Crack pipe sharing among street-involved youth in a Canadian setting
Tessa Cheng
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
Search for more papers by this authorEvan Wood
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorPaul Nguyen
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Search for more papers by this authorJulio Montaner
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorThomas Kerr
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorCorresponding Author
Kora DeBeck
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
School of Public Policy, Simon Fraser University, Burnaby, Canada
Correspondence to Dr Kora DeBeck, B.C. Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Tel: (604) 806 9116; Fax: (604) 806 9044; E-mail: [email protected]Search for more papers by this authorTessa Cheng
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
Search for more papers by this authorEvan Wood
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorPaul Nguyen
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Search for more papers by this authorJulio Montaner
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorThomas Kerr
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
Faculty of Medicine, University of British Columbia, Vancouver, Canada
Search for more papers by this authorCorresponding Author
Kora DeBeck
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
School of Public Policy, Simon Fraser University, Burnaby, Canada
Correspondence to Dr Kora DeBeck, B.C. Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Tel: (604) 806 9116; Fax: (604) 806 9044; E-mail: [email protected]Search for more papers by this authorAbstract
Introduction and Aims
Crack pipe sharing is a risky practice that has been associated with the transmission of hepatitis C and other harms. While previous research has exclusively focused on this phenomenon among adults, this study examines crack pipe sharing among street-involved youth.
Design and Methods
From May 2006 to May 2012, data were collected from the At-Risk Youth Study, a cohort of street-involved youth aged 14–26 in Vancouver, Canada. Survey data from active crack smokers were analysed using generalised estimating equations logistic regression.
Results
Over the study period, 567 youth reported smoking crack cocaine and contributed 1288 observations, among which 961 (75%) included a report of crack pipe sharing. In multivariate analysis, factors that were associated with crack pipe sharing included difficulty accessing crack pipes [adjusted odds ratio (AOR) = 1.58, 95% confidence interval (CI) 1.13–2.20]; homelessness (AOR = 1.87, 95% CI 1.43–2.44); regular employment (AOR = 1.53, 95% CI 1.15–2.04); daily non-injection crystal methamphetamine use (AOR = 2.04, 95% CI 1.11–3.75); daily crack smoking (AOR = 1.37, 95% CI 1.01–1.85); encounters with the police (AOR = 1.42, 95% CI 1.01–1.99); and reporting unprotected sex (AOR = 1.95, 95% CI 1.47–2.58).
Discussion and Conclusions
The prevalence of crack pipe sharing was high among our sample and independently associated with structural factors including difficulty accessing crack pipes and homelessness. Crack pipe sharing was also associated with high-intensity drug use and a number of other markers of risk and vulnerability. Collectively, these findings highlight opportunities for health services to better engage with this vulnerable group and reduce this risky behaviour.
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