Mehdi Noroozi1, Bahram Armoon2, Hesam Ghisvand1, Alireza Noroozi3,4, Mahmood Karimy5, Mohammad Rafi Bazrafshan6, Brandon D L Marshall7, Bahman Dieji8. 1. Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 2. Student Research Committee, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. 4. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. 5. Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran. 6. Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran. 7. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. 8. Psychosis Research Center, Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract
BACKGROUND/ OBJECTIVES: Injection drug use is one of the major public health problems in Iran. Injection drug use is associated with numerous negative health outcomes, such as blood-borne infections (HIV, HCV) and injection site skin infections (abscesses, cellulitis). The aim of this study was to determine prevalence of injection site skin infections and its associated risk factors among people who inject drugs (PWID) in Tehran, Iran. METHODS: The cross-sectional study was conducted from March to August 2016 in Tehran province. A total of 500 PWID were recruited by convenience and snowball sampling from Drop-in Centers (DIC) in the South of Tehran. Our primary outcomes were self-report of ever having injection sites skin infections and receiving treatment for them. We first examined associations between individual variables and lifetime history of having injection site infections in bivariate analysis using the chi-square or Fisher's exact tests, as appropriate. Variables with P-value <.2 were included in a multiple logistic regression model. RESULTS: Overall, 40% (CI95%: 30.3%, 52.2%) of participants reported ever having an injection site infection. In the multivariable model, those with low socioeconomic status (AOR = 2.4, P = .03), self-reported as HIV positive (AOR =1.6, P = .01), reporting more than 3 injections per day (AOR = 4.1, P = .03) and reuse of their own syringes (AOR = 8.5, P = .03) were more likely to have injection sites skin infections. PWID who used needle and syringe program (NSP) services were less likely to report injection site infections (AOR = 0.5, P = .04). CONCLUSION: We have identified several risk factors for injection sites infections among PWID, including frequency of injection per day, reuse of their own syringes, not using NSP services, HIV status, socioeconomic status with skin infections in PWID. Prevention strategies to reduce skin infections should focus on high-risk injection behaviors and improving access to NSP services.
BACKGROUND/ OBJECTIVES: Injection drug use is one of the major public health problems in Iran. Injection drug use is associated with numerous negative health outcomes, such as blood-borne infections (HIV, HCV) and injection site skin infections (abscesses, cellulitis). The aim of this study was to determine prevalence of injection site skin infections and its associated risk factors among people who inject drugs (PWID) in Tehran, Iran. METHODS: The cross-sectional study was conducted from March to August 2016 in Tehran province. A total of 500 PWID were recruited by convenience and snowball sampling from Drop-in Centers (DIC) in the South of Tehran. Our primary outcomes were self-report of ever having injection sites skin infections and receiving treatment for them. We first examined associations between individual variables and lifetime history of having injection site infections in bivariate analysis using the chi-square or Fisher's exact tests, as appropriate. Variables with P-value <.2 were included in a multiple logistic regression model. RESULTS: Overall, 40% (CI95%: 30.3%, 52.2%) of participants reported ever having an injection site infection. In the multivariable model, those with low socioeconomic status (AOR = 2.4, P = .03), self-reported as HIV positive (AOR =1.6, P = .01), reporting more than 3 injections per day (AOR = 4.1, P = .03) and reuse of their own syringes (AOR = 8.5, P = .03) were more likely to have injection sites skin infections. PWID who used needle and syringe program (NSP) services were less likely to report injection site infections (AOR = 0.5, P = .04). CONCLUSION: We have identified several risk factors for injection sites infections among PWID, including frequency of injection per day, reuse of their own syringes, not using NSP services, HIV status, socioeconomic status with skin infections in PWID. Prevention strategies to reduce skin infections should focus on high-risk injection behaviors and improving access to NSP services.
Authors: Salequl Islam; Damani A Piggott; Alberto Moriggia; Jacquie Astemborski; Shruti H Mehta; David L Thomas; Gregory D Kirk Journal: Harm Reduct J Date: 2019-06-17