Factors Associated With Skin and Soft Tissue Infections (SSTIS) Among People who Inject Drugs (PWID) in New York City (NYC)

Author: Leonardo Dominguez Gomez Ashly Jordan Izza Zaidi Alexandra Harocopos

Theme: Epidemiology & Public Health Research Year: 2022

SSTIs can cause serious morbidity among PWID. Safer injection practices may be challenging to carry
out when material supplies are low such as during the COVID-19 pandemic. We examined factors
associated with SSTIs including an application of the Bacterial Infections Risk Scale for Injectors
(BIRSI) among PWID in NYC during the COVID-19 pandemic.
People in NYC who use opioids were interviewed (N=312) (Mar/2021-Nov/2021); 146 reported drug
injection (prior 90-days) and were included in this analysis. We examined factors (e.g.,
sociodemographic, drug use, syringe services program [SSP] use) including the 7-item BIRSI and a
summed composite BIRSI score. Associations were examined between factors and reporting >1 SSTI
in 90-days prior.
Participants were 55% Hispanic, 30% female, and a mean age of 45 years. 17.8% and 23.3% reported
using syringes or other injection equipment used by others, respectively. SSTI prevalence was 25%.
Younger age (OR: 0.95, 95%CI: 0.91, 0.99), using a syringe (OR: 6.01, 95%CI: 2.46, 15.23) or injection
equipment that someone else had used (OR: 4.55, 95%CI: 2.00, 10.55), injecting heroin (OR: 4.32,
95%CI: 1.18, 27.94), and a higher BIRSI score (OR: 1.61, 95%CI, 1.27, 2.11) were associated with
SSTIs. Controlling for age, gender, race, heroin injection, and number of injections, a higher BIRSI
score was independently associated with SSTIs (aOR: 1.47, 95%CI: 1.13, 1.95). There was no
difference in BIRSI scores between those reporting and not reporting past 90-day SSP use.
Our findings emphasize the importance of providing wound prevention and care in programs serving
PWID to reduce injection-related SSTI risk and related morbidity. The high prevalence of PWID
reporting SSTIs and sharing injection equipment despite SSP engagement indicates the potential
impact of COVID-19 on service access and material supply availability as well as on-going risk for
blood-borne infections such as hepatitis C and HIV.
Disclosure of Interest Statement:
The authors have no conflicts of interest and therefore, have none to disclose.

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