title: Survival sex work involvement among street-involved youth who use drugs in a Canadian setting.
abstract: BACKGROUND
  Drug users engaged in survival sex work are at heightened risk for drug- and sexual-related harms. We examined factors associated with survival sex work 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 14-26 who use illicit drugs. Using multiple logistic regression, we compared youth who reported exchanging sex for money, drugs etc. with those who did not.
  
  
  RESULTS
  The sample included 560 youth: median age 22; 179 (32%) female; 63 (11%) reporting recent survival sex work. Factors associated with survival sex work in multivariate analyses included non-injection crack use [adjusted odds ratio (AOR) = 3.45, 95% confidence interval (CI): 1.75-6.78], female gender (AOR = 3.02, 95% CI: 1.66-5.46), Aboriginal ethnicity (AOR = 2.35, 95% CI: 1.28-4.29) and crystal methamphetamine use (AOR = 2.02, 95% CI: 1.13-3.62). In subanalyses, the co-use of crack cocaine and methamphetamine was shown to be driving the association between methamphetamine and survival sex work.
  
  
  CONCLUSIONS
  This study demonstrates a positive interactive effect of dual stimulant use in elevating the odds of survival sex work among street youth who use drugs. Novel approaches to reduce the harms associated with survival sex work among street youth who use stimulants are needed.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Chettiar
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Ruth
authors.initials: R
authors.lastname: Zhang
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D015331:Cohort Studies; D005260:Female; D018453:Homeless Youth; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D011477:Sex Work; D019966:Substance-Related Disorders; D017741:Survivors; D055815:Young Adult