A Comparison of Drug Use and Risk Behavior Profiles Among Younger and Older Street Youth

Abstract

Among 559 street youth recruited between 2005 and 2007 in Vancouver, Canada, young drug users (<21 years of age) were compared with older drug users (≥21 years) with regard to recent drug use and sexual practices using multiple logistic regression. Older youth were more likely to be male and of Aboriginal ancestry, to have more significant depressive symptoms, to have recently engaged in crack smoking, and to have had a recent history of injection drug use. Young drug users, by contrast, were more likely to have engaged in recent binge alcohol use. Efforts to reduce drug use-related harm among street youth may be improved by considering the highly prevalent use of “harder” drugs and risk for depression among older youth.

RÉSUMÉ

Consommation de drogues et comportements à risque parmi des jeunes de la rue de différents âges: Une étude comparative

Au moyen de régressions logistiques, les chercheurs ont comparé la consommation récente de drogues et les pratiques sexuelles parmi de jeunes consommateurs de drogues (<21 ans) et des consommateurs plus âgés (≥21 ans), au sein d'un groupe de 559 jeunes de la rue recrutés entre 2005 et 2007 à Vancouver, au Canada. Les jeunes plus âgés étaient plus susceptibles d’être des hommes et d’être d'origine autochtone, d'avoir des symptômes de dépression plus importants, d'avoir récemment fumé du crack et de s’être récemment injecté des drogues. Par comparaison, les consommateurs plus jeunes étaient plus susceptibles d'avoir vécu des épisodes récents de consommation excessive d'alcool. Les efforts visant à réduire les préjudices liés aux drogues parmi les jeunes de la rue pourraient être améliorés si on prenait en considération les taux élevés de consommation de drogues «dures» et le risque de dépression parmi les jeunes plus âgés.

Mots clés jeunes de la rue, adolescents, injection, consommation de drogues, VIH et sida

RESUMEN

Comparación de perfiles de consumo de drogas y comportamientos de riesgo entre jóvenes de la calle, de mayor y menor edad.

Se reclutaron 559 jóvenes de la calle, entre el 2005 y el 2007, en Vancouver, Canadá, y se comparó consumidores de drogas jóvenes (<21 años de edad), con consumidores de drogas de mayor edad (≥21 años de edad); con respecto a reciente consumo de drogas y prácticas sexuales, empleando una regresión logística múltiple. Los consumidores mayores, más bien del género masculino y de origen nativo, presentaban significativos síntomas de depresión, consumían crack, con antecedentes recientes de uso de drogas inyectables. Por el contrario, los consumidores jóvenes, tenían antecedentes recientes de consumo de alcohol en exceso. Los esfuerzos para reducir el daño ocasionado por las drogas, entre la juventud de la calle, se podrían mejorar, si se tuviera en cuenta el alto y frecuente uso de drogas “más fuertes” y riesgos de depresión entre los jóvenes de mayor edad.

Palabras claves juventud de la calle, adolescentes, inyección, consumo de drogas, sexo, VIH/SIDA

Keywords :

• street youth
• adolescents
• injection
• drug use
• sex
• HIV/AIDS

THE AUTHORS

Scott E. Hadland, MD, MPH, holds an MD degree from Washington University in St. Louis and an MPH degree from the Johns Hopkins Bloomberg School of Public Health, where his studies focused on epidemiology, biostatistics, and child and adolescent health. He is currently a resident in pediatrics at Children's Hospital Boston and Boston Medical Center, affiliated with Harvard University and Boston University, respectively. He has been appointed as the Chief Resident for the academic year 2012–2013. His clinical and research interests focus on adolescent health, particularly with regard to risk behaviors among marginalized youth populations. He has won numerous awards at all levels of training recognizing his clinical abilities, research skills, leadership, and humanism.

Brandon D. L. Marshall, Ph.D., completed his Ph.D. in epidemiology at the University of British Columbia School of Population and Public Health. He is currently a Postdoctoral Fellow in the Department of Epidemiology at the Columbia University Mailman School of Public Health. His research interests focus on substance use epidemiology and the social, environmental, and structural determinants of health among vulnerable populations. He has published more than 30 scientific papers and has won numerous research and training awards, including the American College of Epidemiology 2010 Student Prize. He holds a postdoctoral fellowship from the CIHR and is the recipient of the International AIDS Society/National Institutes of Drug Abuse Fellowship Encouraging & HIV Drug Use Research.

Thomas Kerr, Ph.D., is the Co-director of the Urban Health Research Initiative at the British Columbia Centre for Excellence in HIV/AIDS, Assistant Professor in the Department of Medicine at the University of British Columbia (Division of AIDS), as well as a Michael Smith Foundation for Health Research Scholar. In his role at the British Columbia Centre for Excellence in HIV/AIDS, Dr. Kerr is a principal investigator of several large cohort studies involving people who inject drugs and individuals living with HIV/AIDS, including the Vancouver Injection Drug Users Study (VIDUS). Dr. Kerr's primary research interests are HIV/AIDS, injection drug use, health policy and service evaluation, and community-based research methods. A key focus of Dr. Kerr's work has been the scientific evaluation of Insite, North America's first safer injecting facility, and his research in this area has contributed significantly to academic, public, and government discussion, both nationally and internationally. Dr. Kerr has published over 245 scientific papers in international peer-reviewed journals and has received local and national awards for his contribution to public health, including the National Knowledge Translation Award from the Canadian Institutes of Health Research for his efforts to promote scientific discussion on the links between drug policy and HIV/AIDS.

Ruth Zhang, MSc, works as a Senior Statistician for the Addiction and Urban Health Research Initiative at the BC Centre for Excellence in HIV/AIDS. She is responsible for data integration, statistical analysis, and interpretation of collaborative research projects. She also provides statistical consultation and support to students, epidemiologists, and medical doctors working with the Addiction and Urban Health Research Program. She holds an MSc degree in statistics from the University of British Columbia.

Julio S. Montaner, MD, is a Professor of Medicine at University of British (UBC) and has held the Endowed Chair in AIDS Research at School of Public Health (SPH)/UBC since 1996. He is the founding Co-director of the Canadian HIV Trials Network and the Director of the BC Centre for Excellence in HIV/AIDS. He has been a member of the International AIDS Society since 1988 and was President from 2008–2010. Dr. Montaner has authored over 400 scientific publications on HIV/AIDS. He has received numerous awards: the inaugural National Institute on Drug Abuse (NIDA) Avant-Garde Award and the Knowledge Translation Award from the CIHR; in November 2009, he was inducted into the Royal Society of Canada—The Academies of Arts, Humanities and Sciences (RSC); in 2010, he received a Doctor of Science honoris causa from Simon Fraser University, the Order of BC, as well as the Albert Einstein World of Science Award. His current research interests include highly active antiretroviral therapy (HAART) as prevention, optimal use of HAART, salvage therapy, new antiretrovirals, as well as hard-to-reach populations and harm reduction. Dr. Montaner has authored over 400 scientific publications on HIV/AIDS.

Evan Wood, MD, Ph.D., is the Co-director of the Urban Health Research Initiative at the British Columbia Centre for Excellence in HIV/AIDS, and a Clinical Associate Professor in the Department of Medicine at the University of British Columbia (Division of AIDS). He has extensive research experience in the area of clinical epidemiology, especially in evaluating the treatment of HIV/AIDS, addiction, and epidemiologic study design, especially among injection drug-using populations. Dr. Wood is a physician epidemiologist, with a long history of involvement in the healthcare issues facing persons who inject drugs, and his current research focuses on the prevention and treatment of HIV infection among drug users.