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Crack pipe sharing among street‐involved youth in a C anadian setting
Author(s) -
Cheng Tessa,
Wood Evan,
Nguyen Paul,
Montaner Julio,
Kerr Thomas,
DeBeck Kora
Publication year - 2015
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1111/dar.12180
Subject(s) - confidence interval , odds ratio , medicine , logistic regression , demography , cohort , crack cocaine , forensic engineering , psychiatry , engineering , sociology
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 M ay 2006 to M ay 2012, data were collected from the At‐Risk Youth Study, a cohort of street‐involved youth aged 14–26 in V ancouver, C anada. 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.