Publication Detail

Gibbs, D., Peacock, A., O'Keefe, D., Butler, K., Bruno, R., Lenton, S., Burns, L. and Larney, S. Use of alcohol swabs to clean injecting sites among people who regularly inject drugs in Australia. Drug and Alcohol Review. [In Press] [RJ1483]

Introduction and Aims: Cleaning drug injection sites with alcohol swabs prior to injecting reduces risk of abscesses and other skin and soft tissue infections (SSTI). Better understanding of swabbing behaviours can inform interventions to improve injecting hygiene. We aimed to determine the sociodemographic, drug use, and injecting risk exposure correlates of swabbing prior to injecting, and reasons for not swabbing.

Design and Methods: Participants who had injected drugs at least monthly in the past six months were recruited in May-July 2017 from all Australian capital cities via needle and syringe programs and word-of-mouth. A structured interview was used to collect information on swabbing practices, as well as drug use and related behaviour. Logistic regression was used to identify factors associated with not swabbing at last injection.

Results: Of 853 participants, one quarter (26%) reported that they did not swab prior to their last injection. In adjusted analyses, crystal methamphetamine as the last drug injected, past month receptive or distributive syringe sharing, and past month reuse of one’s own needle were significantly associated with not swabbing at last injection. Among participants who did not swab at last injection, swabbing was frequently considered unnecessary and, a small number disliked using alcohol swabs.

Discussion and Conclusions: Efforts are needed to increase awareness of the importance of injecting hygiene in preventing SSTI. Interventions to increase swabbing should be included as part of a wider package of injecting hygiene education, particularly in light of the associations with receptive and/or distributive syringe sharing.

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