title: Examining the link between cocaine binging and individual, social and behavioral factors among street-based cocaine users.
abstract: To estimate the prevalence of cocaine binging and examine associated factors, to characterize binge episodes and to study the relationship between cocaine binging and HIV and HCV risk behaviors among street-based cocaine users.
  
  
  
  A prospective cohort study was conducted in Montréal, Canada. Interviewer-administered questionnaire were carried out at 3-month intervals. Cocaine binging was defined as using large quantities of cocaine, without stopping, over a limited period of time, until resources run out or until being physically incapable of consuming. Generalized Estimation Equations (GEE) analyses were used. Covariates considered included demographic, behavioral, mental health and social risk factors.
  
  
  
  In total, 605 participants were recruited. Prevalence of cocaine binging over the month prior to recruitment was 24.5%. Correlates of cocaine binging were older age (AOR 1.46), homelessness (AOR 1.44), criminal/marginal income strategies (AOR 1.61), high psychological distress (AOR 1.31), high cocaine dependence (AOR 3.71), drug overdoses (AOR 1.56) and smoking as the main route of cocaine administration (AOR 1.38). Additional GEE analyses showed that cocaine binging was significantly associated with the sharing of drug paraphernalia (AOR 1.35) and sexual relations under the influence of cocaine (AOR 1.21).
  
  
  
  Cocaine binging is frequent among street-based cocaine users and is associated with markers of vulnerability. It is also associated with increased odds of both sexual and drug use risk behaviors. Interventions need to be tailored in order to help cocaine bingers develop personal strategies that could prevent binging. Harm reduction programs should help cocaine bingers adequately assess their drug equipment needs.
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada; Institut national de santé publique du Québec, Montréal, Québec, Canada. Electronic address: Elise.Roy@USherbrooke.ca.
authors.forename: Élise
authors.initials: É
authors.lastname: Roy
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Nelson
authors.initials: N
authors.lastname: Arruda
authors.affiliation: Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Didier
authors.initials: D
authors.lastname: Jutras-Aswad
authors.affiliation: Faculty of Medecine and Health Sciences, Charles-Le Moyne Hospital Research Centre, Longueuil, Québec, Canada.
authors.forename: Djamal
authors.initials: D
authors.lastname: Berbiche
authors.affiliation: Douglas Mental Health Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Perreault
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Bertrand
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Magali
authors.initials: M
authors.lastname: Dufour
authors.affiliation: Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Family Medecine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Bruneau
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Binge; Cocaine; Drug use behaviors; HCV risk behaviors; HIV risk behaviors