title: Residential eviction and exposure to violence among people who inject drugs in Vancouver, Canada.
abstract: People who inject drugs (PWID) experience markedly elevated rates of physical and sexual violence, as well as housing instability. While previous studies have demonstrated an association between homelessness and increased exposure to violence among PWID, the relationship between residential eviction and violence is unknown. We therefore sought to examine the association between residential eviction and experiencing violence among PWID in Vancouver, Canada.
  
  
  
  Data were derived from two open prospective cohort studies of PWID: the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS). We used generalized estimating equations (GEE) to estimate the relationship between residential eviction and experiencing violence among male and female PWID, respectively.
  
  
  
  Between June 2007 and May 2014, 1689 participants were eligible for the analysis, contributing a median of 5.5 years of follow-up. Of these, 567 (33.6%) were female. In total, 259 (45.7%) of females and 566 (50.4%) of males experienced at least one incident of violence over the study period. In multivariable GEE models, residential eviction was independently associated with greater odds of experiencing violence among both females (Adjusted Odds Ratio [AOR]=2.09; 95% confidence interval [CI]: 1.39-3.13) and males (AOR=1.95; 95% CI=1.49-2.55), after adjustment for potential confounders.
  
  
  
  Residential eviction was independently associated with an increased likelihood of experiencing violence among both male and female PWID. These findings point to the need for evidence-based social-structural interventions to mitigate housing instability and violence among PWID in this setting.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2205 East Mall, Vancouver, BC V6T 1Z3, Canada.
authors.forename: Mary Clare
authors.initials: MC
authors.lastname: Kennedy
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: McNeil
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: M-J
authors.initials: MJ
authors.lastname: Milloy
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2205 East Mall, Vancouver, BC V6T 1Z3, Canada.
authors.forename: Huiru
authors.initials: H
authors.lastname: Dong
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. Electronic address: uhri-kh@cfenet.ubc.ca.
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D000069581:Exposure to Violence / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012742:Sex Offenses / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
keywords: Canada; Eviction; Generalized estimating equations; Housing; Injection drug use; Violence