Cutaneous Abscess Prevalence and Risk Factors Among People Who Inject Drugs in Denver, Colorado

Skin and soft tissue infections (SSTIs) are considered common problems for people who inject drugs (PWID), yet few studies actually quantify injection-related SSTIs or identify contributing risk behaviors. We report the prevalence of self-reported cutaneous abscesses among PWID and explore associations between abscesses and injection-related behaviors.

PWID were recruited to participate in the National HIV Behavioral Surveillance system in Denver, Colorado, and answered questions about their experiences with abscesses and injection-related activities. We used χ² statistics to assess differences between sociodemographic and healthcare characteristics and injection-related behaviors associated with self-reported abscess in the past 12 months. We used generalized linear models to estimate the unadjusted and adjusted prevalence ratios to describe the association between using sterile needles and abscess in the past 12 months. We also examined the association between using alcohol swabs and abscess in the past 12 months.

Of the 533 participants who completed the survey in 2018, 257 (48%) reported having at least 1 abscess in the past 12 months while 98 of the 277 (35%) participants in 2022 reported an abscess. In both 2018 and 2022, participants who reported less consistent use of sterile needles were significantly more likely to report having an abscess in the past 12 months.

These findings highlight the relatively high prevalence of recent abscesses among PWID and underscore the need to identify simple, accessible prevention strategies for use in clinical and nonclinical settings.