Public injecting and HIV risk behaviour among street-involved youth.
BACKGROUND
Although street-involved youth who inject illicit drugs are known to be at an increased risk of HIV and other adverse health outcomes, little is known about public injecting among this population and how injecting in public environments may impact HIV risk behaviour.


METHODS
We used data derived from a study of 560 street-involved youth in Vancouver, Canada to examine the factors associated with injecting in public environments among youth who reported injecting drugs in the past 6 months.


RESULTS
At baseline, 162 (28.9%) reported injecting drugs in the past 6 months. Among injectors, the 124 (76.5%) participants who reported injecting in public were more likely to be homeless (odds ratio [OR]=6.39, p<0.001), engage in unprotected intercourse (OR=3.09, p=0.004), deal drugs (OR=2.26, p=0.032), smoke crack cocaine (OR=3.00, p=0.005), inject heroin (OR=3.48, p=0.001), drop used syringes outdoors (OR=8.44, p<0.001), share syringes (OR=4.43, p=0.004), and were less likely to clean injection sites >75% of the time (OR=0.36, p=0.008). The majority (62.1%) reported feeling rushed while injecting in public.


CONCLUSIONS
Youth who inject in public are significantly more likely to engage in sexual and injection-related risk behaviour. Given the known elevated rates of HIV infection and other harms among this population, youth-focused interventions that target both sexual and drug-related risks associated with public drug-using environments are in urgent need of evaluation.
Marshall
Brandon D L
BD
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada.
Kerr
Thomas
T
Qi
Jiezhi
J
Montaner
Julio S G
JS
Wood
Evan
E
D000293:Adolescent; D002170:Canada; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D008297:Male; D012306:Risk; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012931:Social Environment; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology*; D014505:Urban Population; D055815:Young Adult
Harm Reduct J. 2006 May 24;3:18
16723029
Addiction. 2001 Feb;96(2):241-6
11182868
Int J Drug Policy. 2007 Jan;18(1):27-36
17689341
Am J Public Health. 2008 Mar;98(3):515-9
18235063
J Infect Dis. 2005 Sep 1;192(5):811-8
16088830
Sex Transm Dis. 2001 Jan;28(1):4-10
11196044
Soc Sci Med. 2005 Aug;61(3):673-84
15899325
Addiction. 2006 Oct;101(10):1384-93
16968336
J Adolesc Health. 2006 Mar;38(3):208-12
16488817
Addiction. 1995 Jun;90(6):837-41
7633302
Drug Alcohol Depend. 1998 Aug 1;51(3):219-27
9787995
Cult Health Sex. 2008 Nov;10(8):787-99
18975227
Nurs Res. 2002 May-Jun;51(3):168-74
12063415
Health Place. 2009 Sep;15(3):753-60
19201642
Int J Circumpolar Health. 2007 Jun;66(3):226-40
17655063
J Epidemiol Community Health. 2009 Jan;63(1):81-6
18628270
J Acquir Immune Defic Syndr. 2001 Jun 1;27(2):193-201
11404542
AIDS. 2008 Nov 12;22(17):2371-80
18981777
BMC Public Health. 2009 Jan 09;9:7
19134203
Harm Reduct J. 2008 Nov 19;5:35
19019253
Sex Transm Infect. 2009 Apr;85(2):121-6
18812391
CMAJ. 2004 Sep 28;171(7):731-4
15451834
Soc Work. 2006 Jan;51(1):71-9
16512512
Drug Alcohol Depend. 2008 Oct 1;97(3):237-46
18487025
AIDS. 2003 May 2;17(7):1071-5
12700458
AIDS Behav. 2006 Mar;10(2):179-84
16479414