Assessing geographic and individual level factors associated with arrests among injection drug users in California.

Law enforcement strategies to reduce street-based drug activity are often concentrated in neighborhoods with high levels of social and economic disadvantage. Intensive street-level policing is associated with fear and reluctance on the part of injection drug users (IDUs) to utilize syringe exchange programs (SEPs). We aim to build on previous research by analyzing the influence of zip code and individual level factors on the probability of arrest among IDUs in California. Individual characteristics and behaviors were more strongly associated with arrest than zip code characteristics. However, living in a disadvantaged zip code exerted a protective effect against arrest after adjusting for individual level factors (AOR 0.7, 95% 0.5, 0.9). Further efforts to contextualize the circumstances surrounding an arrest, including the characteristics of the geographic setting, may be useful for understanding how law enforcement practices impact the success of SEPs and the health of injection drug users.