Moving into an urban drug scene among people who use drugs in Vancouver, Canada: Latent class growth analysis


Autoři: Kanna Hayashi aff001;  Lianping Ti aff001;  Huiru Dong aff001;  Brittany Bingham aff002;  Andrew Day aff005;  Ronald Joe aff005;  Rolando Barrios aff005;  Kora DeBeck aff001;  M-J Milloy aff001;  Thomas Kerr aff001
Působiště autorů: British Columbia Centre on Substance Use, Vancouver, BC, Canada aff001;  Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada aff002;  Department of Medicine, University of British Columbia, Vancouver, BC, Canada aff003;  School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada aff004;  Vancouver Coastal Health Authority, Vancouver, BC, Canada aff005;  School of Public Policy, Simon Fraser University, Vancouver, Canada aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224993

Souhrn

Background

Urban drug scenes are characterized by high prevalence of illicit drug dealing and use, violence and poverty, much of which is driven by the criminalization of people who use illicit drugs (PWUD) and the associated stigma. Despite significant public health needs, little is understood about patterns of moving into urban drug scenes among PWUD. Therefore, we sought to identify trajectories of residential mobility (hereafter ‘mobility’) among PWUD into the Downtown Eastside (DTES), an urban neighbourhood with an open drug scene in Vancouver, Canada, as well as characterize distinct trajectory groups among PWUD.

Methods

Data were derived from three prospective cohort studies of community-recruited PWUD in Vancouver between 2005 and 2016. We used latent class growth analysis (LCGA) to identify distinct patterns of moving into the DTES among participants residing outside of DTES at baseline. Multivariable multinomial logistic regression was used to determine baseline factors associated with each trajectory group.

Results

In total, 906 eligible participants (30.9% females) provided 9,317 observations. The LCGA assigned four trajectories: consistently living outside of DTES (52.8%); early move into DTES (11.9%); gradual move into DTES (19.5%); and move in then out (15.8%). Younger PWUD, those of Indigenous ancestry, those who were homeless or living in a single-room occupancy hotel (SRO), and those injecting drugs daily were more likely to move in then out of DTES (all p<0.05). Living in an SRO, daily injection drug use, and recent incarceration were also positively associated with early mobility (all p<0.05).

Conclusions

Nearly half of the participants moved into the DTES. Younger PWUD and Indigenous peoples appeared to have particularly high mobility, as did those with markers of social-structural vulnerability and high intensity drug use. These findings indicate a need to tailor existing social and health services within the DTES and expand affordable housing options outside the DTES.

Klíčová slova:

Drug research and development – Hepatitis C virus – Housing – Neighborhoods – Opioids – Recreational drug use – Socioeconomic aspects of health


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