A Dose-Dependent Relationship between Exposure to a Street-Based Drug Scene and Health-Related Harms among People Who Use Injection Drugs

摘要: While the community impacts of drug-related street disorder have been well described, lesser attention has given to potential health and social implications drug scene exposure on street-involved people who use illicit drugs. Therefore, we sought assess a street-based among injection users (IDU) in Canadian setting. Data were derived from prospective cohort study known as Vancouver Injection Drug Users Study. Four categories defined based numbers hours spent each day. Three generalized estimating equation (GEE) logistic regression models constructed identify factors associated with varying levels (2–6, 6–15, over 15 hours) during period December 2005 March 2009. Among our sample 1,486 IDU, at baseline, total 314 (21%) fit criteria for high (>15 hours per day). In multivariate GEE analysis, significantly independently included: unstable housing (adjusted odds ratio [AOR] = 9.50; 95% confidence interval [CI], 6.36–14.20); daily crack (AOR = 2.70; CI, 2.07–3.52); encounters police (AOR = 2.11; 1.62–2.75); being victim violence (AOR = 1.49; 95 % 1.14–1.95). Regular employment (AOR = 0.50; 0.38–0.65), engagement addiction treatment (AOR = 0.58; 0.45–0.75) negatively exposure. Our findings indicate that is markers vulnerability higher intensity addiction. Intensity was indicators harm dose-dependent fashion. These highlight opportunities policy interventions address areas employment, housing, treatment.