Factors associated with skin and soft tissue infections among people who inject drugs in the United Kingdom: A comparative examination of data from two surveys

Jason Doran, Magdalena Harris*, Vivian D. Hope, Talen Wright, Claire Edmundson, Katherine Sinka, Ellen Heinsbroek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background: People who inject drugs (PWID) are at high risk of injection-related skin and soft tissue infections (SSTI). If not treated promptly, these can lead to serious health complications, which are a considerable healthcare burden. Data from two community surveys, with different approaches, were used to assess SSTI prevalence and associated factors among PWID to inform intervention implementation. Methods: Data were analysed from two surveys, a national surveillance survey (n=2,874; 2017–18) of infections among PWID in the United Kingdom (UK) and an in-depth survey (n=455; 2018–19) of SSTI among PWID based in London, UK. Multivariable logistic regression models were constructed to ascertain the factors associated with self-reported SSTI. Results: High prevalence of SSTI were reported in both samples: 52 % of participants from the national surveillance survey reported having SSTI within the preceding 12 months and 65 % of the London sample reported a lifetime history of SSTI. The factors associated with SSTI in both surveys were similar, including older age; number of years injecting; number of attempts required to inject into the vein; injecting into the hands, feet, groin or neck and re-using or sharing needles/syringes. Conclusions: The number of PWID reporting SSTI in the UK is concerningly high. The two surveys used different recruitment approaches but found similar associations. We provide strong evidence of a relationship between venous access difficulty and SSTI. To stem the increase of SSTI and related complications in the UK, it is crucial that interventions attend to the underlying causes of venous damage among PWID.

Original languageEnglish
Article number108080
JournalDrug and Alcohol Dependence
Publication statusPublished - 1 Aug 2020

Bibliographical note

Funding Information:
Magdalena Harris was funded by a National Institute for Health Research (NIHR) Career Development Fellowship [ CDF-2016-09-014 ] for the Care & Prevent Study. The UAM survey was core funded by Public Health England . The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2020 Elsevier B.V.

Copyright 2020 Elsevier B.V., All rights reserved.


  • Abscesses
  • Bacterial infections
  • Harm reduction
  • Injection-site infections
  • People who inject drugs
  • Skin and soft tissue infections
  • Vein damage


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