title: Health and social harms associated with crystal methamphetamine use among street-involved youth in a Canadian setting.
abstract: OBJECTIVE
  Despite recent increases in crystal methamphetamine use among high-risk populations such as street-involved youth, few prospective studies have examined the health and social outcomes associated with active crystal methamphetamine use.
  
  
  METHODS
  We enrolled 1,019 street-involved youth in Vancouver, Canada, in a prospective cohort known as the at-risk youth study (ARYS). Participants were assessed semi-annually and a generalized estimating equation (GEE) logistic regression was used to identify factors independently associated with active crystal methamphetamine use.
  
  
  RESULTS
  Among 1,019 participants recruited into ARYS between 2005 and 2012 the median follow up duration was 17 months, 320 (31.4%) participants were female and 454 (44.6%) had previously used crystal methamphetamine at baseline. In adjusted GEE analyses, active crystal methamphetamine use was independently associated with Caucasian ethnicity (adjusted odds ratio [AOR] = 1.37; 95% confidence interval [CI]: 1.04-1.81), homelessness (AOR = 1.34; 95% CI: 1.15-1.56), injection drug use (AOR = 3.40; 95% CI: 2.76-4.19), non-fatal overdose (AOR = 1.46; 95%CI: 1.07-2.00), being a victim of violence (AOR = 1.19; 95% CI: 1.02-1.38), involvement in sex work (AOR = 1.39; 95% CI: 1.03-1.86), and drug dealing (AOR = 1.60; 95% CI: 1.35-1.90).
  
  
  CONCLUSIONS
  Prevalence of crystal methamphetamine use was high in this setting and active use was independently associated with a range of serious health and social harms.
  
  
  CONCLUSIONS
  Evidence-based strategies to prevent and treat crystal methamphetamine use are urgently needed.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada, V6Z 1Y6.
authors.forename: Sasha
authors.initials: S
authors.lastname: Uhlmann
authors.forename: Kora
authors.initials: K
authors.lastname: DeBeck
authors.forename: Annick
authors.initials: A
authors.lastname: Simo
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D019548:Crime Victims / Q000706:statistics & numerical data; D062787:Drug Overdose / Q000453:epidemiology; D064423:Drug Trafficking / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D018453:Homeless Youth / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008694:Methamphetamine / Q000633:toxicity*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D060386:Sex Workers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D008694:Methamphetamine