The impact of recent homelessness on the provision of injection drug use initiation assistance among persons who inject drugs in Tijuana, Mexico and Vancouver, Canada.
Drug Alcohol Depend
; 225: 108829, 2021 08 01.
Article
in En
| MEDLINE
| ID: mdl-34237582
OBJECTIVE: To assess the relationship between experiencing homelessness and assisting injection drug use (IDU) initiation among people who inject drugs (PWID) in Tijuana, Mexico and Vancouver, Canada. METHODS: We used self-reported questionnaire data collected semi-annually on PWID from Tijuana (n = 703) and Vancouver (n = 1551) between 2014 and 2017. Within each setting, the effect of recent (i.e., past six months) homelessness on recent provision of injection initiation assistance (i.e., helping anybody inject for the first time in the past six months) was estimated using inverse-probability-of-treatment (IPT)-weighted estimation of a marginal structural model. RESULTS: Across follow-up, the prevalence of recent homelessness at a given visit ranged from 11.6%-16.5% among Tijuana-based participants and 9.4%-18.9% among Vancouver-based participants; the prevalence of recent provision of injection initiation at a given follow-up visit was lower, ranging from 3.3%-5.4% in Tijuana and 2.5%-4.1% in Vancouver. Based on the IPT-weighted estimates, recent homelessness was associated with 66% greater odds among Tijuana-based PWID (Adjusted Odds Ratio [AOR] = 1.66; 95% CI: 1.01-2.73) and 47% greater odds among Vancouver-based PWID (AOR = 1.47, 95% CI: 1.02-2.13) of providing injection initiation assistance over the same six-month period. CONCLUSION: We found that recently experiencing homelessness was associated with an increased likelihood of PWID reporting IDU initiation assistance over time in both Tijuana and Vancouver. Addressing homelessness may decrease the initiation of IDU via multiple pathways.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ill-Housed Persons
/
Pharmaceutical Preparations
/
Substance Abuse, Intravenous
/
Drug Users
Type of study:
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Humans
Country/Region as subject:
Mexico
Language:
En
Journal:
Drug Alcohol Depend
Year:
2021
Document type:
Article
Affiliation country:
United States
Country of publication:
Ireland