Self-treatment of skin infections by people who inject drugs.

Abstract

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.