Evidence map›Paper›PMID 41564493›Full record

ArticleDrug and alcohol dependence2026

Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California.

Esther O Chung, Bradley Ray, Jamie L Humphrey, Megan Lindstrom, Cariné E Megerian, Barrot H Lambdin, Alex H Kral

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Esther O ChungRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States. Electronic address: echung@rti.org.
Bradley RayRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States.
Jamie L HumphreyRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States.
Megan LindstromRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States.
Cariné E MegerianRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States.
Barrot H LambdinRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States; University of California San Francisco, 1500 Owens St, San Francisco, CA 94158, USA.
Alex H KralRTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States.

Funding

Assessing the Reach, Effectiveness, and Implementation of Multiple InterventionsR01DA057613 · NIDA · RESEARCH TRIANGLE INSTITUTE · PI ALEXANDER H KRAL · 2022 to 2026
$3.6M
NIDA NIH HHS R01 DA057613
6 · The paper itself

Abstract

backgroundSyringe services programs (SSPs) are a cornerstone of preventing infectious disease and overdose for people who use drugs. Given efforts to achieve universal access, we examined factors associated with SSP use, including proximity.

methodsWe used cross-sectional data from 713 people who use drugs across San Francisco, California (September 2023-September 2024). We assessed proximity to an SSP by calculating the walking time between where participants slept the night before and nearest SSP location. We conducted multivariable negative binomial models to explore factors associated with SSP use and assess whether the association between proximity and SSP use was modified by race-ethnicity.

resultsAlmost 80 % of participants used an SSP at least once in the past 3 months. Age, race-ethnicity, mode of use, and proximity to SSP were negatively associated with SSP use. Participants who only smoked used SSPs less often than those who used in other ways (adjusted rate ratio [aRR]=0.77, 95 % CI: 0.61-0.97), as well as those more than a 20-minute walk to an SSP (aRR=0.54, 95 % CI: 0.36-0.83). The effect size between walking time to SSP and SSP use was substantially larger for Black participants than non-Black (Black: aRR=0.38, 95 % CI: 0.15-0.60 vs. non-Black: aRR=0.72, 95 % CI: 0.40-1.31).

conclusionsGeographic distance was a barrier to SSP use, especially for Black participants. SSPs may not reach people who only smoke drugs. SSPs should be added to areas with limited geographic access and include safer smoking supply distribution.

Indexed as

Needle-Exchange ProgramsSubstance Abuse, IntravenousAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedSan FranciscoSociodemographic FactorsYoung AdultPeople who use drugsSpatial analysisSyringe services programs

Identifiers

PMID41564493
PMCPMC13182906

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.