#VP25: Prevalence And Factors Associated With Hospitalisation For Drug-Related Causes Among People Who Inject Drugs: The Ethos Engage Study

Author: Alice Wheeler Heather Valerio Evan Cunningham Marianne Martinello Gail Matthews Samantha Colledge Maryam Alavi Janaki Amin Adrian Dunlop Carla Gorton Jeremy Hayllar Charles Henderson Jo Holden Thao Lam Phillipa Marks Andrew Milat Phillip Read David Reid David Silk Carla Treloar Louisa Degenhardt Gregory Dore Jason Grebely

Theme: Epidemiology and Public Health Research Year: 2021

Background: Health consequences of injecting drug use often necessitate medical management in hospital settings. Injecting-related skin and soft tissue infections (SSTIs) are a common reason for hospitalisation of people who inject drugs (PWID) and contribute considerable burden to healthcare systems. This study assessed the prevalence and factors associated with drug-related hospitalisation among PWID. Methods: ETHOS Engage is an observational study of PWID engaged in harm reduction services in Australia. Participants completed a self-administered questionnaire at baseline. Logistic regression models were used to identify factors associated with hospitalisation in the preceding year for (1) any drug-related cause, and (2) SSTIs (abscess and/or cellulitis) specifically. Results: Among 1,443 participants enrolled between May 2018 – September 2019, 1,100 reported injecting drug use in the past six months(65% male; 63% aged ≥ 40 years; 40% receiving opioid agonist treatment [OAT]). Past-year hospitalisation for drug-related causes was reported by 39% (n=433) of participants. Participants who were female (adjusted odds ratio [aOR] 1.41; 1.07-1.85), recently incarcerated (aOR 1.49; 1.02-2.19), injected cocaine (past 6 months; aOR 2.34; 1.53-3.57), received OAT >1 year ago (vs. never; aOR 1.49; 1.06-2.11) or had hazardous alcohol use (AUDIT-C; aOR 1.36; 1.05-1.77) were more likely to be hospitalised for drug use. Drug-related hospitalisation was less likely among participants injecting heroin (past 6 months; aOR 0.66; 0.50-0.87) or recruited from outer regional areas (aOR 0.59; 0.39-0.91). Past-year hospitalisation for SSTIs was reported by 21% (n=228) of participants and was more likely among females (aOR 1.75; 1.27-2.42) and participants with recent incarceration (aOR 1.89; 1.20-2.97). Injecting frequency was not associated with likelihood of SSTI-related hospitalisation (

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