{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T23:53:00Z","timestamp":1777765980375,"version":"3.51.4"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260302-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Syringe services programs (SSPs) are evidence-based interventions that reduce bloodborne infections and injection-related harms among people who inject drugs, yet access remains limited and geographically uneven across the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260302-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify the travel time, distance, and cost required to reach the nearest SSP from population-weighted census tracts nationwide and to examine differences by urbanicity, state, and SSP legality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260302-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional geospatial study linked all known SSP locations as of August 2024 to the population-weighted centroids of census tracts in the 50 US states and the District of Columbia. Analyses were conducted between December 2024 and February 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260302-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Population-weighted mean and median driving time, distance, and cost to access the nearest SSP, stratified by National Center for Health Statistics urban-rural county category and SSP legal status. Costs were estimated using 2024 Internal Revenue Service (IRS) medical mileage deduction rates and 2022 state-specific gasoline prices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260302-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 1338 SSPs across 83\u202f780 census tracts, the population-weighted mean 1-way driving time to the nearest SSP was 46.1 minutes (95% CI, 45.7-46.5 minutes) and the median was 23.3 minutes (IQR, 12.2-58.5 minutes). Altogether, 23.1% of the population lived more than 60 minutes from an SSP and 12.6% lived over 120 minutes away. The mean 1-way driving distance was 41.8 miles (95% CI, 41.3-42.2 miles). The mean 1-way driving cost was $8.77 (95% CI, $8.68-$8.86) using the 2024 IRS mileage rate and $6.91 (95% CI, $6.84-$6.98) using state mean gasoline prices in 2022. In states where SSPs were legal, mean driving time was 30.1 minutes (95% CI, 29.8-30.4 minutes) and mean cost by IRS mileage rates was $4.94 (IQR, $4.88-$5.00), compared with 110.7 minutes (95% CI, 109.6-111.8 minutes) and $24.19 (IQR, $23.92-$24.46) in states where SSPs were illegal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260302-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cross-sectional study of travel burden to SSPs found substantial geographic and financial barriers to accessing SSPs across the US, particularly in nonmetropolitan areas. Targeting new SSPs to areas with the greatest travel burden could improve utilization and reduce drug-related morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.9753","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:30:35Z","timestamp":1777476635000},"page":"e269753","source":"Crossref","is-referenced-by-count":0,"title":["Driving Time, Distance, and Cost to Access Syringe Services Programs in the US"],"prefix":"10.1001","volume":"9","author":[{"given":"Spruha","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengni","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann 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Grossman School of Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"issue":"4","key":"zoi260302r3","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf197","article-title":"Injection-related infections and self-treatment practices among people who inject drugs in rural Appalachia.","volume":"12","author":"Fanucchi","year":"2025","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"zoi260302r5","doi-asserted-by":"publisher","first-page":"S118","DOI":"10.1016\/j.amepre.2021.05.044","article-title":"Syringe services programs\u2019 role in ending the HIV epidemic in the US: why we cannot do it without 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