Skin and soft tissue infections (SSTIs) are the most common medical complication of injection drug use in the United States, though little work has been done assessing SSTI treatment among people who inject drugs (PWID). We examined past-3-month abscess characteristics, treatment utilization, and barriers to medical treatment among N = 494 community-recruited PWID. We used descriptive statistics to determine the frequencies of self-treatment and medical treatment for their most recent past-3-month abscess as well as barriers to seeking medical treatment. We then used bivariate and multivariate logistic regression to identify factors associated with having an abscess in the past 3 months. Overall, 67% of participating PWID ever had an abscess and 23% had one in the past 3 months. Only 29% got medical treatment for their most recent abscess whereas 79% self-treated. Methods for self-treatment included pressing the pus out (81%), applying a hot compress (79%), and applying hydrogen peroxide (67%). Most (91%) self-treated abscesses healed without further intervention. Barriers to medical treatment included long wait times (56%), being afraid to go (49%), and not wanting to be identified as a PWID (46%). Factors associated independently with having an abscess in the past 3 months were injecting purposely into muscle tissue (adjusted odds ratio [AOR] = 2.64), having difficulty finding a vein (AOR = 2.08), and sharing injection preparation equipment (AOR = 1.74). Our findings emphasize the importance of expanding community-based access to SSTI education and treatment services, particularly at syringe service programs where PWID may be more comfortable seeking resources.

中文翻译：

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一项关于美国注射吸毒者脓肿自我治疗和医疗护理障碍的社区研究

皮肤和软组织感染 (SSTI) 是美国注射吸毒最常见的医疗并发症，但评估注射吸毒者 (PWID) SSTI 治疗的工作却很少。我们调查了N  = 494 名社区招募的注射吸毒者过去 3 个月的脓肿特征、治疗利用率和医疗障碍。我们使用描述性统计数据来确定他们最近 3 个月内脓肿的自我治疗和药物治疗的频率以及就医的障碍。然后，我们使用双变量和多变量逻辑回归来确定与过去 3 个月内出现脓肿相关的因素。总体而言，67% 的参与注射吸毒者曾经有过脓肿，23% 的人在过去 3 个月内曾有过脓肿。只有 29% 的人因最近的脓肿接受了治疗，而 79% 的人进行了自我治疗。自我治疗的方法包括挤出脓液（81%）、热敷（79%）和使用过氧化氢（67%）。大多数（91%）自我治疗的脓肿无需进一步干预即可愈合。医疗治疗的障碍包括等待时间长（56%）、不敢去（49%）以及不想被识别为吸毒者（46%）。过去 3 个月内与脓肿独立相关的因素包括故意向肌肉组织注射（调整优势比 [AOR] = 2.64）、难以找到静脉（AOR = 2.08）以及共用注射准备设备（AOR = 1.74） 。我们的研究结果强调了扩大以社区为基础的 SSTI 教育和治疗服务的重要性，特别是在注射器服务项目中，注射吸毒者可能更愿意寻求资源。