Smith Maria Elisa, Robinowitz Natanya, Chaulk Patrick, Johnson Kristine E
Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, 5200 Eastern Avenue, MFL Building, Center Tower, 3rd Floor, Baltimore, MD 21224, USA.
Harm Reduct J. 2014 Oct 19;11(1):28. doi: 10.1186/1477-7517-11-28.
We surveyed a population of injection drug users (IDUs) frequenting the mobile Baltimore City Needle Exchange Program (BNEP) to investigate self-care factors associated with chronic wounds, a significant cause of morbidity especially among older IDUs.
Participants ≥18 years old completed a survey regarding chronic wounds (duration ≥8 weeks), injection and hygiene practices. Study staff visually verified the presence of wounds. Participants were categorized into four groups by age and wound status. Factors associated with the presence of chronic wounds in participants ≥45 years were analyzed using logistic regression.
Of the 152 participants, 19.7% had a chronic wound. Of those with chronic wounds, 18 were ≥45 years old (60.0%). Individuals ≥45 years old with chronic wounds were more likely to be enrolled in a drug treatment program (Odds ratio (OR) 3.4, 95% Confidence interval (CI) 1.0-10.8) and less likely to use cigarette filters when drawing up prepared drug (OR 0.2, 95% CI 0.03-0.7) compared to the same age group without chronic wounds. Compared to individuals <45 years old without chronic wounds, individuals ≥45 with a chronic wound were more likely to report cleaning reused needles with bleach (OR 10.7, 95% CI 1.2-93.9) and to use the clinic, rather than an emergency room, as a primary source of medical care (OR 3.4, 95% CI 1.1-10.4).
Older IDUs with chronic wounds have different, and perhaps less risky, injection and hygiene behaviors than their peers and younger IDUs without wounds in Baltimore City. Because of these differences, older IDUs with wounds may be more receptive to community-based healthcare and substance abuse treatment messages.
我们对经常光顾巴尔的摩市流动针头交换项目（BNEP）的注射吸毒者群体进行了调查，以研究与慢性伤口相关的自我护理因素，慢性伤口是发病率的一个重要原因，在老年注射吸毒者中尤为如此。
18岁及以上的参与者完成了一项关于慢性伤口（持续时间≥8周）、注射和卫生习惯的调查。研究人员通过肉眼检查伤口情况。参与者按年龄和伤口状况分为四组。使用逻辑回归分析45岁及以上参与者中与慢性伤口存在相关的因素。
在152名参与者中，19.7%有慢性伤口。在有慢性伤口的参与者中，18人年龄≥45岁（占60.0%）。与同年龄组无慢性伤口的人相比，有慢性伤口的45岁及以上个体更有可能参加药物治疗项目（比值比（OR）3.4，95%置信区间（CI）1.0 - 10.8），在抽取已准备好的药物时使用香烟过滤嘴的可能性更小（OR 0.2，95% CI 0.03 - 0.7）。与无慢性伤口的＜45岁个体相比，有慢性伤口的45岁及以上个体更有可能报告用漂白剂清洁重复使用的针头（OR 10.7，95% CI 1.2 - 93.9），并将诊所而非急诊室作为主要医疗保健来源（OR 3.4，95% CI 1.1 - 10.4）。
在巴尔的摩市，有慢性伤口的老年注射吸毒者与同龄人及无伤口的年轻注射吸毒者相比，具有不同的、或许风险更低的注射和卫生行为。由于这些差异，有伤口的老年注射吸毒者可能更容易接受基于社区的医疗保健和药物滥用治疗信息。
