title: Injection drug use among street-involved youth in a Canadian setting.
abstract: BACKGROUND
  Street-involved youth contend with an array of health and social challenges, including elevated rates of blood-borne infections and mortality. In addition, there has been growing concern regarding high-risk drug use among street-involved youth, in particular injection drug use. We undertook this study to examine the prevalence of injection drug use and associated risks among street-involved youth in Vancouver, Canada.
  
  
  METHODS
  From September 2005 to November 2007, baseline data were collected for the At-Risk Youth Study (ARYS), a prospective cohort of street-recruited youth aged 14 to 26 in Vancouver, Canada. Using multiple logistic regression, we compared youth with and without a history of injection.
  
  
  RESULTS
  The sample included 560 youth among whom the median age was 21.9 years, 179 (32%) were female, and 230 (41.1%) reported prior injection drug use. Factors associated with injection drug use in multivariate analyses included age >or= 22 years (adjusted odds ratio [AOR] = 1.18, 95% CI: 1.10-1.28); sex work involvement (AOR = 2.17, 95% CI: 1.35-3.50); non-fatal overdose (AOR = 2.10, 95% CI: 1.38-3.20); and hepatitis C (HCV) infection (AOR = 22.61, 95% CI: 7.78-65.70).
  
  
  CONCLUSIONS
  These findings highlight an alarmingly high prevalence of injection drug use among street-involved youth and demonstrate its association with an array of risks and harms, including sex work involvement, overdose, and HCV infection. These findings point to the need for a broad set of policies and interventions to prevent the initiation of injection drug use and address the risks faced by street-involved youth who are actively injecting.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, British Columbia, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.forename: Cari
authors.initials: C
authors.lastname: Miller
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.forename: Ruth
authors.initials: R
authors.lastname: Zhang
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D062787:Drug Overdose; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology; D018453:Homeless Youth; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D011477:Sex Work; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D055815:Young Adult