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Spore forming bacteria infections and people who inject drugs: Implications for harm reduction.

Dunleavy, K, Munro, A, Roy, K, Hutchinson, S, Palmateer, N, Knox, T, Goldberg, D, Hope, V, Campbell, J, Hamilton, E, Liddell, D, Penrice, G and Taylor, A (2017) Spore forming bacteria infections and people who inject drugs: Implications for harm reduction. International Journal of Drug Policy, 53. pp. 45-54. ISSN 0955-3959

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Abstract

BACKGROUND: There is no research on public health interventions that alert people who inject drugs (PWID) to clusters/outbreaks of severe bacterial infections. In Scotland, during the botulism cluster/outbreak of Dec 2014-July 2015 harm reduction (HR) messages detailed on a postcard (Botulism Postcard) were distributed to PWID between Feb-April 2015. We examined the impact of the Botulism Postcard on cluster/outbreak awareness, healthcare seeking and HR behaviours among PWID; and their views on such clusters/outbreaks. METHODS: The Botulism Postcard questionnaire survey was undertaken with 288 PWID recruited in Greater Glasgow and Clyde between May-August 2015. Multivariate logistic regression was undertaken. Between Oct 2015-January 2016 22 in-depth interviews were conducted with PWID in Glasgow and Edinburgh, these underwent thematic analysis. RESULTS: 38% (108/284) had never seen the postcard, 14% (40/284) had only seen it, 34% (98/284) read but not discussed it and 13% (38/284) had discussed it with service staff. Cluster/outbreak awareness was higher among those who had read (adjusted odds ratio (aOR) = 5.374, CI 2.394-11.349, p < 0.001) or discussed the postcard (aOR = 25.114, CI 3.188-190.550, p < 0.001); and symptom awareness was higher among those who had read (aOR = 2.664, CI 1.322-4.890, p < 0.001) or discussed the postcard (aOR = 6.707, CI 2.744 16.252, p < 0.001) than among those who had never seen it. The odds of introducing HR was higher among those who had discussed the postcard (AOR = 3.304 CI 1.425 7.660, p < 0.01) than those who had only read it. PWID learnt about clusters/outbreaks from several sources and despite concerns they continued to inject during such events. CONCLUSION: More widespread exposure to the Botulism Postcard during the outbreak/cluster was needed. The Botulism Postcard distributed to PWID may raise awareness of such events, the symptoms, and may encourage HR particularly when used as a tool by frontline staff to initiate discussion. Acknowledging that people continue to inject during clusters/outbreaks of such infections necessitates a pragmatic HR approach.

Item Type: Article
Uncontrolled Keywords: 11 Medical And Health Sciences, 17 Psychology And Cognitive Sciences, 16 Studies In Human Society
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Public Health Institute
Publisher: Elsevier
Related URLs:
Date Deposited: 10 Jan 2018 10:18
Last Modified: 10 Jan 2018 10:18
DOI or Identification number: 10.1016/j.drugpo.2017.12.001
URI: http://researchonline.ljmu.ac.uk/id/eprint/7794

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