Student-Run Free Clinic at a Syringe Services Program, Miami, Florida, 2017–2019

Ginoza, Margaret; Tomita-Barber, Jasmine; Onugha, Jason; Bullock, Corinne; Bartholomew, Tyler S.; Tookes, Hansel; Serota, David P.

doi:10.2105/ajph.2020.305705

Cited by 13 publications

(28 citation statements)

References 7 publications

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“…For example, wound care has been successfully implemented at some SSPs in the United States, but is not universal [27][28][29]. Ginoza et al reported success with a medical student-led wound care clinic that provides low-barrier SSTI care and linkages to care for other resources, such as food and housing [30]. Such programs may serve as a model for other community-based clinics.…”

Section: Discussionmentioning

confidence: 99%

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

Figgatt

Salazar²,

Vincent³

et al. 2021

Harm Reduct J

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Introduction Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading to delays in getting necessary care. The objective of this study was to examine SSTI treatment experiences among people utilizing services from syringe services programs. This study was initiated by people with lived experience of drug use to improve quality of care. Methods We conducted a cross-sectional survey among participants of five syringe services programs in North Carolina from July through September 2020. Surveys collected information on each participant’s history of SSTIs and IE, drug use and healthcare access characteristics, and SSTI treatment experiences. We examined participant characteristics using counts and percentages. We also examined associations between participant characteristics and SSTI history using binomial linear regression models. Results Overall, 46% of participants reported an SSTI in the previous 12 months and 10% reported having IE in the previous 12 months. Those with a doctor they trusted with drug use-related concerns had 27 fewer (95% confidence interval = − 51.8, − 2.1) SSTIs per every 100 participants compared to those without a trusted doctor. Most participants with a SSTI history reported delaying (98%) or not seeking treatment (72%) for their infections. Concerns surrounding judgment or mistreatment by medical staff and self-treating the infection were common reasons for delaying or not seeking care. 13% of participants used antibiotics obtained from sources other than a medical provider to treat their most recent SSTI. Many participants suggested increased access to free antibiotics and on-site clinical care based at syringe service programs to improve treatment for SSTIs. Conclusions Many participants had delayed or not received care for SSTIs due to poor healthcare experiences. However, having a trusted doctor was associated with fewer people with SSTIs. Improved access to non-judgmental healthcare for people who use drugs with SSTIs is needed. Expansion of syringe services program-based SSTI prevention and treatment programs is likely a necessary approach to improve outcomes among those with SSTI and IE.

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Section: Discussionmentioning

confidence: 99%

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

Figgatt

Salazar²,

Vincent³

et al. 2021

Harm Reduct J

View full text Add to dashboard Cite

show abstract

“…If a participant reported a WSI, they were referred to the weekly on‐site wound care clinic. A more in‐depth description of the wound care clinic has been previously published 18 . Data were linked by unique participant ID that is assigned to each participant during enrollment to ensure anonymity.…”

Section: Methodsmentioning

confidence: 99%

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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“…for hand and neck abscesses) occurs. Appropriate wound care supplies are dispensed and follow-up is scheduled on an ad hoc basis [69].…”

Section: Syringe Services Programsmentioning

confidence: 99%

Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

Sanchez

Tookes

Pastar

et al. 2021

Advances in Wound Care

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Significance: Opioid use disorder and transition to injection drug use (IDU) is an urgent, nationwide public health crisis. Wounds and skin and soft tissue infections (SSTIs) are common complications of IDU that disproportionately affect people who inject drugs (PWID) and are a major source of morbidity and mortality for this population.Critical Issues: Injections in a non-sterile environment and re-using or sharing needles facilitates bacterial inoculation, with subsequent risk of serious complications such as sepsis, gangrene, amputation, and death. PWID are susceptible to infections with a wide spectrum of organisms beyond common culprits of SSTI, including Clostridium and Bacillus spp, as well as Candida. Recent Advances: Syringe services programs (SSPs) are cost-effective and successful in reducing harms associated with IDU. SSPs provide new equipment to PWID and aid in discarding used equipment. SSPs aim to reduce the risks of unhygienic injecting practices, which are associated with transmission of infections and blood-borne pathogens. Future Directions: Concurrently run SSPs and wound care clinics are uniquely positioned to facilitate care to PWID. Providing new, sterile equipment as well as early wound care intervention, can reduce morbidity and mortality as well as healthcare expenditures by reducing the number of SSTI and injection-related wounds that require hospital admission. Establishment of wound care clinics as part of an SSP represents an untapped potential to reduce harm.

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Student-Run Free Clinic at a Syringe Services Program, Miami, Florida, 2017–2019

Cited by 13 publications

References 7 publications

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

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

Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

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