BACKGROUND: Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking. METHODS: Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months. RESULTS: Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.08-10.00), smoking methamphetamine (aOR 1.65, 95% CI 1.05-2.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.18-3.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.15-3.96). CONCLUSIONS: Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk.
BACKGROUND: Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking. METHODS: Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months. RESULTS: Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.08-10.00), smoking methamphetamine (aOR 1.65, 95% CI 1.05-2.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.18-3.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.15-3.96). CONCLUSIONS: Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk.
Authors: Sophia V Kazakova; Jeffrey C Hageman; Matthew Matava; Arjun Srinivasan; Larry Phelan; Bernard Garfinkel; Thomas Boo; Sigrid McAllister; Jim Anderson; Bette Jensen; Doug Dodson; David Lonsway; Linda K McDougal; Matthew Arduino; Victoria J Fraser; George Killgore; Fred C Tenover; Sara Cody; Daniel B Jernigan Journal: N Engl J Med Date: 2005-02-03 Impact factor: 91.245
Authors: Steffanie A Strathdee; Remedios Lozada; Robin A Pollini; Kimberly C Brouwer; Andrea Mantsios; Daniela A Abramovitz; Tim Rhodes; Carl A Latkin; Oralia Loza; Jorge Alvelais; Carlos Magis-Rodriguez; Thomas L Patterson Journal: J Acquir Immune Defic Syndr Date: 2008-03-01 Impact factor: 3.731
Authors: Adam L Cohen; Carrie Shuler; Sigrid McAllister; Gregory E Fosheim; Michael G Brown; Debra Abercrombie; Karen Anderson; Linda K McDougal; Cherie Drenzek; Katie Arnold; Daniel Jernigan; Rachel Gorwitz Journal: Emerg Infect Dis Date: 2007-11 Impact factor: 6.883
Authors: Daniel Ciccarone; George Jay Unick; Jenny K Cohen; Sarah G Mars; Daniel Rosenblum Journal: Drug Alcohol Depend Date: 2016-04-14 Impact factor: 4.492
Authors: Leo Beletsky; Gustavo Martinez; Tommi Gaines; Lucie Nguyen; Remedios Lozada; Gudelia Rangel; Alicia Vera; Heather L McCauley; Andrea Sorensen; Steffanie A Strathdee Journal: Rev Panam Salud Publica Date: 2012-05
Authors: David S Fink; Suzanne P Lindsay; Donald J Slymen; Alex H Kral; Ricky N Bluthenthal Journal: Subst Use Misuse Date: 2013-04-12 Impact factor: 2.164
Authors: Robin A Pollini; Remedios Lozada; Manuel Gallardo; Perth Rosen; Alicia Vera; Armando Macias; Lawrence A Palinkas; Steffanie A Strathdee Journal: AIDS Behav Date: 2010-06
Authors: Miguel Pinedo; Jose Luis Burgos; Maria Luisa Zuniga; Ramona Perez; Caroline A Macera; Victoria D Ojeda Journal: J Stud Alcohol Drugs Date: 2015-09 Impact factor: 2.582
Authors: Alysse G Wurcel; Deirdre Burke; Margie Skeer; David Landy; Robert Heimer; John B Wong; Kenneth K H Chui; Thomas J Stopka Journal: Drug Alcohol Depend Date: 2018-02-20 Impact factor: 4.492
Authors: Dan Werb; María Elena Medina Mora; Leo Beletsky; Claudia Rafful; Tim Mackey; Jaime Arredondo; Steffanie A Strathdee Journal: Int J Drug Policy Date: 2014-06-02