Initiation to drug injection among street youth: a gender-based analysis.
OBJECTIVE
To estimate the incidence rate of initiation into drug injection and to identify predictors of initiation into drug injection separately among street girls and boys.


METHODS
Data from two consecutive prospective street youth cohort studies (1995-2001 and 2001-2005) were used to conduct these analyses, stratified by gender.


METHODS
Data were collected using semi-annual interviewer-administered questionnaires. Variables from the following domains were considered in Cox regression models: socio-demographic characteristics, early and current substance abuse, marginalization, childhood traumatic sexual events and injection exposure.


RESULTS
Of the 946 youth who had never injected drugs at study entry, 86.4% completed at least two questionnaires representing 243 girls and 574 boys. Incidence rates of injection of 7.0 and 5.9 per 100 person-years were observed among these girls and boys respectively. Among girls, cocaine or crack use (adjusted hazard ratio (AHR)=1.97), heroin use (AHR=2.86), homelessness (AHR=2.49) and hanging out regularly with people who inject (AHR=4.46) all independently increased risk of first injection. Among boys, age decreased risk of initiating injection (AHR=0.90/year), while cocaine or crack use (AHR=2.14), heroin use (AHR=3.56), homelessness before age 16 (AHR=1.68), incest or rape before age 14 (AHR=1.98) and hanging out regularly with people who inject (AHR=1.66) all independently increased this risk.


CONCLUSIONS
Our findings suggest similar rates of initiation among girls and boys; however, factors associated with initiation vary by gender. This might lead to the design of more effective programs to prevent initiation into drug injection.
Université de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Service de Toxicomanie, Longueuil, Québec J4K0A8, Canada. Elise.Roy@USherbrooke.ca
Elise
E
Roy
Jean-François
JF
Boivin
Pascale
P
Leclerc
D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult