Childhood sexual abuse and risk for initiating injection drug use: a prospective cohort study.
Childhood sexual abuse and risk for initiating injection drug use: a prospective cohort study.
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DOI：
10.1016/j.ypmed.2012.08.015
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发表时间：
2012-11
影响因子：
5.1
通讯作者：
Wood, Evan
中科院分区：
文献类型：
--
作者：
Hadland, Scott E.;Werb, Dan;Kerr, Thomas;Fu, Eric;Wang, Hong;Montaner, Julio S.;Wood, Evan
本研究探讨是否儿童期性虐待预测开始注射毒品使用的前瞻性队列的青年。从2005年10月至2010年11月，数据收集的风险青年研究（阿里斯），在加拿大温哥华街头参与青年的前瞻性队列研究。入选标准为年龄14-26岁，终生无药物注射，入组前一个月无注射药物使用。参与者在基线时接受采访，此后每半年一次。采用考克斯回归确定开始注射的风险因素。在395名未接受过注射的青少年中，有81人（20.5%）报告了儿童期性虐待。在中位随访15.9个月（总随访606.6人-年）期间，45名（11.4%）青年开始使用注射药物，导致发病率密度为7.4/100人-年。在单变量分析中，儿童期性虐待与开始注射的风险增加有关（未校正的风险比[HR]，2.38; 95%置信区间[CI]，1.29-4.38; p=0.006），尽管对性别、年龄、土著血统和近期非注射药物使用进行了校正，但这种效应在多变量分析中仍然存在。（校正HR，2.71; 95% CI，1.42-5.20; p=0.003）。儿童期性虐待使吸毒者有开始注射的风险。成瘾治疗方案应包括为儿童虐待幸存者提供的服务。
This study examined whether childhood sexual abuse predicts initiation of injection drug use in a prospective cohort of youth. From October 2005 to November 2010, data were collected from the At Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Inclusion criteria were age 14-26 years, no lifetime drug injection, and non-injection drug use in the month preceding enrollment. Participants were interviewed at baseline and semiannually thereafter. Cox regression was employed to identify risk factors for initiating injection. Among 395 injection-naïve youth, 81 (20.5%) reported childhood sexual abuse. During a median follow-up of 15.9 months (total follow-up 606.6 person-years), 45 (11.4%) youth initiated injection drug use, resulting in an incidence density of 7.4 per 100 person-years. In univariate analyses, childhood sexual abuse was associated with increased risk of initiating injection (unadjusted hazard ratio [HR], 2.38; 95% confidence interval [CI], 1.29–4.38; p=0.006), an effect that persisted in multivariate analysis despite adjustment for gender, age, Aboriginal ancestry and recent non-injection drug use (adjusted HR, 2.71; 95% CI, 1.42–5.20; p=0.003). Childhood sexual abuse places drug users at risk for initiating injection. Addiction treatment programs should incorporate services for survivors of childhood maltreatment.
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