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. 2021 Mar 15;8(6):ofab128.
doi: 10.1093/ofid/ofab128. eCollection 2021 Jun.

The Dynamics of Infectious Diseases Associated With Injection Drug Use in Lawrence and Lowell, Massachusetts

Gregg S Gonsalves  1   2 , A David Paltiel  3   2 , Thomas Thornhill  1   2 , Suzan Iloglu  1   2 , Alfred DeMaria Jr  4 , Kevin Cranston  4 , R Monina Klevens  4 , Rochelle P Walensky  5 , Joshua L Warren  6   2
Affiliations

The Dynamics of Infectious Diseases Associated With Injection Drug Use in Lawrence and Lowell, Massachusetts

Gregg S Gonsalves et al. Open Forum Infect Dis. .

Abstract

Background: There are a wide variety of infectious complications of injection drug use. Understanding the trajectory of these complications might inform the development of an early warning system for human immunodeficiency virus (HIV) outbreaks that occur regularly among people who inject drugs (PWID).

Methods: A distributed lag Poisson regression model in the Bayesian setting was used to examine temporal patterns in the incidence of injection-associated infectious diseases and their association with HIV cases in Lawrence and Lowell, Massachusetts between 2005 and 2018.

Results: Current-month HIV counts are associated with fatal overdoses approximately 8 months prior, cases of infective endocarditis 10 months prior, and cases of skin and soft tissue infections and incision and drainage procedures associated with these infections 12 months prior.

Conclusions: Collecting data on these other complications associated with injection drug use by public health departments may be important to consider because these complications may serve as input to a sentinel system to trigger early intervention and avert potential outbreaks of HIV.

Keywords: HIV; endocarditis; injection drug uses; overdose; skin and soft tissue infection.

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Figures

Figure 1.
Figure 1.
Time series plots for human immunodeficiency virus (HIV) cases and each infectious disease and other health outcome variables. The first month corresponds to January 2005 and the last month corresponds to December 2018. Red dashed lines indicate the period of HIV outbreak in the area. Echo, echocardiogram; HCV, hepatitis C virus; IE, infective endocarditis; I&D, incision and drain procedures; OD, overdose; SSTI, skin, soft tissue, and musculoskeletal infections.
Figure 2.
Figure 2.
Results for the individual distributed lag regression parameters on the relative risk scale. Red indicates that the 90% lower bound of the credible interval is >1, whereas blue indicates that the upper limit is <1. Echo, echocardiogram; HCV, hepatitis C virus; IE,: infective endocarditis; I&D, incision and drain procedures; OD, overdose; SSTI, skin, soft-tissue, and musculoskeletal infections.
See this image and copyright information in PMC

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