Highlights
- Intentional subcutaneous and intramuscular injections are rare.
- 56% of those aiming to inject intravenously reported ever missing a vein.
- One-in-six report a ‘missed hit’ more than four times a month.
- ‘Missed hits’ are associated with poor injection practice & injection site problems.
- Interventions to improve injecting technique and hygiene are needed.
Background
The
extent of intentional or accidental subcutaneous and intramuscular injections and
the factors associated with these have rarely been studied among people who
inject drugs, yet these may play an important role in the acquisition bacterial
infections. This study describes the extent of these, and in particular the
factors and harms associated with accidental subcutaneous and intramuscular
injections (i.e. ‘missed hits’).
Method
People
who inject drugs were recruited using respondent driven sampling. Weighted data
was examined using bivariate analyses and logistic regression.
Results
The
participants mean age was 33 years (31% aged under 30-years), 28% were women,
and the mean time since first injection was 12 years (N = 329). During the
preceding three months, 97% had injected heroin, 71% crack-cocaine, and 16%
amphetamines; 36% injected daily. Overall, 99% (325) reported that they aimed
to inject intravenously; only three aimed to inject subcutaneously and one
intramuscularly. Of those that aimed to inject intravenously, 56% (181)
reported ever missing a vein (for 51 this occurred more than four times month
on average). Factors associated with ‘missed hits’ suggested that these were
the consequence of poor vascular access, injection technique and/or hygiene.
‘Missed hits’ were twice as common among those reporting sores/open wounds, abscesses,
or redness, swelling & tenderness at injection sites.
Conclusions
Intentional
subcutaneous and intramuscular injections are rare in this sample. ‘Missed
hits’ are common and appear to be associated with poor injection practice.
Interventions are required to reduce risk through improving injecting practice
and hygiene.
Purchase full article at: http://goo.gl/dXnkaE
By:
Affiliations
National Infection service, Public Health England, London,
UK
Centre for Research on Drugs & Health Behaviour,
Department of Social and Environmental Health Research, London School of
Hygiene & Tropical Medicine, London, UK
Correspondence
Corresponding author.at: Centre for Infectious Disease
Surveillance and Control, Public Health England, 61 Colindale Avenue, London,
NW9 5EQ, UK.
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