Michele Calvo1, Jessica MacFarlane2, Heather Zaccaro3, Matthew Curtis4, María Cabán5, Jamie Favaro6, Marian R Passannante7, Taeko Frost8. 1. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; Rutgers University School of Public Health, Newark, NJ 07101, United States. Electronic address: calvo.michele@gmail.com. 2. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; Columbia University Mailman School of Public Health, New York, NY 10032, United States. 3. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States. 4. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; Voices of Community Activists and Leaders of New York (VOCAL-NY), Brooklyn, NY 11217, United States. 5. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; BOOM!Health, Bronx, NY 10451, United States. 6. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; Harm Reduction Coalition, New York, NY 10001, United States. 7. Rutgers University School of Public Health, Newark, NJ 07101, United States. 8. Injection Drug Users Health Alliance (IDUHA), New York, NY 10001, United States; Washington Heights CORNER Project, New York, NY 10033, United States; Harm Reduction Coalition, New York, NY 10001, United States.
Abstract
BACKGROUND: Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. METHODS: The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey. We investigated differences in socio-demographics, service utilization, and risk behaviors between young (aged 18-30) and older participants and examined factors associated with overdose among young participants. RESULTS: The study included 257 young participants. They were significantly more likely than older participants to be white, educated, uninsured, unstably housed or homeless, and have a history of incarceration and residential drug treatment. They were more likely to report recent overdose but less likely to report knowledge of naloxone. Young participants also had higher rates of alcohol, marijuana, benzodiazepine, and injection drug use, and related risk behaviors such as public injection. Factors associated with past year overdose among young participants included experiencing symptoms of psychological distress (AOR=9.71), being unstably housed or homeless (AOR=4.39), and utilizing detox (AOR=4.20). CONCLUSIONS: Young PWUD who access services at HRPs in NYC differ significantly from their older counterparts. New York City and other urban centers that attract young PWUD should consider implementing harm reduction oriented services tailored to the unique needs of young people.
BACKGROUND: Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. METHODS: The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey. We investigated differences in socio-demographics, service utilization, and risk behaviors between young (aged 18-30) and older participants and examined factors associated with overdose among young participants. RESULTS: The study included 257 young participants. They were significantly more likely than older participants to be white, educated, uninsured, unstably housed or homeless, and have a history of incarceration and residential drug treatment. They were more likely to report recent overdose but less likely to report knowledge of naloxone. Young participants also had higher rates of alcohol, marijuana, benzodiazepine, and injection drug use, and related risk behaviors such as public injection. Factors associated with past year overdose among young participants included experiencing symptoms of psychological distress (AOR=9.71), being unstably housed or homeless (AOR=4.39), and utilizing detox (AOR=4.20). CONCLUSIONS: Young PWUD who access services at HRPs in NYC differ significantly from their older counterparts. New York City and other urban centers that attract young PWUD should consider implementing harm reduction oriented services tailored to the unique needs of young people.
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