Homelessness Independently Predicts Injection Drug Use Initiation Among Street-Involved Youth in a Canadian Setting

Feng, Cindy; DeBeck, Kora; Kerr, Thomas; Mathias, Steve; Montaner, Julio; Wood, Evan

doi:10.1016/j.jadohealth.2012.07.011

Cited by 80 publications

(66 citation statements)

References 10 publications

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“…Previous studies suggest that crystal methamphetamine is a key risk factor for injection drug use among street-involved youth in our setting (15,23). However, our findings indicate that crystal methamphetamine may be uniquely risky for female youth.…”

Section: Discussionmentioning

confidence: 76%

“…In addition, to protect against reverse causation whereby reported behaviours were a consequence of drug injecting, all substance use variables were lagged to the previous available observation. In this way, we were able to assess behaviors that were reported prior to the injecting initiation event (15). Since participants could have varying durations between their last injecting naive and their first interview where they report injecting, the date of first injection was estimated as the midpoint between the first injecting naive follow up and the follow up visit where injecting was reported.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Gender influences on initiation of injecting drug use

Ahamad¹,

DeBeck²,

Feng³

et al. 2014

The American Journal of Drug and Alcohol Abuse

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Background and Objectives Gender differences in illicit drug use patterns and related harms (e.g. HIV infection) are becoming increasingly recognized. However, little research has examined gender differences in risk factors for initiation into injecting drug use. We undertook this study to examine the relationship between gender and risk of injection initiation among street-involved youth and to determine whether risk factors for initiation differed between genders. Methods From September 2005 to November 2011, youth were enrolled into the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada. Cox regression analyses were used to assess variables associated with injection initiation and stratified analyses considered risk factors for injection initiation among male and female participants separately. Results Among 422 street-involved youth, 133 (32.5%) were female, and 77 individuals initiated injection over study follow-up. Although rates of injection initiation were similar between male and female youth (p =0.531), stratified analyses demonstrated that, among male youth, risk factors for injection initiation included sex work (Adjusted Hazard Ratio [AHR] =4.74, 95% Confidence Intervals [CI]: 1.45–15.5) and residence within the city's drug use epicentre (AHR =1.95, 95% CI: 1.12–3.41), whereas among female youth, non-injection crystal methamphetamine use (AHR =4.63, 95% CI: 1.89– 11.35) was positively associated with subsequent injection initiation. Conclusion Although rates of initiation into injecting drug use were similar for male and female street youth, the risk factors for initiation were distinct. These findings suggest a possible benefit of uniquely tailoring prevention efforts to high-risk males and females.

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Section: Discussionmentioning

confidence: 76%

Section: Methodsmentioning

confidence: 99%

Gender influences on initiation of injecting drug use

Ahamad¹,

DeBeck²,

Feng³

et al. 2014

The American Journal of Drug and Alcohol Abuse

Self Cite

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show abstract

“…With respect to structural factors, the availability of housing and housing status (including homelessness) consistently appears as a risk factor for injection initiation across a range of settings [13,16,32]. For example, Roy et al found that homelessness was the key risk factor for injection initiation among street-involved youth in Montreal.…”

Section: Risk Factors For Injection Initiatesmentioning

confidence: 99%

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

et al. 2017

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“…42 Homelessness is an independent predictor of substance use. 43 Both homelessness and substance use are harmful yet common aspects of street life, 5,44,45 and both are associated with suicidality. 46,47 Qualitative research shows that homelessness, substance use, and adverse childhood experiences converge on feelings of hopelessness and of being "trapped," which contribute to suicide among street youth.…”

Section: Discussionmentioning

confidence: 99%

Suicide Attempts and Childhood Maltreatment Among Street Youth: A Prospective Cohort Study

2015

PEDIATRICS

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BACKGROUND: Although suicide is a known leading cause of death among street youth, few prospective studies have explored childhood experiences as risk factors for future suicide attempt in this population. We examined the risk of attempted suicide in relation to childhood maltreatment among street youth. METHODS:From September 2005 to November 2013, data were collected from the At Risk Youth Study (ARYS), a prospective cohort of street youth in Vancouver, Canada. Inclusion criteria were age 14 to 26 years, past-month illicit drug use, and street involvement. Participants completed the Childhood Trauma Questionnaire, an instrument measuring self-reported sexual, physical, and emotional abuse and physical and emotional neglect. Suicide attempts were assessed semiannually. Using Cox regression, we examined the association between the 5 types of maltreatment and suicide attempts.RESULTS: Of 660 participants, 68.2% were male and 24.6% were Aboriginal. Median age was 21.5 years. The prevalence of moderate to extreme childhood maltreatment ranged from 16.8% (sexual abuse) to 45.2% (emotional abuse). Participants contributed 1841 personyears, with suicide attempts reported by 35 (5.3%) individuals (crude incidence density: 1.9 per 100 person-years; 95% confidence interval [CI]: 1.4-2.6 per 100 person-years). In adjusted analyses, types of maltreatment associated with suicide attempts included physical abuse (adjusted hazard ratio [HR]: 4.47; 95% CI: 2.12-9.42), emotional abuse (adjusted HR: 4.92; 95% CI: 2.11-11.5), and emotional neglect (adjusted HR: 3.08; 95% CI: 1.05-9.03).CONCLUSIONS: Childhood maltreatment is associated with subsequent risk of suicidal behavior among street youth. Suicide prevention efforts should be targeted toward this marginalized population and delivered from a trauma-informed perspective.WHAT'S KNOWN ON THIS SUBJECT: Street youth demonstrate elevated mortality compared with the general adolescent and young adult population. Suicide is a leading cause of death among street youth. Many street youth have experienced childhood maltreatment, including abuse and neglect. WHAT THIS STUDY ADDS:In this prospective cohort of street youth, self-reported attempted suicide and history of childhood maltreatment were common. Individuals who experienced childhood physical abuse, emotional abuse, or emotional neglect were at highest risk of attempting suicide.

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Homelessness Independently Predicts Injection Drug Use Initiation Among Street-Involved Youth in a Canadian Setting

Cited by 80 publications

References 10 publications

Gender influences on initiation of injecting drug use

Gender influences on initiation of injecting drug use

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

Suicide Attempts and Childhood Maltreatment Among Street Youth: A Prospective Cohort Study

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