Childhood sexual abuse and risk for initiating injection drug use: A prospective cohort study |
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| Authors: | Scott E Hadland Dan Werb Thomas Kerr Eric Fu Hong Wang Julio S Montaner Evan Wood |
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| Institution: | 1. Boston Medical Center, Department of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, USA;2. Children''s Hospital Boston, Department of Medicine, 300 Longwood Avenue, Boston, MA 02115, USA;3. British Columbia Centre for Excellence in HIV/AIDS, St. Paul''s Hospital, 608‐1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6;4. University of British Columbia, School of Population and Public Health, Mather Building, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3;5. University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada V6T 1Z3;1. Department of General Surgery, Kathmandu Model Hospital, GPO Box: 6064, Pradarshani Marg, Kathmandu, Nepal;2. Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK;3. Neurosurgery Unit, Department of Surgery, Tribhuvan University Teaching Hospital, Maharajgunj Kathmandu, Nepal;1. Physical Activity Nutrition Obesity Research Group, School of Public Health, University of Sydney, NSW, Australia;2. Centre for Population Health, NSW Ministry of Health, North Sydney, Australia;1. Department of Community Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam;2. Sydney School of Public Health, Sydney Medical School, University of Sydney, NSW 2006 Australia |
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| Abstract: | ObjectiveThis study examined whether childhood sexual abuse predicts initiation of injection drug use in a prospective cohort of youth.MethodFrom 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.ResultsAmong 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).ConclusionChildhood 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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