Factors Associated with Injury and Blood-borne Infection Risk when Providing Assisted Injection Among People Who Inject Drugs

Overview

Journal Int J Drug Policy

Publisher Elsevier

Specialties Psychiatry
Public Health

Date 2021 Jun 2

PMID 34077825

Citations 1

Authors

Rachel Carmen Ceasar

Jesse L Goldshear

Sarah Brothers

Lynn D Wenger

Alex H Kral

Ricky N Bluthenthal

Affiliations

Soon will be listed here.

Abstract

Objective: Prior research has associated assisted injection with risk behaviors, but other risks such as injury, missed veins, and incidental exposures to blood-borne infections during an injection episode have not been assessed. In the following, we present the frequency of these other risks and determine factors associated with missing a vein and incidental blood exposure among people who inject drugs (PWID).

Methods: We conducted a cross-sectional analysis of data from PWID who were recruited using targeted sampling in Los Angeles and San Francisco, California, during 2016 and 2017. The analytic sample consist of 336 participants who reported providing injection assistance in the last 6 months. Multivariate logistic regression models were developed for reporting the following risks: missing a vein; getting the recipient's blood on the injection provider; and getting blood on clothes or surfaces.

Results: In the last 6 months, the most common negative consequences were getting blood on clothes or surfaces (40%), getting the recipient's blood on the injection provider (23%), and missing a vein (17%). In multivariate logistic regression analysis, missing the vein was significantly associated with higher odds of assisting a leg injection while getting the injection recipient's blood on the provider or getting blood on clothes or nearby surfaces was associated with higher odds of assisting a groin injection injecting in the groin.

Conclusion: Providing injection assistance can result in incidental blood exposures and injury, particularly when injecting in sensitive locations on the body. Harm reduction interventions to reduce risks associated with this practice are essential to improving the well-being of PWID.

Citing Articles

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References

Darke S, Ross J, Kaye S . Physical injecting sites among injecting drug users in Sydney, Australia. Drug Alcohol Depend. 2001; 62(1):77-82. DOI: 10.1016/s0376-8716(00)00161-7. View

Small W, Rhodes T, Wood E, Kerr T . Public injection settings in Vancouver: physical environment, social context and risk. Int J Drug Policy. 2007; 18(1):27-36. DOI: 10.1016/j.drugpo.2006.11.019. View

Jozaghi E, Reid A, Andresen M, Juneau A . A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada. Subst Abuse Treat Prev Policy. 2014; 9:31. PMC: 4123501. DOI: 10.1186/1747-597X-9-31. View

Small W, Wood E, Tobin D, Rikley J, Lapushinsky D, Kerr T . The Injection Support Team: a peer-driven program to address unsafe injecting in a Canadian setting. Subst Use Misuse. 2012; 47(5):491-501. DOI: 10.3109/10826084.2012.644107. View

Navarro S, Kral A, Strike C, Simpson K, Wenger L, Bluthenthal R . Factors Associated with Frequency of Recent Initiation of Others into Injection Drug Use Among People Who Inject Drugs in Los Angeles and San Francisco, CA, USA, 2016-17. Subst Use Misuse. 2019; 54(10):1715-1724. PMC: 6863088. DOI: 10.1080/10826084.2019.1608252. View

Harris M, Scott J, Wright T, Brathwaite R, Ciccarone D, Hope V . Injecting-related health harms and overuse of acidifiers among people who inject heroin and crack cocaine in London: a mixed-methods study. Harm Reduct J. 2019; 16(1):60. PMC: 6854679. DOI: 10.1186/s12954-019-0330-6. View

Miller C, Firestone M, Ramos R, Burris S, Ramos M, Case P . Injecting drug users' experiences of policing practices in two Mexican-U.S. border cities: public health perspectives. Int J Drug Policy. 2007; 19(4):324-31. PMC: 2546504. DOI: 10.1016/j.drugpo.2007.06.002. View

Brothers S . A good "doctor" is hard to find: Assessing uncredentialed expertise in assisted injection. Soc Sci Med. 2019; 237:112446. DOI: 10.1016/j.socscimed.2019.112446. View

Huang G, Barnes E, Peacock Jr J . Repeat Infective Endocarditis in Persons Who Inject Drugs: "Take Another Little Piece of my Heart". Open Forum Infect Dis. 2018; 5(12):ofy304. PMC: 6288769. DOI: 10.1093/ofid/ofy304. View

10.

Robinson W, Risser J, McGoy S, Becker A, Rehman H, Jefferson M . Recruiting injection drug users: a three-site comparison of results and experiences with respondent-driven and targeted sampling procedures. J Urban Health. 2006; 83(6 Suppl):i29-38. PMC: 1705501. DOI: 10.1007/s11524-006-9100-3. View

11.

Hagan H, Thiede H, Weiss N, Hopkins S, Duchin J, ALEXANDER E . Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health. 2001; 91(1):42-6. PMC: 1446500. DOI: 10.2105/ajph.91.1.42. View

12.

Irwin A, Jozaghi E, Weir B, Allen S, Lindsay A, Sherman S . Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility. Harm Reduct J. 2017; 14(1):29. PMC: 5441005. DOI: 10.1186/s12954-017-0153-2. View

13.

Pedersen J, Dong H, Small W, Wood E, Nguyen P, Kerr T . Declining trends in the rates of assisted injecting: a prospective cohort study. Harm Reduct J. 2016; 13:2. PMC: 4728798. DOI: 10.1186/s12954-016-0092-3. View

14.

Nelson P, Mathers B, Cowie B, Hagan H, Des Jarlais D, Horyniak D . Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011; 378(9791):571-83. PMC: 3285467. DOI: 10.1016/S0140-6736(11)61097-0. View

15.

Kral A, Bluthenthal R, Erringer E, Lorvick J, Edlin B . Risk factors among IDUs who give injections to or receive injections from other drug users. Addiction. 1999; 94(5):675-83. DOI: 10.1046/j.1360-0443.1999.9456755.x. View

16.

Fast D, Small W, Wood E, Kerr T . The perspectives of injection drug users regarding safer injecting education delivered through a supervised injecting facility. Harm Reduct J. 2008; 5:32. PMC: 2605439. DOI: 10.1186/1477-7517-5-32. View

17.

Binswanger I, Kral A, Bluthenthal R, Rybold D, Edlin B . High prevalence of abscesses and cellulitis among community-recruited injection drug users in San Francisco. Clin Infect Dis. 2000; 30(3):579-81. DOI: 10.1086/313703. View

18.

Akbarzadeh V, Mumtaz G, Awad S, Weiss H, Abu-Raddad L . HCV prevalence can predict HIV epidemic potential among people who inject drugs: mathematical modeling analysis. BMC Public Health. 2016; 16(1):1216. PMC: 5135754. DOI: 10.1186/s12889-016-3887-y. View

19.

Coutinho R . HIV and hepatitis C among injecting drug users. BMJ. 1998; 317(7156):424-5. PMC: 1113707. DOI: 10.1136/bmj.317.7156.424. View

20.

Suryaprasad A, White J, Xu F, Eichler B, Hamilton J, Patel A . Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006-2012. Clin Infect Dis. 2014; 59(10):1411-9. DOI: 10.1093/cid/ciu643. View