Profile and correlates of injecting-related injuries and diseases among people who inject drugs in Australia

Introduction: People who inject drugs (PWID) commonly experience harms related to their injecting, many ofwhich are consequences of modifiable drug use practices. There is currently a gap in our understanding of howcertain injecting-related injuries and diseases (IRID) cluster together, and socio-demographic and drug usecharacteristics associated with more complex clinical profiles.Method: Surveys were conducted with 902 Australian PWID in 2019. Participants provided information regarding their drug use, and past month experience of the following IRID: artery injection, nerve damage, skinand soft tissue infection, thrombophlebitis, deep vein thrombosis, endocarditis, septic arthritis, osteomyelitis,and septicaemia. We performed a latent class analysis, grouping participants based on reported IRID and ran aclass-weighted regression analysis to determine variables associated with class-membership.Results: One-third (34 %) of the sample reported any IRID. A 3-class model identified: 1) no IRID (73 %),moderate IRID (21 %), and 3) high IRID (6%) clusters. Re-using one`s own needles was associated with belonging to the high IRID versus moderate IRID class (ARRR = 2.38; 95 % CI = 1.04−5.48). Other factors,including daily injecting and past 6-month mental health problems were associated with belonging to moderateand high IRID classes versus no IRID class.Conclusion: A meaningful proportion of PWID reported highly complex IRID presentations distinguished by thepresence of thrombophlebitis and associated with greater re-use of needles. Increasing needle and syringecoverage remains critical in addressing the harms associated with injecting drug use and expanding the capacityof low-threshold services to address less severe presentations might aid in reducing IRID amongst PWID