Objective: The purposes of this study for persons with a history of injection drug use (IDU) were to examine the legs for changes related to chronic venous insufficiency (CVI) and to examine the extent to which pain mediates the relationship between CVI severity and functioning. Low income African-Americans have greater use of IDU and experience health care disparities. Little is known about CVI and IDU. Design: A cross sectional design was used. Sample: Participants were 100 persons with a history of IDU;they were recruited from a medical clinic and a methadone treatment center. Most were African-American (94%); 59% were male and 41% female; the mean age was 47.3 years. Concepts: The clinical portion of the CEAP was used to classify the legs for CVI. Ability to function (coefficient alpha .93) and pain (coefficient alpha .92) were rated on 10 point scales. Methods: Participants had their legs examined and classified for CVI. They responded to a questionnaire about their background, drug use, leg pain, and functioning. Findings: According to CVI of the worse leg, 57 had current ulcers, 31 had healed ulcers or other skin changes, 5 had mild disease, and 7 had no evidence of CVI. The greatest interference to the legs was stair climbing and walking. The path analysis showed CVI class mediated function through pain. Conclusions: The higher the CVI class, the greater the pain. Pain interfered with function. Implications: CVI adds burden to vulnerable persons with a history of IDU. Strategies must be developed and implemented to protect the legs and prevent advanced CVI as much as possible.
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