High prevalence of abscesses and self-treatment among injection drug users in Tijuana, Mexico.
BACKGROUND
Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking.


METHODS
Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months.


RESULTS
Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.08-10.00), smoking methamphetamine (aOR 1.65, 95% CI 1.05-2.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.18-3.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.15-3.96).


CONCLUSIONS
Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk.
Pollini
Robin A
RA
Department of Medicine, University of California-San Diego, La Jolla, CA 92093, USA. rpollini@ucsd.edu
Gallardo
Manuel
M
Hasan
Samreen
S
Minuto
Joshua
J
Lozada
Remedios
R
Vera
Alicia
A
Zúñiga
María Luisa
ML
Strathdee
Steffanie A
SA
D000038:Abscess / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D000504:Aloe; D019969:Amphetamine-Related Disorders / Q000150:complications; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008517:Phytotherapy; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care; D011477:Sex Work; D018461:Soft Tissue Infections / Q000209:etiology* / Q000628:therapy*; D015819:Substance Abuse, Intravenous / Q000150:complications*
JAMA. 1998 Mar 18;279(11):859-63
9516001
Aust N Z J Public Health. 2008 Feb;32(1):34-7
18290911
N Engl J Med. 2005 Apr 7;352(14):1436-44
15814879
J Acquir Immune Defic Syndr. 2008 Mar 1;47(3):369-76
18176320
J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2006 Apr;24(1):103-54
16690538
Soc Sci Med. 2003 Jul;57(1):39-54
12753815
Addiction. 2008 Jan;103(1):101-8
18028520
Clin Infect Dis. 2005 May 15;40(10):1529-34
15844078
J Urban Health. 2003 Mar;80(1):127-36
12612102
Clin Infect Dis. 2003 Jan 15;36(2):131-9
12522744
Arch Intern Med. 1998 Apr 27;158(8):895-9
9570176
Clin Infect Dis. 2001 Jul 1;33(1):35-40
11389492
Harm Reduct J. 2005 Nov 10;2:24
16281979
Clin Infect Dis. 2002 Feb 15;34(4):425-33
11797167
Drug Alcohol Depend. 2009 Feb 1;100(1-2):9-16
19013725
J Infect Dis. 2004 Nov 15;190(10):1730-8
15499526
Clin Infect Dis. 2000 Mar;30(3):579-81
10722447
J Urban Health. 2005 Sep;82(3 Suppl 4):iv58-73
16107441
Ann Emerg Med. 2007 Jan;49(1):116-7
17197298
Emerg Infect Dis. 2007 Nov;13(11):1707-13
18217555
Liver Int. 2008 Jul;28(6):781-6
18312289
Antimicrob Agents Chemother. 2003 Mar;47(3):1137-9
12604556
Soc Sci Med. 2005 Aug;61(3):673-84
15899325
J Clin Epidemiol. 1996 Oct;49(10):1149-54
8826995
N Engl J Med. 2006 Aug 17;355(7):666-74
16914702
Eur J Gastroenterol Hepatol. 2008 Jan;20(1):29-32
18090987
Molecules. 2008 Aug 08;13(8):1599-616
18794775
N Engl J Med. 2005 Feb 3;352(5):468-75
15689585
Am J Addict. 2008 Mar-Apr;17(2):111-5
18393053
Am J Public Health. 2002 Dec;92(12):1915-7
12453808
CMAJ. 2001 Aug 21;165(4):415-20
11531049
Public Health Rep. 1992 Sep-Oct;107(5):595-8
1410243
JAMA. 2001 Jun 6;285(21):2707-9
11419421
Health Place. 2001 Dec;7(4):319-31
11682331
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Sep;13(1):87-92
8797690
BMC Public Health. 2008 Dec 09;8:405
19068133