Association of Self-Reported Abscess With High-Risk Injection-Related Behaviors Among Young Persons Who Inject Drugs.
Alice K Asher, Yuna Zhong, Richard S Garfein and 2 others
PMID 30822287WHAT IT FOUND
Young people who inject drugs and report a history of abscesses are significantly more likely to share syringes and ancillary equipment than those without abscesses.
An abscess presentation is a strong indicator of ongoing high-risk injection behaviors that require immediate harm reduction counseling and infectious disease screening.
Key findings
01Distributive syringe sharing at least 50% of the time was independently associated with a history of abscess (adjusted odds ratio 1.92).
02Participants with a history of abscess were more likely to report sharing ancillary injecting equipment such as cookers, cottons, and rinse water.
03Sixty-one percent of participants with a history of abscess reported increasing drug use to cope with the pain, and 60% self-treated their last abscess.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot prove that risky behaviors caused the abscesses; the association may reflect a general pattern of high-risk behavior. Data were self-reported and not verified through medical records, so abscesses may have been misclassified or underreported. The sample was limited to young adults (18-40) in San Diego, primarily White males, which may not represent older or more diverse populations. Injection risk behaviors were assessed for the previous 3 months, while abscess history was lifetime, creating a temporal mismatch. The data were collected between 2009 and 2010, which may not reflect current injection practices or drug supplies.
Declared interests
The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.
The easy way to misread this
Do not assume that sterile syringe use alone prevents abscesses. This study found that sharing ancillary equipment like cookers and cottons was significantly associated with abscess history, and guidelines often overlook these items. Additionally, the cross-sectional design means the abscess did not necessarily cause the risky behavior; both are likely markers of a broader high-risk lifestyle.