The opioid epidemic in the United States has contributed to a rise in drug injection-related disease transmission and infection. People who inject drugs (PWID) are at an increased risk of developing bacterial infections such as Methicillin-resistant Staphylococcus aureus (MRSA). This study examines the prevalence and correlates of MRSA infections and related abscesses amongst PWID in San Diego, California, and Tijuana, Mexico, to better inform harm reduction practices. This is a cross-sectional study conducted from June 2022 until November 2022 in which PWID (N = 187) participating in an ongoing cohort study completed interviewer-administered questionnaires and MRSA swabs nasally and at abscess sites (if present). Chi-Square Tests of Independence, Fisher’s Exact Tests, and Wilcoxon Rank Sum Tests were used to identify potential risk factors. Analysis revealed significant associations between injection practices, structural factors (e.g. homelessness), and prevalent MRSA infections. These positive associations between arm injections, homelessness, and MRSA infections emphasize the need for structural interventions that reduce the barriers PWID face when accessing resources that would improve their health outcomes.