title: The Cedar Project: Residential transience and HIV vulnerability among young Aboriginal people who use drugs.
abstract: Aboriginal homelessness is considered to be a result of historic dispossession of traditional territories and forced displacement from community structures. Using data collected from 2005-2010 from the Cedar Project, a cohort of young Aboriginal people who use drugs in two Canadian cities, we examined how residential transience shapes HIV vulnerability. At baseline, 48 of 260 participants (18.5%) reported sleeping in six or more places ('highly transient') in the past six months. Generalized linear mixed models identified associations between high transience and sex and drug related HIV vulnerabilities. Transience was independently associated with sex work (AOR:3.52, 95%CI:2.06, 6.05); sexual assault (AOR:2.48, 95%CI:1.26, 4.86); injection drug use (AOR:4.54, 95%CI:2.71, 7.61); daily cocaine injection (AOR:2.16, 95%CI:1.26, 3.72); and public injection (AOR:2.87, 95%CI:1.65, 5.00). After stratification, transience and sexual vulnerability remained significantly associated among women but not men. Ensuring that young Aboriginal people have access to safe spaces to live, work, and inject must include policies addressing residential transience as well as the absence of a roof and walls.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Jongbloed
authors.affiliation: The Cedar Project, Centre for Evaluation and Outcome Sciences, St. Paul׳s Hospital, Vancouver, Canada; Wuikinuxv Nation, The Cedar Project, Prince George, Canada.
authors.forename: Vicky
authors.initials: V
authors.lastname: Thomas
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Margo E
authors.initials: ME
authors.lastname: Pearce
authors.affiliation: Splatsin te Secwepemc, British Columbia, Canada.
authors.forename: Kukpi Wunuxtsin
authors.initials: KW
authors.lastname: Christian
authors.affiliation: The Cedar Project, Centre for Evaluation and Outcome Sciences, St. Paul׳s Hospital, Vancouver, Canada.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Zhang
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Oviedo-Joekes
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Martin T
authors.initials: MT
authors.lastname: Schechter
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada. Electronic address: spittal@mail.hivnet.ubc.ca.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Spittal
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American; D008297:Male; D011446:Prospective Studies; D011477:Sex Work / Q000208:ethnology / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000208:ethnology*; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000208:ethnology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Aboriginal peoples; Drug use; HIV risk; Housing stability; Residential transience