31	(1.43, 3.75)	2.47	(1.39, 4.40)	2.81	(1.75, 4.52)
Street fentanyl	0.93	(0.56, 1.54)	0.94	(0.55, 1.60)	1.17	(0.74, 1.84)
Opiate painkillers	0.79	(0.51, 1.20)	1.43	(0.89, 2.29)	1.77	(1.20, 2.61)
Proximity to SSP
Walking distance	Ref	–	Ref	–	Ref	–
< 30-min drive	0.70	(0.46, 1.07)	0.60	(0.37, 0.96)	0.45	(0.31, 0.68)
> 30-min drive	0.49	(0.25, 0.99)	0.34	(0.14, 0.82)	0.33	(0.17, 0.65)
No program reasonably close	0.16	(0.02, 1.44)	0.22	(0.02, 2.00)	0.39	(0.09, 1.65)

Bold indicates statistically significant at p < 0.05
SSP Syringe service program, PWID people who inject drugs, aOR adjusted odds ratios, CI confidence interval
Multivariable regression was performed excluding participants who reported ‘don’t know how close an SSP is’ (n = 5) because model would not converge due to small cell sizes
^aReference period: prior 6 months
^bReference period: prior 30 days

ISSN: 1477-7517