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      Sex Work, Injection Drug Use, and Abscesses: Associations in Women, But Not Men

      abstract
      , MPH 1 , , MD, MS 2 , , BS 3 , , ScD, MPH, MSW 4 , , PhD 5 , , PhD 4 , , PhD, MHS 3
      Open Forum Infectious Diseases
      Oxford University Press

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          Abstract

          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)
          Disclosures

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

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          Author and article information

          Journal
          Open Forum Infect Dis
          Open Forum Infect Dis
          ofid
          Open Forum Infectious Diseases
          Oxford University Press (US )
          2328-8957
          Fall 2017
          04 October 2017
          04 October 2017
          : 4
          : Suppl 1 , ID Week 2017 Abstracts
          : S109
          Affiliations
          [1 ] Infectious Disease and Geographic Medicine, Tufts Medical Center, Tufts University , Boston, Massachusetts
          [2 ] Department If Geographic Medicine and Infectious Diseases, Tufts Medical Center , Boston, Massachusetts
          [3 ] Public Health and Community Medicine, Tufts University School of Medicine , Boston, Massachusetts
          [4 ] Public Health, Tufts University School of Medicine , Boston, Massachusetts
          [5 ] Yale School of Public Health , New Haven, Connecticut
          Author notes

          Session: 47. Clinical: Skin and Soft Tissue

          Thursday, October 5, 2017: 12:30 PM

          Article
          ofx163.113
          10.1093/ofid/ofx163.113
          5632174
          be927ef8-05db-4536-a5ca-decea32e836f
          © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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