255. Sex Work, Injection Drug Use, and Abscesses: Associations in Women, But Not Men
Session: Poster Abstract Session: Clinical: Skin and Soft Tissue
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • IDWEEK_poster_9.22.2017.pdf (782.3 kB)
  • Background:Abscesses are a common health issue for people who inject drugs (PWID). Females have a higher risk of abscesses, yet it is unclear if the risks are comparable among female sub-populations. The goal of this study was to examine the associations between gender, sex work, and risks of abscesses in PWID.

    Methods:We combined data from two cross-sectional studies conducted in the greater Boston area with 225 participants aged 18-45 years, who participated in injection drugs use in the previous 30 days. Demographics, injection-mediated risks, and sexual behaviors were collected using ACASI. Injection drug use was defined as “high” if injection frequencies exceeded the median. Odds ratios from multivariable logistic regressions were used to represent the associations; all analyses were gender-stratified.

    Results:The cohort was 31% women (71/225). White race was more common in women than men (89% vs 63%). Women were more likely than men to report: sex work 31% vs. 14%, heavy heroin use 56% vs 40%, HCV 76% vs 61%, abscesses 54% vs. 38%. Controlling for confounders, females who engaged in sex work had > 7 times higher odds of reporting abscesses [AOR 7.51; 95% CI (1.41, 40.07)]. There was no association between sex work in men and increased risk for abscess.

    Conclusion:We found a gender-specific association between sex work, injection drug use and abscesses among PWID. The cross-sectional designs precluded causal inferences; further longitudinal studies are necessary to better understand the gender-associated risks for abscesses and to develop harm reduction interventions.

    Factors Associated with Abscess for Female PWID, Massachusetts, 2015-2016 (n=71)

    Predictor

    N (%), Median [IQR]

    OR (95% CI)

    AOR

    Sex work

    22 (31)

    3.27 (1.10, 9.78)

    7.51 (1.41, 40.07)

    Age

    32 [30,36]

    0.97 (0.89, 1.06)

    0.90 (0.78, 1.04)

    Heavy heroin use

    40 (56)

    1.82 (0.71, 4.71)

    3.60 (0.95, 13.69)

    Heavy cocaine use

    15 (21)

    0.71 (0.23, 2.21)

    0.12 (0.02, 0.84)

    White

    63 (89)

    1.17 (0.27, 5.11)

    0.32 (0.04, 2.94)

    High school education or greater

    49 (69)

    0.55 (0.20, 1.54)

    0.43 (0.11, 1.74)

    Homeless

    59 (83)

    4.38 (1.07, 17.85)

    5.16 (0.95, 28.13)

    HCV+

    54 (76)

    4.68 (1.31, 16.66)

    11.26 (1.85, 68.67)

    HIV+

    2 (3)

    0.86 (0.05, 14.39)

    0.44 (0.01, 26.84)

    Needle Exchange Program

    50 (70)

    0.62 (0.22, 1.74)

    0.41 (0.10, 1.70)

    Deirdre Burke, MPH1, Alysse Wurcel, MD, MS2, David Landy, BS3, Margie Skeer, ScD, MPH, MSW4, Robert Heimer, PhD5, Kenneth K. H. Chui, PhD4 and Thomas Stopka, PhD, MHS3, (1)Infectious Disease and Geographic Medicine, Tufts Medical Center, Tufts University, Boston, MA, (2)Department of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, (3)Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, (4)Public Health, Tufts University School of Medicine, Boston, MA, (5)Yale School of Public Health, New Haven, CT

    Disclosures:

    D. Burke, None

    A. Wurcel, Tufts Medical Center, Tufts University School of Medicine: Grant Investigator , Grant recipient , Merck, BMS and Research support

    D. Landy, None

    M. Skeer, None

    R. Heimer, None

    K. K. H. Chui, None

    T. Stopka, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.