Sex work, injection drug use, and abscesses: Associations in women, but not men

Wurcel, Alysse G.; Burke, Dave; Skeer, Margie R.; Landy, David; Heimer, Robert; Wong, John B.; Chui, Kenneth; Stopka, Thomas J.

doi:10.1016/j.drugalcdep.2017.12.028

Cited by 16 publications

(10 citation statements)

References 38 publications

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“…These nonmodifiable risk factors, and limited public assistance for homes and suitable hygiene, highlight SSPs as plausible mechanism to reduce the number of WSI and associated complications. The increased risk of WSI in women is consistent with previous reports and could be secondary to smaller veins, injecting 'second' (i.e., after a different person) and injection by partners 33 . Interestingly, increasing age was associated with higher WSI risk but increased years injecting was not, which warrants further investigation.…”

Section: Discussionsupporting

confidence: 88%

“…The increased risk of WSI in women is consistent with previous reports and could be secondary to smaller veins, injecting 'second' (i.e., after a different person) and injection by partners. 33 Interestingly, increasing age was associated with higher WSI risk but increased years injecting was not, which warrants further investigation. Importantly, cocaine injection was shown to be associated with higher incidence of WSI, consistent with prior literature, and even more critical in the fourth wave the of the US overdose crisis with coinjection of opioids and stimaulants.…”

Section: Discussionmentioning

confidence: 93%

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Correlates of injection‐related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: A single center study

Cahn

Bartholomew

Patel

et al. 2021

International Wound Journal

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Risk factors associated with wounds and skin infections amongst persons who inject drugs may have changed in the era of fentanyl and now stimulant coinjection. We assessed the number of injection site wounds and skin infections and associated factors amongst 675 persons who inject drugs in a syringe services programme. Of this sample, 173 participants reported a total of 307 wounds and skin infections. Significant factors associated with increased number of wounds and skin infections were age 30 or older, female gender, ever experiencing homelessness, cocaine injection, and injecting between 5 and 10 years. Wounds and skin infections were common amongst syringe services programme clients and are associated with certain risk factors that may help to design effective interventions. Given the high prevalence of wounds in syringe services programme clients, wound care clinicians can make a significant difference and improve outcomes. We also shed light on correlates of wounds and skin infections in persons who inject drugs in order to spur further research to devise efficacious interventions for this underserved group.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Correlates of injection‐related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: A single center study

Cahn

Bartholomew

Patel

et al. 2021

International Wound Journal

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“…However, the underlying mechanism by which trading sex influences HCV status among our sample is unclear. Importantly, although females in our study were more likely to trade sex than males, 56 including gender in the final model did not appreciably alter the association between trading sex and HCV status (data not shown), and gender was not associated significantly with HCV status among our sample at the bivariate or multivariable levels. Thus, although other work has shown that female PWID may be more at risk for HCV infection than males, 57,58 such an association was not reflected in our sample.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 62%

Hepatitis C antibody prevalence, correlates and barriers to care among people who inject drugs in Central California

Ozga

Syvertsen

Pollini

2022

Journal of Viral Hepatitis

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Hepatitis C (HCV) infection among people who inject drugs (PWID) is a major public health concern. We examined correlates of HCV antibody (anti‐HCV) seropositivity and characteristics of prior HCV testing and treatment among PWID in Fresno, California, which has among the highest prevalence of injection drug use (IDU) in the United States. We surveyed 494 peer‐recruited PWID (≥18 years of age) in 2016 about their experiences with HCV testing and treatment, and conducted HCV and HIV antibody testing for all participants. Bivariate analyses and multivariable logistic regressions were used to identify correlates of anti‐HCV seropositivity. A majority (65%) tested positive for anti‐HCV, with 32% of those being unaware of their HCV status. Anti‐HCV seroprevalence was independently and positively associated with older age (AOR = 1.11 per year, 95% CI = 1.06, 1.17), years injecting (AOR = 1.08 per year, 95% CI = 1.03, 1.13), distributive syringe sharing (AOR = 2.76, 95% CI = 1.29, 5.94), having syringes confiscated by police (AOR = 2.65, 95% CI = 1.22, 5.74), ever trading sex (AOR = 3.51, 95% CI = 1.40, 8.81) and negatively associated with being Black/African American (non‐Hispanic) (AOR = 0.06, 95% CI = 0.01, 0.47). Prior HCV testing was associated with older age, ever getting syringes from a syringe services program, and having interactions with police. For those aware of their anti‐HCV seropositivity, only 11% had initiated treatment; reasons for not seeing a physician regarding diagnosis included not feeling sick (23%), currently using drugs/alcohol (19%) and not knowing where to go for HCV medical care (19%). Our findings highlight the importance of expanding community‐based access to sterile syringes alongside HCV testing and treatment services, particularly at syringe service programs where PWID may be more comfortable seeking testing and treatment.

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“…In rural northern New England, the introduction of fentanyl accelerated the opioid epidemic ( Somerville et al, 2017 ). Hepatitis C virus (HCV) rates ( Stopka et al, 2017 , 2019a , b ) and other comorbidities of drug injection, including infectious endocarditis and osteomyelitis ( Wurcel et al, 2016 , 2018 ), have similarly increased.…”

Section: Introductionmentioning

confidence: 99%

Opioid initiation and injection transition in rural northern New England: A mixed-methods approach

Nolte

Drew

Friedmann

et al. 2020

Drug and Alcohol Dependence

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Background: In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England. Methods: This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England. Results: Median age of first injection was 22 years (interquartile range 18–28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection. Conclusions: Trauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas.

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Sex work, injection drug use, and abscesses: Associations in women, but not men

Cited by 16 publications

References 38 publications

Correlates of injection‐related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: A single center study

Correlates of injection‐related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: A single center study

Hepatitis C antibody prevalence, correlates and barriers to care among people who inject drugs in Central California

Opioid initiation and injection transition in rural northern New England: A mixed-methods approach

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