Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder

Marks, Laura R.; Durkin, Michael J.; Ayres, Kelly; Ellis, Matthew

doi:10.1186/s12954-024-00939-6

Harm Reduction Journal

Table 2 Sociodemographic characteristics of survey respondents who used injection drugs and associations with development of any injection drug use-associated bacterial or fungal infection

From: Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder

	No infection (n = 266)		Any infection (n = 462)		Total (N = 728)		sig. (χ²)
Demographics
Female	98	37.3%	166	36.5%	264	36.8%	0.835
White	177	70.0%	352	79.1%	529	75.8%	0.007
Black	32	12.6%	30	6.7%	62	8.9%	0.008
Latinx	25	9.9%	32	7.2%	57	8.2%	0.212
Other race	12	4.6%	17	3.7%	29	4.0%	0.565
Sexual minority (i.e., non-heterosexual)	50	19.0%	79	17.2%	129	17.9%	0.543
Transgender or gender non-binary	3	1.2%	13	2.9%	16	2.3%	0.133
Age at survey completion
18–24	20	7.5%	28	6.1%	48	6.6%	0.445
25–34	107	40.2%	211	45.7%	318	43.7%	0.154
35–44	87	32.7%	151	32.7%	238	32.7%	0.995
45+	52	19.5%	72	15.6%	124	17.0%	0.171
Past month housing status
Temporarily with friend/family member	67	35.8%	128	34.9%	195	35.2%	0.825
Safe Haven/shelter	25	13.4%	43	11.7%	68	12.3%	0.575
Rent/Own	44	23.5%	70	19.1%	114	20.6%	0.220
Street dwelling	21	11.2%	72	19.6%	93	16.8%	0.012
Other	69	25.9%	137	29.7%	206	28.3%	0.895
Urbanicity
Urban	128	49.8%	225	50.2%	353	50.1%	0.915
Suburban	50	19.5%	95	21.2%	145	20.6%	0.580
Rural	80	31.1%	130	29.0%	210	29.8%	0.555
Primary source of income
Employed/retired	100	38.5%	156	34.1%	256	35.7%	0.245
Public assistance	28	10.8%	73	16.0%	101	14.1%	0.054
Friend/family	72	27.7%	112	24.5%	184	25.7%	0.348
Other	68	26.2%	144	31.5%	212	29.6%	0.131
Healthcare coverage
None	103	39.6%	155	34.4%	258	36.3%	0.168
Covered under another individual	7	2.7%	9	2.0%	16	2.3%	0.549
Medicare/Medicaid	120	46.2%	245	54.4%	365	51.4%	0.033
Private	14	5.4%	13	2.9%	27	3.8%	0.094
VA/Military Healthcare	1	0.4%	4	0.9%	5	0.7%	0.439
Educational attainment
Less than high school	44	16.5%	99	21.4%	143	19.6%	0.110
High school/GED	136	51.1%	243	52.6%	379	52.1%	0.702
Some college	64	24.1%	103	22.3%	167	22.9%	0.585
Any post-secondary accreditation	32	12.0%	46	10.0%	78	10.7%	0.384
Comorbid conditions
Lifetime history of psychiatric diagnosis/treatment	127	47.7%	268	58.0%	395	54.3%	0.004
Chronic pain (i.e., pain lasting 3 months or longer)	131	49.2%	231	50.0%	362	49.7%	0.708
Lifetime history of suicide attempt	95	36.7%	166	36;5%	261	36.6%	0.958
Lifetime history of an opioid overdose	154	57.9%	307	66.5%	461	63.3%	0.021
Past month non-opioid use
Nicotine/tobacco	241	94.5%	402	94.4%	643	94.4%	0.937
Marijuana	129	48.5%	234	50.6%	363	49.9%	0.576
Alcohol (> 4 times in one day)	79	31.0%	118	27.7%	197	28.9%	0.361
Crystal meth	107	42.0%	228	53.5%	335	49.2%	0.003
Anxiolytics	66	24.8%	114	24.7%	180	24.7%	0.967
Crack/cocaine	81	31.8%	113	26.5%	194	28.5%	0.143
Muscle relaxants	38	14.3%	71	15.4%	109	15.0%	0.694
Antidepressants	26	9.8%	45	9.7%	71	9.8%	0.988
Prescription stimulants	31	11.7%	50	10.8%	81	11.1%	0.731
Prescription sleep medications	25	9.4%	53	11.5%	78	10.7%	0.384
Hallucinogens	14	5.5%	37	8.7%	51	7.5%	0.125
MDMA	27	8.6%	35	8.2%	57	8.4%	0.851
Sexually transmitted infections
Any STI (including HIV/HCV)	107	40.2%	248	53.7%	355	48.8%	< .001
Chlamydia	51	19.2%	110	23.8%	161	22.1%	0.147
Gonorrhea	33	12.4%	79	17.1%	112	15.4%	0.091
Syphilis	11	4.1%	19	4.1%	30	4.1%	0.988
HPV	5	1.9%	27	5.8%	32	4.4%	0.012
Herpes	9	3.4%	31	6.7%	40	5.5%	0.058
Lifetime history of trading sex for drugs	73	27.4%	194	42.0%	267	36.7%	< .001
HCV status
HCV positive	40	16.6%	136	31.1%	176	26.1%	< .001
HCV negative tested within the past 3 months	74	30.7%	114	26.3%	188	27.9%	0.218
HCV Negative tested over three months ago	69	28.6%	106	24.4%	175	25.9%	0.232
Never tested for HCV	58	24.1%	78	18.0%	136	20.1%	0.059
HIV status
HIV positive	5	2.1%	13	3.0%	18	2.7%	0.472
HIV negative tested within the past three months	103	42.6%	176	40.6%	279	41.3%	0.611
HIV negative tested over three months ago	98	40.5%	181	41.7%	279	41.3%	0.759
Never tested for HIV	36	14.9%	64	14.7%	100	14.8%	0.964
Injection drug use
Prescription opioids	66	24.8%	208	45.0%	274	37.6%	< .001
Heroin/illicit fentanyl	207	77.8%	438	94.8%	645	88.6%	< .001
Amphetamines	25	9.4%	131	28.4%	156	21.4%	< .001
Methamphetamine	151	56.8%	337	72.9%	488	67.0%	< .001
Crack/cocaine	82	30.8%	231	50.0%	313	43.0%	< .001
Harm reduction practices
Any harm reduction practice	172	64.7%	384	83.1%	556	76.4%	< .001
Used alcohol pads to clean an injection site	141	53.0%	299	64.7%	440	60.4%	0.002
Cleaned used needles with bleach or alcohol	111	41.7%	307	66.5%	418	57.4%	< .001
Non-sterile drug preparation practices
Reused needles	144	54.1%	381	82.5%	525	72.1%	< .001
Reused needles you previously used to drain an infection to drain or treat an infection	10	3.8%	62	13.4%	72	9.9%	< .001
Shared needles with someone else who had a fever might have had a fever or was sick	16	6.0%	115	24.9%	131	18.0%	< .001
Shared needles with other individuals	76	28.6%	270	58.4%	346	47.5%	< .001
Used saliva to lubricate a dull needle	26	9.8%	128	27.7%	154	21.2%	< .001
Used lemon or other acidic fruit juice to prepare drugs prepare drugs for injection	24	9.0%	146	31.6%	170	23.4%	< .001

HCV hepatitis C Virus, HIV human immunodeficiency virus
*Patients may report more than one type of substance use in addition to opioids

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ISSN: 1477-7517

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