Understanding Gender Differences in Injecting-Related Harms Among an Australian Sample of People Who Inject Drugs

People who inject drugs may experience several non-viral injecting-related injuries and diseases (IRID), including skin and soft tissue infection (SSTI) and venous disease, often resulting from bacteria introduced via unsafe injecting practices or environments. Women are overrepresented among those reporting multiple and recent IRID. However, limited evidence exists about how gender interacts with known IRID risk factors.

Surveys were conducted 2009-2023 with approximately 900 Australians who inject drugs per year (N = 7538 total). Participants self-reported past-month drug use behaviours and IRID experience. We conducted multivariable binary logistic regression to determine the relationship between gender and SSTI and venous disease. To examine whether gender uniquely affected specific injecting risk behaviours with respect to SSTI and venous disease, two interaction terms were separately added: (i) gender and injecting frequency; (ii) gender and reuse of one's needles.

Surveys were completed by 5038 men and 2500 women. Past-month SSTI was reported by 8% of the sample (95% confidence interval 7%-9%), with a higher proportion among women (10%) than men (7%). Overall, 4% reported past-month venous disease (95% confidence interval 3%-4%), a higher proportion among women (5%) than men (3%). Examining both outcomes, no statistically significant interactions between gender and needle reuse or injecting frequency were found.

Despite no statistically significant interaction between gender and reuse or injecting frequency, our study demonstrates a gender difference in exposure to risk factors associated with SSTIs and venous disease. Interventions to reduce SSTI and venous disease, particularly those deemed safe and appropriate by women, are needed.