Homelessness and a history of childhood sexual abuse place Vancouver street-involved youth at great risk of intravenous injection drug use and potential transmission of HIV and hepatitis C, according to a pair of new studies by UBC researchers.
The studies, funded by the US National Institute on Drug Abuse and the Canadian Institutes of Health Research, sought to determine why some high-risk youth initiate injection drug use while others do not.
Results published in the Journal of Adolescent Health found that youth who were homeless were almost twice as likely to inject drugs than youth who were not homeless. A separate study published in Preventive Medicine found those reporting childhood sexual abuse were more than two-and-a-half times as likely to start injecting drugs as compared to those who had no history of such abuse.
“These are among the first studies to identify early life experiences and subsequent environments that clearly contribute to initiation of injecting drug use,” said Evan Wood, Canada Research Chair in Inner City Medicine and senior author of both studies. “This research underscores the urgent need for evidence-based interventions to address homelessness and child abuse, as well as the immediate expansion of evidence-based addiction treatment services for high risk youth.”
Research for both studies was derived from the At-Risk Youth Study (ARYS) by the BC Centre for Excellence in HIV/AIDS, which is following a cohort of street-involved youth in Vancouver aged 14-26 years.
Investigators for the Journal of Adolescent Health study interviewed 422 street-involved youth between September 2005 and November 2011. Researchers led by Scott Hadland, chief resident in pediatrics at Harvard University-affiliated Boston Children’s Hospital, studied 395 street-involved youth from October 2005 to November 2010 for Preventive Medicine. Researchers closely examined Vancouver street youth behaviours over time in an effort to untangle the mystery of why some youth choose to begin drug injecting while others do not. They also identified key risk factors that can be targeted for implementing treatment and prevention programs.
“There are serious medical harms associated with injection drug use, including the transmission of HIV and hepatitis C,” said Kora DeBeck, lead author of the Journal of Adolescent Health study and a post-doctoral fellow at UBC and the BC-CfE. “While overall rates of injection drug use are down in Vancouver, there is increasing evidence that expanding addiction treatment interventions and providing other tools like supportive housing can intervene to further reduce rates of injection drug use among street youth.”