The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4188.0: Tuesday, November 18, 2003 - 2:45 PM

Abstract #62712

Abscesses and cellulitis common among injection drug users attending needle exchange

Kristen C. Ochoa, MSIII, Keck School of Medicine, University of Southern California, 1333 San Pablo Street, MCH 51-C, Los Angeles, CA 90089-9152, 323-547-1813, kochoa@usc.edu, Terry L. Hair, PharmD, MPH, Clean Needles Now, Harm Reduction Central, 4201 Wilshire Blvd. Ste. 527, Los Angeles, CA 90010-3601, Keith G. Heinzerling, MD, RWJ Clinical Scholars Program, UCLA Department of Medicine, 911 Broxton Ave. #307, Los Angeles, CA 90024, and Justeen Hyde, PhD, Division of Adolescent Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #2, Los Angeles, CA 90027.

Background: Soft tissue infections (STIs) are a common complication of injection drug use. We examine the prevalence, risk factors, experiences and knowledge and beliefs of injection drug users (IDUs) attending needle exchange in Los Angeles. Methods: Using a structured questionnaire, IDUs were interviewed at downtown and Skid Row sites, where the majority of clients are homeless. Participants who reported STIs were examined. Results: Among 101 IDU, the median age was 48 (range 21-75), and the median years injecting was 20 (range 1-50). 65% were men, 54% African American, 19% Latino, and 91% injected heroin. 87% had ever had an abscess, and 25% had a current abscess. The median number of lifetime abscesses was 3.5 (range 1-100). 68% had ever visited the ER for an abscess, most (95%) visited a public hospital. 48% had ever been hospitalized, most (96%) stayed in a public hospital. 69% have ever delayed treatment for an STI, 38% attributing this to fear of poor treatment by medical providers. Only 32% identified the cause of an STI to be bacterial infection. In a stepwise multivariate regression model, being female (OR 2.8), skin popping (OR 3.0) and number of punctures required to administer drug (OR 1.9) were independently associated with number of lifetime abscesses. Conclusions: STIs are a common health problem among IDUs. Most delay treatment, resulting in the high use of public emergency and inpatient services. Prevention efforts alongside low-threshold, on-site medical care at needle exchange could reduce treatment barriers and public healthcare costs associated with STIs.

Learning Objectives:

Keywords: Injection Drug Users, Barriers to Care

Related Web page: www.cleanneedlesnow.org

Presenting author's disclosure statement:
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.

Health Needs and Service Use Among Homeless People

The 131st Annual Meeting (November 15-19, 2003) of APHA