Mohammad Karamouzian1,2,3, Tessa Cheng1,4, Ekaterina Nosova1, Kali Sedgemore1, Jean Shoveller1,2, Thomas Kerr1,5, Kora Debeck1,6. 1. a British Columbia Centre on Substance Use , University of British Columbia, St. Paul's Hospital , Vancouver , BC , Canada. 2. b School of Population and Public Health , University of British Columbia , Vancouver , BC , Canada. 3. c HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences , Kerman , Iran. 4. d Faculty of Health Sciences , Simon Fraser University , Burnaby , BC , Canada. 5. e Department of Medicine , University of British Columbia, St. Paul's Hospital , Vancouver , BC , Canada. 6. f School of Public Policy , Simon Fraser University, Harbour Centre , Vancouver , BC , Canada.
Abstract
BACKGROUND: Perceived devaluation is a barrier to seeking mental and physical health services among people who use illicit drugs. OBJECTIVE: Assessing the prevalence and correlates of perceived devaluation within a cohort of street-involved youth. METHODS: Data were drawn from an open prospective cohort of street-involved youth who use illicit drugs (aged 14-26 at study enrollment) between December 2013 and May 2015 in Vancouver, Canada. Perceived devaluation was measured using an adapted version of Perceived Devaluation and Discrimination scale. Multivariable generalized estimating equations were constructed to examine factors independently associated with high perceived devaluation. RESULTS: Among 411 street-involved youth, 95.1% reported high perceived devaluation at some point during the study period. In a multivariable analysis, youth who reported high perceived devaluation were significantly more likely to engage in: unprotected sex (Adjusted Odds Ratio [AOR] = 1.56, 95% Confidence Interval 1.03-2.37); heavy alcohol use (AOR = 2.31, 95% CI 1.22-4.36); and daily heroin use (AOR = 2.07, 95% CI 1.16-3.70). Youth who resided in the Downtown Eastside neighborhood were significantly less likely to report high perceived devaluation (AOR = 0.41, 95% CI 0.26-0.65). CONCLUSIONS: Perceived devaluation was extremely prevalent among street-involved youth in our sample. We also observed that youth most in need of health and social services were significantly more likely to report high levels of perceived devaluation which may result in a reluctance to seek out key services and supports. These findings highlight the need to implement stigma reduction interventions for vulnerable youth in this setting.
BACKGROUND: Perceived devaluation is a barrier to seeking mental and physical health services among people who use illicit drugs. OBJECTIVE: Assessing the prevalence and correlates of perceived devaluation within a cohort of street-involved youth. METHODS: Data were drawn from an open prospective cohort of street-involved youth who use illicit drugs (aged 14-26 at study enrollment) between December 2013 and May 2015 in Vancouver, Canada. Perceived devaluation was measured using an adapted version of Perceived Devaluation and Discrimination scale. Multivariable generalized estimating equations were constructed to examine factors independently associated with high perceived devaluation. RESULTS: Among 411 street-involved youth, 95.1% reported high perceived devaluation at some point during the study period. In a multivariable analysis, youth who reported high perceived devaluation were significantly more likely to engage in: unprotected sex (Adjusted Odds Ratio [AOR] = 1.56, 95% Confidence Interval 1.03-2.37); heavy alcohol use (AOR = 2.31, 95% CI 1.22-4.36); and daily heroin use (AOR = 2.07, 95% CI 1.16-3.70). Youth who resided in the Downtown Eastside neighborhood were significantly less likely to report high perceived devaluation (AOR = 0.41, 95% CI 0.26-0.65). CONCLUSIONS: Perceived devaluation was extremely prevalent among street-involved youth in our sample. We also observed that youth most in need of health and social services were significantly more likely to report high levels of perceived devaluation which may result in a reluctance to seek out key services and supports. These findings highlight the need to implement stigma reduction interventions for vulnerable youth in this setting.
Entities:
Keywords:
Perceived devaluation; discrimination; illicit drug use; stigma; street-involved youth
Authors: Jonathan Avery; Bernadine H Han; Erin Zerbo; Guojiao Wu; Elizabeth Mauer; Joseph Avery; Stephen Ross; Julie B Penzner Journal: Am J Addict Date: 2016-10-17
Authors: Leonieke C van Boekel; Evelien P M Brouwers; Jaap van Weeghel; Henk F L Garretsen Journal: Drug Alcohol Depend Date: 2013-03-13 Impact factor: 4.492