title: Key drug use, health and socio-economic characteristics of young crack users in two Brazilian cities.
abstract: BACKGROUND
  Crack use constitutes a major problem in cities across Brazil. While existing data suggest that crack use is generally concentrated among disenfranchised young people with extensive health problems and crime involvement, extensive data gaps exist. To address this issue, this study aimed to assess key characteristics of young crack users in two Brazilian cities.
  
  
  METHODS
  N=160 regular and young adult (ages 18-24) crack users were recruited by community-based methods in the cities of Rio de Janeiro (Southeast) and Salvador (Northeast). Assessments included an interviewer-administered questionnaire on key social, drug use, health and service use characteristics, as well as serological testing of HBV, HCV and HIV status, and were conducted anonymously between November 2010 and June 2011. Participants provided informed consent and received transportation vouchers following assessment completion. The study was approved by institutional ethics review boards.
  
  
  RESULTS
  The majority of participants were: male, with less than high school education, unstably housed (Rio only); gained income from legal or illegal work; arrested by police in past year (Salvador only); had numerous daily crack use episodes and shared paraphernalia (Salvador only); co-used alcohol, tobacco, cannabis and cocaine; had no injection history; rated physical and mental health as 'fair' or lower (Salvador only); had unprotected sex; were never HIV tested; were not HIV, HBV or HCV positive; and did not use existing social or health services, but desired access to crack user specific services.
  
  
  CONCLUSIONS
  Crack users in the two Brazilian sites featured extensive socio-economic marginalization, crack and poly-drug use as well as sexual risk behaviours, and compromised health status. Social and health service utilization are low, yet needs are high. There is an urgent need for further research and for targeted interventions for crack use in Brazil.
authors: Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Marcelo
authors: M
authors: Santos Cruz
authors: Tarcisio
authors: T
authors: Andrade
authors: Francisco I
authors: FI
authors: Bastos
authors: Erotildes
authors: E
authors: Leal
authors: Neilane
authors: N
authors: Bertoni
authors: Livia Melo
authors: LM
authors: Villar
authors: Maija
authors: M
authors: Tiesmaki
authors: Benedikt
authors: B
authors: Fischer
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology*; D016578:Crack Cocaine / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006304:Health Status; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D016578:Crack Cocaine
keywords: Blood-borne virus; Brazil; Crack use; Epidemiology; Interventions; Poly-drug use