Wound-related Perceptions and Care Among Participants from a Philadelphia, PA (USA) Harm Reduction Organization

Author: Madison Scialanca, Amy Jessop, Patrick Kelly, Ariel Hoadley, Katie Singley, Rachel Holbert, Sarah Bass

Theme: Epidemiology & Public Health Research Year: 2023

Wounds are ever present among people who inject drugs (PWID), yet harm reduction organizations in Philadelphia, PA, report increasing incidence and severity of wounds. Many attribute this to the increasing presence of xylazine (referred to as “tranq”) in the region’s drug supply. We examined wound-related perceptions and care practices among participants of Prevention Point Philadelphia (PPP), a US-based multi-service harm reduction organization.

Between September 2022 and February 2023, we surveyed 95 PPP participants who reported skin wounds during previous 6 months. The group was 57% male, 30% non-white, mean age 41 years (sd=9.4); 78% graduated high school, and 67% were unsheltered. We questioned them about demographics, healthcare sources, concerns about wounds, and how they treat wounds. Descriptive statistics and non-parametric methods were employed to describe and compare patterns among participants.

Most participants agreed or strongly agreed that the drugs they use now are rougher on skin (91%), that skin wounds are serious (94%), and they are worried about limb loss (81%) and change in appearance (83%); 81% noted they are “ashamed” of their wounds. No significant differences were noted by gender, race or age group. Wound care was received at PPP (71%), emergency rooms (24%) and through selfcare (48%). A majority expressed interest in first-aid training. Reasons for selfcare included lack of available care when needed/urgency, avoiding hospitals and doctors, time/priorities, embarrassment, autonomy, and knowledge.

Wounds are of concern to PPP’s harm reduction participants and they noted seeking care at PPP for their wounds and to obtain supplies for wound self-care. Integrating wound care in harm reduction organizations is a way to address concerns about embarrassment and feeling ashamed about wounds due to xylazine use. This is especially important as xylazine becomes more widespread in the drug supply.

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