Maximizing order or harm? Arrests among a social network of people who inject drugs in a large urban city

Abstract Encountering the criminal justice system at the first point of entry---an arrest---is associated with heightened HIV and Hepatitis risk behavior among people who inject drugs (PWIDS). Intervening structurally through the criminal justice system impacts public health; therefore, determining arrest patterns is an important tool for risk reduction. Among a sample of 740 PWIDs, and their social network members recruited from predominantly African-American neighborhoods in Baltimore City, a third were recently arrested in the previous six months, and of those, the arrests were disproportionately African-American persons and characterized as nonviolent, i.e., drug possession/attempt to purchase (38%) and loitering (29%). Poisson regression models were built adjusted for age, sex, race, education level, homelessness, and monthly income after exploring bivariable characteristics of arrests using chi-squared tests. Active drug use was associated with a recent arrest (adjusted prevalence ratio: aPR 2.38 95% CI 1.6, 3.6), in addition to participants who recently reported attending a syringe exchange program (aPR 1.45 95% CI 1.1, 2.0). Our findings are suggestive of recent media coverage and burgeoning research revealing the prioritization of policing resources toward both communities of color and neighborhoods of intensified drug trafficking. Further research is warranted to contextualize the operationalization of criminal justice resources and the impact on community health.