Youth and HIV

Td, Mastro; Cunningham, Joy; Medrano, T; J, van Dam

doi:10.1097/qad.0b013e32834dcfa0

Cited by 9 publications

(2 citation statements)

References 16 publications

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“…In a 2011 study of street youth in Ukraine, Hillis and colleagues found that being both orphaned and homeless had additive effects on both injection drug use initiation and HIV risks (30). In an accompanying editorial, Mastro and colleagues (31) call for structural interventions for this doubly marginalized group, which should include social welfare systems, child protection and support services for victims of violence and abuse. These recommendations underscore the notion that combination HIV prevention should not focus solely on the individual, but on structural factors, systems and processes that are the underlying drivers of individual-level risk behaviors (9).…”

Section: Addictophobiamentioning

confidence: 99%

Towards combination HIV prevention for injection drug users

Strathdee

Shoptaw

Dyer

et al. 2012

Current Opinion in HIV and AIDS

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Purpose of the review Recent breakthroughs in HIV-prevention science led us to evaluate the current state of combination HIV-prevention for injection drug users (IDUs). We review the recent literature focusing on possible reasons why coverage of prevention interventions for HIV, HCV and tuberculosis among IDUs remains dismal. We make recommendations for future HIV research and policy. Recent findings IDUs disproportionately under-utilize VCT, primary care and ART, especially in countries that have the largest burden of HIV among IDUs. IDUs present later in the course of HIV infection and experience greater morbidity and mortality. Why are IDUs under-represented in HIV-prevention research, access to treatment for both HIV and addiction, and access to HIV combination prevention? Possible explanations include addictophobia, apathy, and inattention, which we describe in the context of recent literature and events. Summary This commentary discusses the current state of HIV-prevention interventions for IDUs including, VCT, NSP, OST, ART and PrEP, and discusses ways to work towards true combination HIV-prevention for IDU populations. Communities need to overcome tacit assumptions that IDUs can navigate through systems that are maintained as separate silos, and take a rights-based approach to HIV-prevention to ensure that IDUs have equitable access to life-saving prevention and treatments.

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Section: Addictophobiamentioning

confidence: 99%

Towards combination HIV prevention for injection drug users

Strathdee

Shoptaw

Dyer

et al. 2012

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

show abstract

“…A range of social and structural factors including lower socioeconomic position, juvenile justice involvement, unstable housing, and lack of social support also may be important to consider, since they have been associated with increased substance use and HIV risk behaviors (12-14). Youth who are homeless or who are unstably housed are demonstrate high HIV risk behaviors due to the street-associated behaviors, which may include substance use and trading sex for drugs or money (15). In addition, many youth may not have positive role models or social support to avoid using alcohol or drugs, which can increase their risk of engaging in substance use behaviors which can interfere with their own health, as well as place others at risk for HIV (16, 17).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of substance use among youth living with HIV in clinical settings

Gamarel

Brown

Kahler

et al. 2016

Drug and Alcohol Dependence

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Objectives The purpose of this study was to better understand the prevalence and correlates of substance use behaviors among HIV-infected adolescents in HIV care settings. Methods A cross-sectional sample of 2216 youth living with HIV (YLWH; ages 12-26) was recruited through the Adolescent Trials Network for HIV Interventions. Participants completed a one-time survey on sociodemographic factors, substance use and health behaviors. We used logistic regression models to understand the correlates of substance use outcomes. Results Overall, weekly or more frequent tobacco use was reported by 32.9% of participants, 27.5% marijuana use, and 21.3% alcohol use; and 22.5% reported any other illicit drug use. In multivariable models, young MSM had higher odds of reporting each substance use behavior, and transgender women had increased odds of marijuana and other illicit drug use. Criminal justice involvement, unstable housing, condomless sex, and suboptimal antiretroviral therapy was associated with increased risk of substance use behaviors. Conclusions Study findings highlight the need for regular screening for substance use in HIV care settings in order to improve access to and delivery of culturally competent substance use prevention and treatment services.

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Police confrontations among street-involved youth in a Canadian setting

Wood

Shannon

et al. 2013

International Journal of Drug Policy

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Background Street-level policing has been recognized as a driver of health-related harms among people who inject drugs (IDU). However, the extent of interaction between police and street-involved youth has not been well characterized. We examined the incidence and risk factors for police confrontations among street-involved youth in a Canadian setting. Methods Using data derived from participants enrolled in the At-Risk Youth Study (ARYS) between 2005 and 2011, we assessed factors associated with being stopped, searched, or detained by police without arrest in the previous six months using generalized estimating equations (GEE) with logit link for binary outcomes. Results Among 991 participants followed during the study period, 440 (44.4%) reported being stopped, searched, or detained by police for an incidence density of 49.20 (95% confidence interval [CI]: 36.42–65.01) per 100 person years. In multivariate GEE analyses, factors associated with police confrontations included: male gender (adjusted odds ratio [AOR] = 1.35), homelessness (AOR = 2.05), recent incarceration (AOR = 1.78), daily cannabis use (AOR = 1.31), daily heroin injecting (AOR = 1.36), crack pipe/syringe sharing (AOR = 1.61), injection drug use (AOR = 1.37), public drug use (AOR = 2.19), sex work involvement (AOR = 1.67), and drug dealing (AOR = 1.49) (all p<0.05). In total, 19.0% of participants reported that police confiscated their drug paraphernalia without arresting them. Additionally, 16.9% individuals reported experiencing violence at the hands of police. Conclusion We found that various factors, such as homelessness and markers of more severe addiction, increased the likelihood of being confronted by police, and police confrontations were associated with markers of health-related harm among street youth. These findings highlight the need for social and structural interventions that best enable police to fulfill public safety and public order objectives without negatively influencing health behaviours of street youth.

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Youth and HIV

Cited by 9 publications

References 16 publications

Towards combination HIV prevention for injection drug users

Towards combination HIV prevention for injection drug users

Prevalence and correlates of substance use among youth living with HIV in clinical settings

Police confrontations among street-involved youth in a Canadian setting

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