HIV seroprevalence among orphaned and homeless youth

Hillis, Susan D.; Zapata, Lauren B.; Robbins, Cheryl L.; Kissin, Dmitry M.; Skipalska, Halyna; Yorick, Roman; Finnerty, Erin; Marchbanks, Polly A.; Jamieson, Denise J.

doi:10.1097/qad.0b013e32834c4be4

Cited by 33 publications

(33 citation statements)

References 30 publications

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“…Considering the high prevalence of homelessness and public drug use among street-involved youth (DeMatteo et al, 1999; Marshall, Kerr, Qi, Montaner, & Wood, 2010; Rachlis, Wood, Zhang, Montaner, & Kerr, 2009), additional efforts to address these environmental determinants of risk among this subpopulation may be of greater benefit than efforts that focus solely on modifying individual behaviour. These include structural and environmental interventions that have demonstrated effectiveness in reducing harm and risk among youth and adult drug users, including the provision of stable housing opportunities, the establishment of supervised injection facilities, and improved access to drug and alcohol treatment centres (Frankish, Hwang, & Quantz, 2005; Hadland, Kerr, Li, Montaner, & Wood, 2009; Hillis et al, 2012; Stoltz et al, 2007). …”

Section: Discussionmentioning

confidence: 99%

Police confrontations among street-involved youth in a Canadian setting

Wood

Shannon

et al. 2013

International Journal of Drug Policy

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Background Street-level policing has been recognized as a driver of health-related harms among people who inject drugs (IDU). However, the extent of interaction between police and street-involved youth has not been well characterized. We examined the incidence and risk factors for police confrontations among street-involved youth in a Canadian setting. Methods Using data derived from participants enrolled in the At-Risk Youth Study (ARYS) between 2005 and 2011, we assessed factors associated with being stopped, searched, or detained by police without arrest in the previous six months using generalized estimating equations (GEE) with logit link for binary outcomes. Results Among 991 participants followed during the study period, 440 (44.4%) reported being stopped, searched, or detained by police for an incidence density of 49.20 (95% confidence interval [CI]: 36.42–65.01) per 100 person years. In multivariate GEE analyses, factors associated with police confrontations included: male gender (adjusted odds ratio [AOR] = 1.35), homelessness (AOR = 2.05), recent incarceration (AOR = 1.78), daily cannabis use (AOR = 1.31), daily heroin injecting (AOR = 1.36), crack pipe/syringe sharing (AOR = 1.61), injection drug use (AOR = 1.37), public drug use (AOR = 2.19), sex work involvement (AOR = 1.67), and drug dealing (AOR = 1.49) (all p<0.05). In total, 19.0% of participants reported that police confiscated their drug paraphernalia without arresting them. Additionally, 16.9% individuals reported experiencing violence at the hands of police. Conclusion We found that various factors, such as homelessness and markers of more severe addiction, increased the likelihood of being confronted by police, and police confrontations were associated with markers of health-related harm among street youth. These findings highlight the need for social and structural interventions that best enable police to fulfill public safety and public order objectives without negatively influencing health behaviours of street youth.

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Section: Discussionmentioning

confidence: 99%

Police confrontations among street-involved youth in a Canadian setting

Wood

Shannon

et al. 2013

International Journal of Drug Policy

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“…Studies 3,10,11,16,17,25,27 conducted in several different cities around the world showed that the prevalence of HIV infection among homeless people is signifi cantly higher than in the general population. In the present study, however, this rate was as high as in those population groups most affected by the HIV/AIDS epidemic in Brazil such as sex workers 23 (4.8%) and MSM 13 (13.6%).…”

Section: Discussionmentioning

confidence: 99%

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

et al. 2012

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OBJETIVO: Analisar a prevalência e o perfil de vulnerabilidade ao HIV de moradores de rua. MÉTODOS: Estudo transversal com amostra não probabilística de 1.405 moradores de rua usuários de instituições de acolhimento de São Paulo, SP, de 2006 a 2007. Foi realizado teste anti-HIV e aplicado questionário estruturado. O perfil de vulnerabilidade foi analisado pela frequência do uso do preservativo, considerando mais vulneráveis os que referiram o uso nunca ou às vezes. Foram utilizadas regressões logística e multinomial para estimar as medidas de efeito e intervalos de 95% de confiança. RESULTADOS: Houve predominância do sexo masculino (85,6%), média de 40,9 anos, ter cursado o ensino fundamental (72,0%) e cor não branca (71,5%). A prática homo/bissexual foi referida por 15,7% e a parceria ocasional por 62,0%. O número médio de parcerias em um ano foi de 5,4 e mais da metade (55,7%) referiu uso de drogas na vida, dos quais 25,7% relataram uso frequente. No total, 39,6% mencionaram ter tido uma doença sexualmente transmissível e 38,3% relataram o uso do preservativo em todas as relações sexuais. A prevalência do HIV foi de 4,9% (17,4% dos quais apresentaram também sorologia positiva para sífilis). Pouco mais da metade (55,4%) tinha acesso a ações de prevenção. A maior prevalência do HIV esteve associada a ser mais jovem (OR 18 a 29 anos = 4,0 [IC95% 1,54;10,46]), história de doença sexualmente transmissível (OR = 3,3 [IC95% 1,87;5,73]); prática homossexual (OR = 3,0 [IC95% 1,28;6,92]) e à presença de sífilis (OR = 2,4 [IC95% 1,13;4,93]). O grupo de maior vulnerabilidade foi caracterizado por ser mulher, jovem, ter prática homossexual, número reduzido de parcerias, parceria fixa, uso de drogas e álcool e não ter acesso a ações de prevenção e apoio social. CONCLUSÕES: O impacto da epidemia entre moradores de rua é elevado, refletindo um ciclo que conjuga exclusão, vulnerabilidade social e acesso limitado à prevenção.

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“…A recent review of studies conducted in Ukraine indicated that youth who were homeless and orphaned were more likely to be HIV-positive and to engage in injecting drug use, compared to youth with stable housing who resided with their parents (40). In Western countries, adolescents have reported use of emerging drugs such as synthetic cannibinoids (e.g., “Spice”) and cathinones (e.g., “bath salts”), and over-the-counter cough medicine dextromethorphan has gained popularity in Thailand among middle and high school students (41).…”

Section: Drug-using Populations and The Hiv Epidemicmentioning

confidence: 99%

Drug use as a driver of HIV risks

El‐Bassel

Shaw

Dasgupta

et al. 2014

Current Opinion in HIV and AIDS

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Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs.

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HIV seroprevalence among orphaned and homeless youth

Abstract: One of four youths who were both homeless and orphaned was HIV-infected; these youths were significantly more likely to be HIV infected and to report injection drug use than those with adequate housing and living parents.

Cited by 33 publications

References 30 publications

Police confrontations among street-involved youth in a Canadian setting

Police confrontations among street-involved youth in a Canadian setting

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

Drug use as a driver of HIV risks

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