Maria Elisa Smith1, Natanya Robinowitz, Patrick Chaulk, Kristine E Johnson. 1. From the Department of Medicine (MES, KEJ), Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD; and Baltimore City Health Department (NR, PC), Baltimore, MD.
Abstract
OBJECTIVES: Abscesses and chronic wounds are common among injection drug users (IDUs) though chronic wounds have been understudied. We assessed the risk factors associated with both acute and chronic wounds within a community-based population of IDUs frequenting the Baltimore City Needle Exchange Program (BNEP). METHODS: We performed a cross-sectional study of BNEP clients aged 18 years or more who completed an in-person survey regarding active or prior wounds including abscesses (duration <8 weeks) and chronic wounds (duration ≥8 weeks), injection practices, and skin care. Factors associated with wounds were analyzed using univariate and multivariate logistic regressions. RESULTS: Of the 152 participants, 63.2% were men, 49.3% were white, 44.7% were African American, 34.9% had any type of current wound, 17.8% had an active abscess, and 19.7% had a current chronic wound. Abscesses were more common in women (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.10-5.97) and those reporting skin-popping (OR, 5.38; 95% CI, 1.85-15.67). In a multivariate model, risk factors for an abscess included injecting with a family member/partner (adjusted OR [AOR], 4.06; 95% CI, 0.99-16.58). In a multivariable analysis of current chronic wounds, cleaning skin with alcohol before injection was protective (AOR, 0.061; 95% CI, 0.0064-0.58). CONCLUSIONS: Abscesses and chronic wounds were prevalent among a sample of IDUs in Baltimore. Abscesses were associated with injection practices, and chronic wounds seemed linked to varying skin and tool cleaning practices. There is a pressing need for wound-related education and treatment efforts among IDUs who are at greatest risk for skin-related morbidity.
OBJECTIVES: Abscesses and chronic wounds are common among injection drug users (IDUs) though chronic wounds have been understudied. We assessed the risk factors associated with both acute and chronic wounds within a community-based population of IDUs frequenting the Baltimore City Needle Exchange Program (BNEP). METHODS: We performed a cross-sectional study of BNEP clients aged 18 years or more who completed an in-person survey regarding active or prior wounds including abscesses (duration <8 weeks) and chronic wounds (duration ≥8 weeks), injection practices, and skin care. Factors associated with wounds were analyzed using univariate and multivariate logistic regressions. RESULTS: Of the 152 participants, 63.2% were men, 49.3% were white, 44.7% were African American, 34.9% had any type of current wound, 17.8% had an active abscess, and 19.7% had a current chronic wound. Abscesses were more common in women (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.10-5.97) and those reporting skin-popping (OR, 5.38; 95% CI, 1.85-15.67). In a multivariate model, risk factors for an abscess included injecting with a family member/partner (adjusted OR [AOR], 4.06; 95% CI, 0.99-16.58). In a multivariable analysis of current chronic wounds, cleaning skin with alcohol before injection was protective (AOR, 0.061; 95% CI, 0.0064-0.58). CONCLUSIONS: Abscesses and chronic wounds were prevalent among a sample of IDUs in Baltimore. Abscesses were associated with injection practices, and chronic wounds seemed linked to varying skin and tool cleaning practices. There is a pressing need for wound-related education and treatment efforts among IDUs who are at greatest risk for skin-related morbidity.
Authors: Bianca Quagliarello; Christian Cespedes; Maureen Miller; Aixsa Toro; Peter Vavagiakis; Robert S Klein; Franklin D Lowy Journal: Clin Infect Dis Date: 2002-08-16 Impact factor: 9.079
Authors: Simon J Palfreyman; Angela M Tod; Brenda King; Darlene Tomlinson; John E Brazier; Jonathan A Michaels Journal: J Adv Nurs Date: 2007-05-01 Impact factor: 3.187
Authors: Kristina T Phillips; Bradley J Anderson; Debra S Herman; Jane M Liebschutz; Michael D Stein Journal: J Addict Med Date: 2017 Nov/Dec Impact factor: 3.702
Authors: Christina E Freibott; Kristina T Phillips; Bradley J Anderson; Catherine Stewart; Jane M Liebschutz; Michael D Stein Journal: J Addict Med Date: 2022 Mar-Apr 01 Impact factor: 3.702
Authors: Shannon R Kenney; Kristina T Phillips; Debra S Herman; Julia Keosaian; Bradley J Anderson; Michael D Stein Journal: J Addict Med Date: 2020 May/Jun Impact factor: 4.647
Authors: Raagini Jawa; Michael D Stein; Bradley Anderson; Jane M Liebschutz; Catherine Stewart; Kristina T Phillips; Joshua A Barocas Journal: Int J Drug Policy Date: 2021-03-18
Authors: Kristina T Phillips; Catherine Stewart; Bradley J Anderson; Jane M Liebschutz; Debra S Herman; Michael D Stein Journal: Drug Alcohol Depend Date: 2021-02-27 Impact factor: 4.492