摘要：A wound and abscess clinic, held concurrently with a syringe exchange, provided economical treatment and aftercare for injection-associated soft tissue infections. During 20 two-hour clinic sessions, 173 treatment episodes were logged, and the visit cost was estimated at $5 per patient. Increased patient–clinician interactions provided opportunities beyond those afforded by the syringe exchange for patients to obtain resources and referrals to services such as HIV counseling and testing, medical care, and drug treatment. Distribution of cards advertising the clinic was substantially less effective than word of mouth in increasing community awareness of the clinic. INJECTION-RELATED SOFT tissue infections are common among injection drug users. 1, 2 In a 1997 sample of injection drug users from one San Francisco neighborhood, the prevalence of soft tissue infections was 32%. 1 These infections place injection drug users at risk for serious medical problems, including cellulitis, septicemia, and necrotizing fasciitis. Although soft tissue infections can be treated in outpatient settings, most community-based clinics do not perform incision and drainage procedures. Hence, treatment is typically hospital based, and estimated costs range from $185 to $360 (excluding medications and physician fees). Many injection drug users are reluctant to seek hospital-based treatment because they lack financial resources or are concerned about negative or punitive interactions with health care providers. 3, 4 Syringe exchange programs have been demonstrated to improve public health. 5, 6 Injection drug users have grown to trust syringe exchange and affiliated programs because they espouse a non–abstinence-based harm reduction philosophy while encouraging customers to adopt healthier habits (e.g., hygienic injection practices, vein care, nutrition) to reduce their health risks. Syringe exchange programs that treat injectionassociated wounds and soft tissue infections have the potential to expand their effectiveness by reducing negative sequelae of infections and providing injectors with access to needed health care resources and social services.
