Risk factors for progression to regular injection drug use among street-involved youth in a Canadian setting.
Risk factors for progression to regular injection drug use among street-involved youth in a Canadian setting.
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DOI：
10.1016/j.drugalcdep.2013.07.008
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发表时间：
2013-12-01
影响因子：
4.2
通讯作者：
Wood, Evan
中科院分区：
文献类型：
--
作者：
DeBeck, Kora;Kerr, Thomas;Marshall, Brandon D. L.;Simo, Annick;Montaner, Julio;Wood, Evan
街头青年尝试注射吸毒的风险很高;然而，很少有人注意到确定预测进展到持续注射的因素。Logistic回归被用来确定与进展到每周注射定期在加拿大队列的街头参与青年的相关因素。在我们的405名在基线或研究观察期间开始注射的青少年样本中，中位年龄为22岁（四分位距[IQR] = 21 - 24），72%（293）的人报告在首次注射后的某个时间点成为常规注射者。其中，大多数（n=186，63%）报告在开始注射药物使用后一个月内这样做。在多变量分析中，首次注射开始事件时使用的药物（阿片类药物与可卡因与甲基苯丙胺与其他药物;所有P > 0.05）与进展无关;然而，第一次注射年龄较小，（调整后的比值比[AOR] =1.13），儿童期身体虐待史（AOR =1.81）、既往定期使用首次注射药物（AOR =1.77）和首次注射时有性伴侣（AOR =2.65）独立预测进展为定期注射。这些数据突出了年轻人在实验后成为常规注射者的速度有多快。研究结果表明，解决童年创伤和干预措施，如循证的青年为重点的成瘾治疗，可以防止或延迟定期非注射吸毒，可能会减少这一人群中的定期注射吸毒的进展。
Street-involved youth are at high risk for experimenting with injection drug use; however, little attention has been given to identifying the factors that predict progression to on-going injecting. Logistic regression was used to identify factors associated with progression to injecting weekly on a regular basis among a Canadian cohort of street-involved youth. Among our sample of 405 youth who had initiated injecting at baseline or during study observation, the median age was 22 years (interquartile range [IQR] = 21 – 24), and 72% (293) reported becoming a regular injector at some point after their first injection experience. Of these, the majority (n=186, 63%) reported doing so within a month of initiating injection drug use. In multivariate analysis, the drug used at the first injection initiation event (opiates vs. cocaine vs. methamphetamine vs. other; all p > 0.05) was not associated with progression; however, younger age at first injection (adjusted odds ratio [AOR] =1.13), a history of childhood physical abuse (AOR =1.81), prior regular use of the drug first injected (AOR =1.77), and having a sexual partner present at the first injection event (AOR =2.65) independently predicted progression to regular injecting. These data highlight how quickly youth progress to become regular injectors after experimentation. Findings indicate that addressing childhood trauma and interventions such as evidence-based youth focused addiction treatment that could prevent or delay regular non-injection drug use, may reduce progression to regular injection drug use among this population.
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