Injection site infections and injuries in men who inject image- and performance-enhancing drugs: prevalence, risks factors, and healthcare seeking

Abstract

People who inject drugs are vulnerable to infections and injuries at injection sites, but these have rarely been studied in those injecting image- and performance-enhancing drugs (IPEDs). This study examined the factors associated with reported symptoms of injection site infections and injuries in IPED injectors. Of the 366 male IPED injectors surveyed, 42% reported ever having redness, swelling and tenderness (36% in the preceding year), and 6·8% had ever had an abscess or open wound at an injection site. Having these symptoms was associated with a range of factors related to drug use and healthcare utilization. One sixth (17%) of those reporting redness, tenderness and swelling had ever sought treatment, as had the majority (76%) of those reporting an abscess, sore or open wound. Most common sources of advice were emergency clinics and General Practitioners. Interventions are needed to support access to appropriate injecting equipment and provide targeted harm reduction advice.

Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia

“…Logistic regression was used to estimate crude and adjusted odds ratios (AOR) and associated 95% confidence intervals (CI). Factors hypothesised to be associated with concurrent use of PIEDs and psychoactive drugs included age , educational attainment , injection and sexual risk behaviour , injection‐related injuries , uptake of HIV and HCV testing and serostatus , with all variables considered in a single fitted logistic regression model. All analyses were conducted using STATA software version 14.2 (State Corporation College Stations, TX, USA).…”

“… point out, harms associated with injection of PIEDs extend beyond the transmission of blood borne viruses (BBV). Injection site infections and injuries are common, with 6–8% of people who inject PIEDs reporting ever experiencing an abscess or open wound in the UK . Other sequelae include cardiovascular disease, liver damage and psychological comorbidities, such as dependence, mood syndromes and body image disorders .…”

Anabolic androgenic steroid abuse in the United Kingdom: An update

“…There is a high incidence of injection site infection and injury reported by anabolic androgenic steroid users (Hope et al, ), but many never seek specialist help with correct injection techniques, relying instead on the guidance of other users or information from their supplier (Hanley Santos & Coomber, ). The injection of anabolic androgenic steroid differs from psychoactive drugs, which are typically injected intravenously.…”

“…However, this practice requires very good injection technique to avoid complications, such as blood vessel breakage, muscle or nerve damage, or even paralysis (Evans, ). Spot injections are concomitant with injection site infections, abscesses and tumours (Hope et al, ; Weinreb, Goldblum, & Rubin, ), as are the reuse of needles and/or syringes and the use of multiple injection vials (Graham et al, ; Hope et al, ; Pai, Parampalli, Hettiarachchi, & Ahmed, ). Unlike most psychoactive drugs, anabolic androgenic steroids are usually purchased as a liquid, ready for injection.…”

Community pharmacist experiences of providing needle and syringe programmes in Ireland

“…[51][52] Hepatitis B and C were also identified in this population, together with concerning levels of localized infection and injury. 53 Pharmacists required some training on where to refer to, and should over time nestle within an interagency approach to dealing with addiction in the community.…”