Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada


Autoři: Verena Knerich aff001;  Andrea A. Jones aff002;  Sam Seyedin aff002;  Christopher Siu aff002;  Louie Dinh aff003;  Sara Mostafavi aff004;  Alasdair M. Barr aff006;  William J. Panenka aff002;  Allen E. Thornton aff007;  William G. Honer aff002;  Alexander R. Rutherford aff008
Působiště autorů: Departments of Computer Science, and Cultural Anthropology, Ludwig-Maximilians University, Munich, Germany aff001;  Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada aff002;  Department of Computer Science, University of British Columbia, Vancouver, BC, Canada aff003;  Department of Statistics, University of British Columbia, Vancouver, BC, Canada aff004;  Medical Genetics, Department Office, University of British Columbia, Vancouver, BC, Canada aff005;  Department of Anesthesia, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada aff006;  Department of Psychology, Simon Fraser University, Burnaby, BC, Canada aff007;  Department of Mathematics, Simon Fraser University, Burnaby, BC, Canada aff008
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222611

Souhrn

Background

The structure of a social network as well as peer behaviours are thought to affect personal substance use. Where substance use may create health risks, understanding the contribution of social networks to substance use may be valuable for the design and implementation of harm reduction or other interventions. We examined the social support network of people living in precarious housing in a socially marginalized neighborhood of Vancouver, and analysed associations between social network structure, personal substance use, and supporters’ substance use.

Methods

An ongoing, longitudinal study recruited 246 participants from four single room occupancy hotels, with 201 providing social network information aligned with a 6-month observation period. Use of tobacco, alcohol, cannabis, cocaine (crack and powder), methamphetamine, and heroin was recorded at monthly visits. Ego- and graph-level measures were calculated; the dispersion and prevalence of substances in the network was described. Logistic mixed effects models were used to estimate the association between ego substance use and peer substance use. Permutation analysis was done to test for randomness of substance use dispersion on the social network.

Results

The network topology corresponded to residence (Hotel) with two clusters differing in demographic characteristics (Cluster 1 –Hotel A: 94% of members, Cluster 2 –Hotel B: 95% of members). Dispersion of substance use across the network demonstrated differences according to network topology and specific substance. Methamphetamine use (overall 12%) was almost entirely limited to Cluster 1, and absent from Cluster 2. Different patterns were observed for other substances. Overall, ego substance use did not differ over the six-month period of observation. Ego heroin, cannabis, or crack cocaine use was associated with alter use of the same substances. Ego methamphetamine, powder cocaine, or alcohol use was not associated with alter use, with the exception for methamphetamine in a densely using part of the network. For alters using multiple substances, cannabis use was associated with lower ego heroin use, and lower ego crack cocaine use. Permutation analysis also provided evidence that dispersion of substance use, and the association between ego and alter use was not random for all substances.

Conclusions

In a socially marginalized neighborhood, social network topology was strongly influenced by residence, and in turn was associated with type(s) of substance use. Associations between personal use and supporter’s use of a substance differed across substances. These complex associations may merit consideration in the design of interventions to reduce risk and harms associated with substance use in people living in precarious housing.

Klíčová slova:

Behavior – Cannabis – Network analysis – Permutation – Social networks – Cocaine – Heroin – Neighborhoods


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