title: Factors associated with recent symptoms of an injection site infection or injury among people who inject drugs in three English cities.
abstract: BACKGROUND
  People who inject drugs (PWID) are at risk of injection site infections and injuries. The factors associated with recent symptoms of these problems are examined.
  
  
  METHODS
  PWID recruited using respondent driven sampling, underwent a computer-assisted interview and provided a dried-blood spot sample. Weight data were examined using logistic regression.
  
  
  RESULTS
  The mean age of the 855 participants was 32 years, and 25% were women. During the preceding 28 days, 94% had injected heroin and 50% crack-cocaine; with 41% injecting into their arms and 47% their groin. The passing on of used needles/syringes was reported by 9.7% and receiving by 8.0%. During the preceding 28 days, 21% reported having redness, swelling and tenderness, 6.1% an abscess, and 5.2% a sore/open wound at an injection site; with a quarter (24%) reporting one or more of these. A range of factors were associated with these symptoms; all three symptoms were associated with more frequent injection and the use of multiple injection sites; two of the symptoms were also associated with having recently overdosed and the use of particular injection sites.
  
  
  CONCLUSIONS
  Injection site infections and injuries are common among PWID and targeted interventions are needed to reduce risk.
authors.affiliation: Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK; Centre for Research on Drugs & Health Behaviour, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: vivian.hope@phe.gov.uk.
authors.forename: V D
authors.initials: VD
authors.lastname: Hope
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hickman
authors.affiliation: Microbiology Services, Public Health England, London, UK; Centre for Research on Drugs & Health Behaviour, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: J V
authors.initials: JV
authors.lastname: Parry
authors.affiliation: Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Ncube
mesh_terms: D000328:Adult; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications / Q000453:epidemiology*; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects; D016602:Needlestick Injuries / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: England; Injection site infections and injuries; People who inject drugs