Boston University School of Public Health and Boston Medical Center, 715 Albany Street, 2nd Floor, Boston, MA 02118, USA.
Center for Integrated Health Care Research (CIHR), Kaiser Permanente 501 Alakawa Street, Suite 201, Honolulu, Hawaii 96817 USA.
Drug Alcohol Depend. 2020 Jan 1;206:107695. doi: 10.1016/j.drugalcdep.2019.107695. Epub 2019 Oct 28.
Persons who inject drugs (PWID) experience high rates of skin and soft tissue infections (SSTI) and often access emergency or inpatient treatment. However, many PWID do not seek care and self-treat some or all of their infections. The goal of the current study was to examine predictors of self-treatment of SSTI in a sample of hospitalized PWID, and describe methods of and reasons for self-treatment.
PWID (N = 252) were recruited from inpatient medical units at an urban safety-net hospital to join a behavioral intervention trial. The baseline interview focused on past-year SSTI incidence and related treatment, including reasons for not accessing medical care and methods of self-treatment.
Of study participants, 162 (64%) reported having at least one SSTI in the past year. This subset was 59.9% White/Caucasian with a mean age of 38.0 (SD + 10.5). One-third of these participants (32.3%) reported ever self-treating SSTI in the past year. In a logistic regression model, number of past-year infections (OR = 1.81, p < .001) and positive outlook (OR = 2.46, p < .001) were associated with self-treatment of SSTI. Common methods of self-treatment included mechanically draining sores, applying heat/warm compress, and cleaning affected areas. Continued drug use and belief that infections were not serious and could be self-treated were two main reasons for not seeking professional medical care.
Interventions targeting SSTI among PWID should include education on when to seek medical care and the risks of serious infection, and could be implemented at local clinics or harm reduction programs to increase access.
注射吸毒者（PWID）皮肤和软组织感染（SSTI）发生率较高，经常接受急诊或住院治疗。然而，许多 PWID 并不寻求治疗，而是自行治疗部分或全部感染。本研究的目的是调查住院 PWID 样本中 SSTI 自我治疗的预测因素，并描述自我治疗的方法和原因。
从城市安全网医院的住院医疗单位招募 PWID 参加行为干预试验。基线访谈重点关注过去一年 SSTI 的发病率及相关治疗，包括未寻求医疗护理的原因和自我治疗方法。
在研究参与者中，162 名（64%）报告过去一年至少有一次 SSTI。这部分参与者中 59.9%为白种人/高加索人，平均年龄为 38.0（+10.5）岁。这些参与者中有三分之一（32.3%）报告过去一年曾自行治疗 SSTI。在逻辑回归模型中，过去一年的感染次数（OR=1.81，p<.001）和积极的前景（OR=2.46，p<.001）与 SSTI 的自我治疗相关。常见的自我治疗方法包括机械排脓、热敷/热敷和清洁受影响的区域。继续吸毒和认为感染不严重且可以自行治疗是不寻求专业医疗护理的两个主要原因。
针对 PWID 的 SSTI 干预措施应包括何时寻求医疗护理以及严重感染风险的教育，并可在当地诊所或减少伤害计划中实施，以增加获得治疗的机会。
