Clinical services to prevent and treat wounds, abscesses and infections caused as a result of injection drug use are now being offered at the University of Illinois at Chicago’s Community Outreach Intervention Project’s, or COIP, west side field office. Services will be provided by physicians, nurses and students from UIC’s Urban Global Medicine Program and the UIC College of Nursing.
COIP provides clean needles to injection drug users, performs testing for hepatitis C and HIV and offers overdose prevention education. Counselors at the clinic also help provide linkage to additional medical care and addiction treatment services for people with drug and alcohol use disorders. The west side office is one of five field sites run by COIP, which is housed in the UIC School of Public Health. COIP also operates a mobile van that provides outreach, needle exchange, HIV and hepatitis C testing and counseling in communities on the city’s south and west sides.
“We wanted to offer additional clinical services to the population seen at the COIP west side clinic. A needs assessment conducted by the UIC Urban Global Health program and COIP identified skin and tissue infections as the most common reason clients at these sites access clinical care,” said Dr. Stockton Mayer, assistant professor of clinical medicine in UIC Department of Medicine, division of infectious diseases and an investigator on a $100,000 grant from the Hearst Foundation to support the new services.
Antonio Jimenez, director of COIP, said he wanted to make sure that any additional services offered at COIP directly addressed the unique needs of its clients.
“I heard often from the field staff working in the clinic that they see a lot of clients with skin and soft tissue infections who asked about where to get treatment,” Jimenez said. “The needs assessment that was conducted by medical residents and students at UIC came up with the same thing: wound care and infection of injection sites were a major medical concern for COIP clients.”
The assessment found that 27 percent of COIP clients sought care for a skin or soft tissue infection in the last 12 months. Mood disorders, drug and/or alcohol use disorder, overdose treatment and hepatitis C were other common reasons COIP clients sought medical care.
A physician, nurse practitioner and care coordinator now see clients at the west side COIP clinic on Friday mornings.
“While wound care might be what brings people through the door, we also provide comprehensive care based on patient needs,” Mayer said.
Testing for STDs is also provided, as well as basic mental health counseling, referral to addiction services or to the University of Illinois Hospital & Clinics to follow up with other health care needs. Patients who need help signing up for Medicaid or health insurance are also assisted.
Gabe Culbert, assistant professor of health systems science in the UIC College of Nursing and a co-investigator on the Hearst Foundation grant will lead a research study aimed at reducing the incidence of skin and soft tissue infections and persistent wounds caused by injection drug use or injuries.
“Many of the clients seen at COIP are homeless in addition to being injection drug users, and so in addition to having injection sites that might be infected, they also frequently present with injuries that are the result of living on the streets. Without proper care, their wounds can become extremely hard to successfully treat,” Culbert said.
Part of the research will determine the efficacy of using chlorhexidine gluconate, a long-acting topical antiseptic, along with alcohol wipes to treat infection. Determining the factors that increase the risk for injection site infections, and designing educational interventions to reduce those risks are also part of the project, Culbert said.
“We need a comprehensive bio-behavioral approach to reducing these types of infections that include behavior change in terms of injection practices, as well as antibiotics that help infections clear up and wounds heal,” Culbert said.
Mayer and Culbert anticipate also offering clinical services via the COIP van, which visits different neighborhoods mostly on Chicago’s south and west sides to offer needle exchange and HIV testing and counseling.
“We will have a physician and nurse on the van one day a week to start with,” Mayer said.
“Right now the program is a pilot, but we certainly hope it grows to include additional days going forward,” Jimenez said.