title: Interest in low-threshold employment among people who inject illicit drugs: implications for street disorder.
abstract: BACKGROUND
  Income generation opportunities available to people who use illicit drugs have been associated with street disorder. Among a cohort of injection drug users (IDU) we sought to examine street-based income generation practices and willingness to forgo these sources of income if other low-threshold work opportunities were made available.
  
  
  METHODS
  Data were derived from a prospective community recruited cohort of IDU. We assessed the prevalence of engaging in disorderly street-based income generation activities, including sex work, drug dealing, panhandling, and recycling/salvaging/vending. Using multivariate logistic regressions based on Akaike information criterion and the best subset selection procedure, we identified factors associated with disorderly income generation activities, and assessed willingness to forgo these sources of income during the period of November 2008 to July 2009.
  
  
  RESULTS
  Among our sample of 874 IDU, 418 (48%) reported engaging in a disorderly income generation activity in the previous six months. In multivariate analyses, engaging in disorderly income generation activities was independently associated with high intensity stimulant use, as well as binge drug use, having encounters with police, being a victim of violence, sharing used syringes, and injecting in public areas. Among those engaged in disorderly income generation, 198 (47%) reported a willingness to forgo these income sources if given opportunities for low-threshold employment, with sex workers being most willing to engage in alternative employment.
  
  
  CONCLUSIONS
  Engagement in disorderly street-based income generation activities was associated with high intensity stimulant drug use and various markers of risk. We found that a high proportion of illicit drug users were willing to cease engagement in these activities if they had options for causal low-threshold employment. These findings indicate that there is a high demand for low-threshold employment that may offer important opportunities to reduce drug-related street disorder and associated harms.
authors.affiliation: BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
authors.forename: Kora
authors.initials: K
authors.lastname: Debeck
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Jiezhi
authors.initials: J
authors.lastname: Qi
authors.forename: Eric
authors.initials: E
authors.lastname: Fu
authors.forename: Doug
authors.initials: D
authors.lastname: McArthur
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D004333:Drug Administration Routes; D055030:Drug Users / Q000523:psychology; D004651:Employment / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000191:economics* / Q000378:metabolism / Q000600:supply & distribution; D007182:Income; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D059027:Recycling / Q000191:economics; D012111:Residence Characteristics; D011477:Sex Work / Q000523:psychology; D060386:Sex Workers / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology / Q000378:metabolism; D013594:Syringes
chemical_list: D013287:Illicit Drugs