ArticleHarm reduction journal2019
Reducing injection intensity is associated with decreased risk for invasive bacterial infection among high-frequency injection drug users.
Article in Harm reduction journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 33 citations in OpenAlex.
- Bacterial and fungal infections in persons who inject drugs.Clinical microbiology reviews · 2025Review
- Prevalence of Injection-Related Bacterial and Fungal Infection Among People Who Inject Drugs: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2025Article
- Substance use patterns, sociodemographics, and health profiles of harm reduction service recipients in Burlington, Vermont.Harm reduction journal · 2024Article
- Review
- A multimorbidity model for estimating health outcomes from the syndemic of injection drug use and associated infections in the United States.BMC health services research · 2023Article
- Grayken lessons: the role of an interdisciplinary endocarditis working group in evaluating and optimizing care for a woman with opioid use disorder requiring a second tricuspid valve replacement.Addiction science & clinical practice · 2023Article
- "They Just Assume That We're All Going to Do the Wrong Thing With It. It's Just Not True": Stakeholder Perspectives About Peripherally Inserted Central Catheters in People Who Inject Drugs.Open forum infectious diseases · 2022Article
- Heroin pipe distribution to reduce high-risk drug consumption behaviors among people who use heroin: a pilot quasi-experimental study.Harm reduction journal · 2022Article
- Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage.Harm reduction journal · 2022Article
- Long-term Infective Endocarditis Mortality Associated With Injection Opioid Use in the United States: A Modeling Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Sequential endogenous endophthalmitis, fungal keratitis, bacteremia and vertebral osteomyelitis in a person who injects drugs.American journal of ophthalmology case reports · 2021Article
- Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina.Harm reduction journal · 2021Article
- Missed Opportunities for Human Immunodeficiency Virus (HIV) Testing During Injection Drug Use-Related Healthcare Encounters Among a Cohort of Persons Who Inject Drugs With HIV Diagnosed During an Outbreak-Cincinnati/Northern Kentucky, 2017-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Medications for Opioid Use Disorder Demonstrate Clear Benefit for Patients With Invasive Infections: Letter-in-reply.Journal of addiction medicine · 2020Article
- Greater Attention Paid to the Patient's Experience Could Improve the Treatment of Individuals With Opioid Use Disorder Hospitalized for Serious Infections.Journal of addiction medicine · 2020Article
- Not Just Endocarditis: Hospitalizations for Selected Invasive Infections Among Persons With Opioid and Stimulant Use Diagnoses-North Carolina, 2010-2018.The Journal of infectious diseases · 2020Article
- Administration of Glucose at Litter Equalization as a Strategy to Increase Energy in Intrauterine Growth Restricted Piglets.Animals : an open access journal from MDPI · 2020Article
- Risk factors for multiple skin abscesses among community-recruited people who inject drugs in Los Angeles, CA, and Denver, CO: a cross-sectional study.Therapeutic advances in infectious diseaseArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 3 countries.
Funding
Abstract
backgroundBacterial infection is a major cause of morbidity and mortality for persons who inject drugs (PWID). Injection cessation may help abrogate such infections, but maintaining complete cessation is challenging. Limited data exists on the role of reduced injection intensity on invasive bacterial infection risk. We sought to evaluate decreased risk for bacterial infections following cessation and substantive reduction in the injection intensity.
methodsParticipants were persons in the AIDS Linked to the Intravenous Experience (ALIVE) cohort with initial high-frequency injection drug use (> 1 daily). Pooled logistic regression with generalized estimating equations was used to estimate risk for invasive bacterial infection (pneumonia, endocarditis, or sepsis) among participants achieving complete injection cessation or reduced injection intensity relative to those with sustained high-frequency use.
resultsOf 2247 study participants with 12,469 paired study visits, complete injection cessation was achieved at 13.5% and reduced injection intensity at 25.5% of study visits. Adjusting for sociodemographics and HIV status, injection cessation was associated with a 54% reduction of bacterial infection at 3 months (odds ratio [OR] 0.46, 95% CI 0.25-0.84) and a 46% reduction at 6 months (OR 0.54, 95% CI 0.36-0.81). Reduced injection intensity was associated with a 36% reduction of infection at 3 months (OR 0.64, 95% CI 0.43-0.96) and a 26% reduction at 6 months (OR 0.74, 95% CI 0.56-0.98).
conclusionsBoth complete cessation and reduced injection frequency demonstrate substantial benefit in reducing invasive bacterial infection risk among PWID. With high rates of relapse into injection use, targeting sustained reductions in drug use intensity may be a key harm reduction modality for improving clinical outcomes in this population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.