Scott E Hadland1, Kora DeBeck2, Thomas Kerr3, Paul Nguyen4, Annick Simo4, Julio S Montaner3, Evan Wood5. 1. Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. 2. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada; School of Public Policy, SFU Harbour Centre, Simon Fraser University, Vancouver, British Columbia, Canada. 3. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 4. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada. 5. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: uhri-ew@cfenet.ubc.ca.
Abstract
PURPOSE: Supervised injecting facilities (SIFs) provide a sanctioned space for injection drug users and are associated with decreased overdose mortality and HIV risk behaviors among adults. Little is known about SIF use among youth. We identified factors associated with use of the Vancouver SIF, the only such facility in North America, among street youth. METHODS: From September 2005 to May 2012, we collected data from the At-Risk Youth Study, a prospective cohort of street youth in Vancouver, BC, Canada. Eligible youth were aged 14-26 years. Participants reporting injection completed questionnaires at baseline and semiannually. We used generalized estimating equation logistic regression to identify factors associated with SIF use. RESULTS: During the study period, 42.3% of 414 injecting youth reported use of the SIF at least once. Of all SIF-using youth, 51.4% went to the facility at least weekly, and 44.5% used it for at least one-quarter of all injections. SIF-using youth were more likely to live or spend time in the neighborhood surrounding the SIF (adjusted odds ratio [AOR], 3.29; 95% confidence interval [CI], 2.38-4.54), to inject in public (AOR, 2.08; 95% CI, 1.53-2.84), or to engage in daily injection of heroin (AOR, 2.36; 95% CI, 1.72-3.24), cocaine (AOR, 2.44; 95% CI, 1.34-4.45), or crystal methamphetamine (AOR, 1.62; 95% CI, 1.13-2.31). CONCLUSIONS: This study, the first to examine SIF use among street youth in North America, demonstrated that the facility attracted high-frequency young drug users most at risk of blood-borne infection and overdose and those who otherwise inject in public spaces.
PURPOSE: Supervised injecting facilities (SIFs) provide a sanctioned space for injection drug users and are associated with decreased overdose mortality and HIV risk behaviors among adults. Little is known about SIF use among youth. We identified factors associated with use of the Vancouver SIF, the only such facility in North America, among street youth. METHODS: From September 2005 to May 2012, we collected data from the At-Risk Youth Study, a prospective cohort of street youth in Vancouver, BC, Canada. Eligible youth were aged 14-26 years. Participants reporting injection completed questionnaires at baseline and semiannually. We used generalized estimating equation logistic regression to identify factors associated with SIF use. RESULTS: During the study period, 42.3% of 414 injecting youth reported use of the SIF at least once. Of all SIF-using youth, 51.4% went to the facility at least weekly, and 44.5% used it for at least one-quarter of all injections. SIF-using youth were more likely to live or spend time in the neighborhood surrounding the SIF (adjusted odds ratio [AOR], 3.29; 95% confidence interval [CI], 2.38-4.54), to inject in public (AOR, 2.08; 95% CI, 1.53-2.84), or to engage in daily injection of heroin (AOR, 2.36; 95% CI, 1.72-3.24), cocaine (AOR, 2.44; 95% CI, 1.34-4.45), or crystal methamphetamine (AOR, 1.62; 95% CI, 1.13-2.31). CONCLUSIONS: This study, the first to examine SIF use among street youth in North America, demonstrated that the facility attracted high-frequency young drug users most at risk of blood-borne infection and overdose and those who otherwise inject in public spaces.
Authors: Evan Wood; Mark W Tyndall; Ruth Zhang; Jo-Anne Stoltz; Calvin Lai; Julio S G Montaner; Thomas Kerr Journal: N Engl J Med Date: 2006-06-08 Impact factor: 91.245
Authors: Jo-Anne Stoltz; Evan Wood; Will Small; Kathy Li; Mark Tyndall; Julio Montaner; Thomas Kerr Journal: J Public Health (Oxf) Date: 2007-01-17 Impact factor: 2.341
Authors: Evan Wood; Mark W Tyndall; Kathy Li; Elisa Lloyd-Smith; Will Small; Julio S G Montaner; Thomas Kerr Journal: Am J Prev Med Date: 2005-08 Impact factor: 5.043
Authors: Scott E Hadland; Dan Werb; Thomas Kerr; Eric Fu; Hong Wang; Julio S Montaner; Evan Wood Journal: Prev Med Date: 2012-08-28 Impact factor: 4.018
Authors: Thomas Kerr; Brandon D L Marshall; Cari Miller; Kate Shannon; Ruth Zhang; Julio S G Montaner; Evan Wood Journal: BMC Public Health Date: 2009-06-03 Impact factor: 3.295