Lindsey Richardson1, Kora DeBeck2, Cindy Feng3, Thomas Kerr1, Evan Wood4. 1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; Faculty of Medicine, University of British Columbia, Room 10203-2775 Laurel St., Vancouver, BC, Canada, V5Z 1M9. 2. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; School of Public Policy, Simon Fraser University, SFU Harbour Centre, 515 West Hastings Street, Suite 3271, Vancouver, BC, Canada, V6B 5K3. 3. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; School of Public Health, University of Saskatchewan, Room 3338, Health Sciences Building E-Wing, 104 Clinic Place, Saskatoon, SK, Canada, S7N 5E5. 4. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; Faculty of Medicine, University of British Columbia, Room 10203-2775 Laurel St., Vancouver, BC, Canada, V5Z 1M9. Electronic address: uhri-ew@cfenet.ubc.ca.
Abstract
OBJECTIVE: Youth unemployment has been associated with labour market and health disparities. However, employment as a determinant of high-risk health behaviour among marginalized young people has not been well described. We sought to assess a potential relationship between employment status and initiation of intravenous drug use among a prospective cohort of street-involved youth. METHOD: We followed injecting naïve youth in the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada, and employed Cox regression analyses to examine whether employment was associated with injection initiation. RESULTS: Among 422 injecting naïve youth recruited between September 2005 and November 2011, 77 participants transitioned from non-injection to injection drug use, for an incidence density of 10.3 (95% confidence interval [CI]: 8.0-12.6) per 100 person years. Results demonstrating that employment was inversely associated with injection initiation (adjusted hazard ratio: 0.53; 95% CI: 0.33-0.85) were robust to adjustment for a range of potential confounders. CONCLUSION: A lack of employment among street-involved youth was associated with the initiation of injection drug use, a practice that predisposes individuals to serious long-term health consequences. Future research should examine if reducing barriers to labour market involvement among street-involved youth prevents transitions into high-risk drug use.
OBJECTIVE: Youth unemployment has been associated with labour market and health disparities. However, employment as a determinant of high-risk health behaviour among marginalized young people has not been well described. We sought to assess a potential relationship between employment status and initiation of intravenous drug use among a prospective cohort of street-involved youth. METHOD: We followed injecting naïve youth in the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada, and employed Cox regression analyses to examine whether employment was associated with injection initiation. RESULTS: Among 422 injecting naïve youth recruited between September 2005 and November 2011, 77 participants transitioned from non-injection to injection drug use, for an incidence density of 10.3 (95% confidence interval [CI]: 8.0-12.6) per 100 person years. Results demonstrating that employment was inversely associated with injection initiation (adjusted hazard ratio: 0.53; 95% CI: 0.33-0.85) were robust to adjustment for a range of potential confounders. CONCLUSION: A lack of employment among street-involved youth was associated with the initiation of injection drug use, a practice that predisposes individuals to serious long-term health consequences. Future research should examine if reducing barriers to labour market involvement among street-involved youth prevents transitions into high-risk drug use.
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