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Behavioral characteristics and injection practices associated with skin and soft tissue infections among people who inject drugs : A community-based observational study

Dahlman, Disa LU ; Håkansson, Anders LU ; Kral, Alex H.; Wenger, Lynn; Ball, Elizabeth L. and Novak, Scott P. (2017) In Substance Abuse 38(1). p.105-112
Abstract

Background: People who inject drugs (PWID) are at increased risk for bacterial skin and soft tissue infections (SSTIs). Although SSTIs pose significant health risks, little is known about their prevalence and characteristics in the population of PWID in the United States. This study investigates whether behavioral factors related to skin and equipment hygiene and tissue-damaging injection practices are associated with recent SSTIs among PWID. Methods: Active PWID were recruited using targeted sampling in San Francisco in 2011–2013. Interviewers collected information on behavioral risk factors of past-month self-reported SSTIs. Inferential analyses used multivariate logistic regression methods (i.e., generalized linear model) to... (More)

Background: People who inject drugs (PWID) are at increased risk for bacterial skin and soft tissue infections (SSTIs). Although SSTIs pose significant health risks, little is known about their prevalence and characteristics in the population of PWID in the United States. This study investigates whether behavioral factors related to skin and equipment hygiene and tissue-damaging injection practices are associated with recent SSTIs among PWID. Methods: Active PWID were recruited using targeted sampling in San Francisco in 2011–2013. Interviewers collected information on behavioral risk factors of past-month self-reported SSTIs. Inferential analyses used multivariate logistic regression methods (i.e., generalized linear model) to characterize risk factors for past-month SSTIs. Results: The self-reported prevalence of lifetime, past-year, and past-month SSTI was 70%, 29%, and 11%, respectively. Several factors were significantly associated with past-month SSTIs in bivariate analysis, including injecting nonpowder drugs (odds ratio [OR] = 3.57; 95% confidence interval [CI] = 1.23, 10.35; P = .01), needle-licking before injection (OR = 3.36; 95% CI = 1.28, 8.81; P = .01), injecting with someone else's preused syringe/needle (OR = 7.97; 95% CI = 2.46, 25.83; P < .001), being injected by another person (OR = 2.63; 95% CI = 1.02, 6.78; P = .04), infrequent skin cleaning before injection (OR = 2.47; 95% CI = 1.00, 6.10; P = .04), and frequent injections (P = .02). In multivariate analysis, only syringe/needle sharing (adjusted OR = 6.38; 95% CI = 1.90, 21.46) remained statistically significant. Conclusion: SSTIs are common among PWID. These data highlight the importance of clinical and public health screening efforts to reduce SSTIs. Needle exchange programs may be good venues for SSTIs screening and treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, injection drug use, PWID, skin and soft tissue infection, street drugs
in
Substance Abuse
volume
38
issue
1
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85007427949
  • wos:000396601600021
ISSN
0889-7077
DOI
10.1080/08897077.2016.1263592
language
English
LU publication?
yes
id
1aaadf2d-4020-4a51-a78f-47535e174012
date added to LUP
2017-01-13 07:21:08
date last changed
2018-01-07 11:44:43
@article{1aaadf2d-4020-4a51-a78f-47535e174012,
  abstract     = {<p>Background: People who inject drugs (PWID) are at increased risk for bacterial skin and soft tissue infections (SSTIs). Although SSTIs pose significant health risks, little is known about their prevalence and characteristics in the population of PWID in the United States. This study investigates whether behavioral factors related to skin and equipment hygiene and tissue-damaging injection practices are associated with recent SSTIs among PWID. Methods: Active PWID were recruited using targeted sampling in San Francisco in 2011–2013. Interviewers collected information on behavioral risk factors of past-month self-reported SSTIs. Inferential analyses used multivariate logistic regression methods (i.e., generalized linear model) to characterize risk factors for past-month SSTIs. Results: The self-reported prevalence of lifetime, past-year, and past-month SSTI was 70%, 29%, and 11%, respectively. Several factors were significantly associated with past-month SSTIs in bivariate analysis, including injecting nonpowder drugs (odds ratio [OR] = 3.57; 95% confidence interval [CI] = 1.23, 10.35; P = .01), needle-licking before injection (OR = 3.36; 95% CI = 1.28, 8.81; P = .01), injecting with someone else's preused syringe/needle (OR = 7.97; 95% CI = 2.46, 25.83; P &lt; .001), being injected by another person (OR = 2.63; 95% CI = 1.02, 6.78; P = .04), infrequent skin cleaning before injection (OR = 2.47; 95% CI = 1.00, 6.10; P = .04), and frequent injections (P = .02). In multivariate analysis, only syringe/needle sharing (adjusted OR = 6.38; 95% CI = 1.90, 21.46) remained statistically significant. Conclusion: SSTIs are common among PWID. These data highlight the importance of clinical and public health screening efforts to reduce SSTIs. Needle exchange programs may be good venues for SSTIs screening and treatment.</p>},
  author       = {Dahlman, Disa and Håkansson, Anders and Kral, Alex H. and Wenger, Lynn and Ball, Elizabeth L. and Novak, Scott P.},
  issn         = {0889-7077},
  keyword      = {Epidemiology,injection drug use,PWID,skin and soft tissue infection,street drugs},
  language     = {eng},
  number       = {1},
  pages        = {105--112},
  publisher    = {Taylor & Francis},
  series       = {Substance Abuse},
  title        = {Behavioral characteristics and injection practices associated with skin and soft tissue infections among people who inject drugs : A community-based observational study},
  url          = {http://dx.doi.org/10.1080/08897077.2016.1263592},
  volume       = {38},
  year         = {2017},
}