Background: Most literature regarding abscesses in injection drug users (IDUs) refers to use of powdered white heroin. Few studies have examined the behavioral risk factors for abscesses in injectors of “black tar” heroin (BTH). Methods: This cross-methodological study used clinical and ethnographic observational data and a hypothesis-driven epidemiological investigation. Data were obtained from: (1) ongoing ethnographic immersion in a homeless encampment of older IDUs starting in fall 1998; (2) clinical observations and focused interviews with young adults recruited from a needle exchange program, and (3) 1049 street-recruited IDUs enrolled in the Urban Health Study (UHS), a longitudinal epidemiological study, in six San Francisco Bay Area sites during summer 1999. UHS participants (n=1049) received a structured interview by trained staff, HIV testing, and an examination by an experienced medical provider for evidence of abscesses, which were graded according to pre-determined guidelines. Results: The median age of UHS participants was 46 years; 69% were male, 56% African American, 30% Caucasian and 6% Latino(a); 11.6% tested HIV positive. 195/1049 (18.6%) had a probable or definite abscess on examination. Multivariate analyses are underway and will be presented. Qualitative observations revealed many injection-related practices which may be involved in abscess formation including: syringe reuse; poor skin hygiene; needle contamination by mouth, finger or surface contact; deep tissue injection following failure to intravenously inject. Clinically interviewed IDUs often suspect and attribute contaminated BTH for causing their abscesses. Conclusion: Abscesses represent a hidden epidemic of suffering in IDUs. Ongoing cross-methodological study will help formulate useful prevention strategies.
Learning Objectives: Describe the behavioral risk factors for abscesses in injection drug users
Keywords: Injecting Drug Use, Pathogens
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.