Karen Dunleavy1, Vivian Hope2, Kirsty Roy3, Avril Taylor4. 1. School of Media, Culture and Society, University of the West of Scotland, Paisley, PA1 2BE, Scotland, United Kingdom. Electronic address: karen.dunleavy@uws.ac.uk. 2. Public Health Institute, Liverpool John Moores University, Liverpool, England, United Kingdom. 3. Health Protection Scotland, NHS National Services Scotland, Glasgow, Scotland, United Kingdom. 4. School of Media, Culture and Society, University of the West of Scotland, Paisley, PA1 2BE, Scotland, United Kingdom.
Abstract
BACKGROUND: Bacterial skin and soft tissue infections (SSTI) among people who inject drugs (PWID) are considered a public health concern. There is a lack of qualitative research examining the lived experience of PWID who have had SSTI. This paper explores PWID views and experiences of their SSTI, their perceptions on the causes of their SSTI and their harm reduction (HR) behaviours. The implications for HR service delivery and practice will be discussed. METHODS: Between October 2015-January 2016, 22 in-depth interviews were conducted with PWID who had experienced a SSTI within the past year. Interviewees were recruited from an injecting equipment provision service and a drug treatment service in Glasgow and Edinburgh respectively. The interview transcripts were transcribed verbatim and underwent thematic analysis. RESULTS: We found that the experience of SSTI can cause strong negative feelings, including panic and stigma and that there was limited knowledge of SSTI prior to first hand experience. The awareness of the unacceptable social and physical consequences of SSTI fostered a sense of personal responsibility and agency which led to the introduction or improved HR uptake. However, when PWID were struggling to inject or when their physical and political environments were compromised there was an increased risk for SSTI and reduced effectiveness of HR. CONCLUSION: Compared to HCV and HIV, SSTI as an injecting related harm has received less policy attention. Policy makers need to address SSTI HR within enabling environments, such as 'safer environment interventions'. It is recommended that peer based support, improved NSP provision and medically supervised injecting facilities are needed to deliver SSTI HR.
BACKGROUND: Bacterial skin and soft tissue infections (SSTI) among people who inject drugs (PWID) are considered a public health concern. There is a lack of qualitative research examining the lived experience of PWID who have had SSTI. This paper explores PWID views and experiences of their SSTI, their perceptions on the causes of their SSTI and their harm reduction (HR) behaviours. The implications for HR service delivery and practice will be discussed. METHODS: Between October 2015-January 2016, 22 in-depth interviews were conducted with PWID who had experienced a SSTI within the past year. Interviewees were recruited from an injecting equipment provision service and a drug treatment service in Glasgow and Edinburgh respectively. The interview transcripts were transcribed verbatim and underwent thematic analysis. RESULTS: We found that the experience of SSTI can cause strong negative feelings, including panic and stigma and that there was limited knowledge of SSTI prior to first hand experience. The awareness of the unacceptable social and physical consequences of SSTI fostered a sense of personal responsibility and agency which led to the introduction or improved HR uptake. However, when PWID were struggling to inject or when their physical and political environments were compromised there was an increased risk for SSTI and reduced effectiveness of HR. CONCLUSION: Compared to HCV and HIV, SSTI as an injecting related harm has received less policy attention. Policy makers need to address SSTI HR within enabling environments, such as 'safer environment interventions'. It is recommended that peer based support, improved NSP provision and medically supervised injecting facilities are needed to deliver SSTI HR.
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: Kirsten M A Trayner; Andrew McAuley; Norah E Palmateer; David J Goldberg; Samantha J Shepherd; Rory N Gunson; Emily J Tweed; Saket Priyadarshi; Catriona Milosevic; Sharon J Hutchinson Journal: Int J Drug Policy Date: 2020-01-22
Authors: Elissa R Weitzman; Joe Kossowsky; Laura M Blakemore; Rachele Cox; David J Dowling; Ofer Levy; Emma W Needles; Sharon Levy Journal: Clin Infect Dis Date: 2022-08-15 Impact factor: 20.999