Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina
Abstract Introduction Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading...
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doaj-829275c398da4478b1386d76f0e0ab1b2021-08-01T11:29:58ZengBMCHarm Reduction Journal1477-75172021-07-011811910.1186/s12954-021-00528-xTreatment experiences for skin and soft tissue infections among participants of syringe service programs in North CarolinaMary C. Figgatt0Zach R. Salazar1Louise Vincent2Diannee Carden-Glenn3Kelly Link4Lauren Kestner5Tyler Yates6Asher Schranz7Elizabeth Joniak-Grant8Nabarun Dasgupta9Injury Prevention Research Center, University of North Carolina At Chapel HillNorth Carolina Survivors UnionNorth Carolina Survivors UnionekiM for ChangeCommunity Hope AllianceCenter for Prevention ServicesGuilford County Solution To the Opioid ProblemDivision of Infectious Disease, Department of Medicine, University of North Carolina At Chapel HillInjury Prevention Research Center, University of North Carolina At Chapel HillDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina At Chapel HillAbstract Introduction Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading to delays in getting necessary care. The objective of this study was to examine SSTI treatment experiences among people utilizing services from syringe services programs. This study was initiated by people with lived experience of drug use to improve quality of care. Methods We conducted a cross-sectional survey among participants of five syringe services programs in North Carolina from July through September 2020. Surveys collected information on each participant’s history of SSTIs and IE, drug use and healthcare access characteristics, and SSTI treatment experiences. We examined participant characteristics using counts and percentages. We also examined associations between participant characteristics and SSTI history using binomial linear regression models. Results Overall, 46% of participants reported an SSTI in the previous 12 months and 10% reported having IE in the previous 12 months. Those with a doctor they trusted with drug use-related concerns had 27 fewer (95% confidence interval = − 51.8, − 2.1) SSTIs per every 100 participants compared to those without a trusted doctor. Most participants with a SSTI history reported delaying (98%) or not seeking treatment (72%) for their infections. Concerns surrounding judgment or mistreatment by medical staff and self-treating the infection were common reasons for delaying or not seeking care. 13% of participants used antibiotics obtained from sources other than a medical provider to treat their most recent SSTI. Many participants suggested increased access to free antibiotics and on-site clinical care based at syringe service programs to improve treatment for SSTIs. Conclusions Many participants had delayed or not received care for SSTIs due to poor healthcare experiences. However, having a trusted doctor was associated with fewer people with SSTIs. Improved access to non-judgmental healthcare for people who use drugs with SSTIs is needed. Expansion of syringe services program-based SSTI prevention and treatment programs is likely a necessary approach to improve outcomes among those with SSTI and IE.https://doi.org/10.1186/s12954-021-00528-xDrug useSkin and soft tissue infectionsAbscessesCellulitisEndocarditisInfectious disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mary C. Figgatt Zach R. Salazar Louise Vincent Diannee Carden-Glenn Kelly Link Lauren Kestner Tyler Yates Asher Schranz Elizabeth Joniak-Grant Nabarun Dasgupta |
spellingShingle |
Mary C. Figgatt Zach R. Salazar Louise Vincent Diannee Carden-Glenn Kelly Link Lauren Kestner Tyler Yates Asher Schranz Elizabeth Joniak-Grant Nabarun Dasgupta Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina Harm Reduction Journal Drug use Skin and soft tissue infections Abscesses Cellulitis Endocarditis Infectious disease |
author_facet |
Mary C. Figgatt Zach R. Salazar Louise Vincent Diannee Carden-Glenn Kelly Link Lauren Kestner Tyler Yates Asher Schranz Elizabeth Joniak-Grant Nabarun Dasgupta |
author_sort |
Mary C. Figgatt |
title |
Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina |
title_short |
Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina |
title_full |
Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina |
title_fullStr |
Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina |
title_full_unstemmed |
Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina |
title_sort |
treatment experiences for skin and soft tissue infections among participants of syringe service programs in north carolina |
publisher |
BMC |
series |
Harm Reduction Journal |
issn |
1477-7517 |
publishDate |
2021-07-01 |
description |
Abstract Introduction Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading to delays in getting necessary care. The objective of this study was to examine SSTI treatment experiences among people utilizing services from syringe services programs. This study was initiated by people with lived experience of drug use to improve quality of care. Methods We conducted a cross-sectional survey among participants of five syringe services programs in North Carolina from July through September 2020. Surveys collected information on each participant’s history of SSTIs and IE, drug use and healthcare access characteristics, and SSTI treatment experiences. We examined participant characteristics using counts and percentages. We also examined associations between participant characteristics and SSTI history using binomial linear regression models. Results Overall, 46% of participants reported an SSTI in the previous 12 months and 10% reported having IE in the previous 12 months. Those with a doctor they trusted with drug use-related concerns had 27 fewer (95% confidence interval = − 51.8, − 2.1) SSTIs per every 100 participants compared to those without a trusted doctor. Most participants with a SSTI history reported delaying (98%) or not seeking treatment (72%) for their infections. Concerns surrounding judgment or mistreatment by medical staff and self-treating the infection were common reasons for delaying or not seeking care. 13% of participants used antibiotics obtained from sources other than a medical provider to treat their most recent SSTI. Many participants suggested increased access to free antibiotics and on-site clinical care based at syringe service programs to improve treatment for SSTIs. Conclusions Many participants had delayed or not received care for SSTIs due to poor healthcare experiences. However, having a trusted doctor was associated with fewer people with SSTIs. Improved access to non-judgmental healthcare for people who use drugs with SSTIs is needed. Expansion of syringe services program-based SSTI prevention and treatment programs is likely a necessary approach to improve outcomes among those with SSTI and IE. |
topic |
Drug use Skin and soft tissue infections Abscesses Cellulitis Endocarditis Infectious disease |
url |
https://doi.org/10.1186/s12954-021-00528-x |
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