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The Cedar Project: childhood sexual abuse and over-time HIV vulnerability among young indigenous men and women who use drugs in two Canadian cities
M. Pearce1,2,3, K. Patterson1,4, S. Patel1,2,3, A. Moniruzzaman1,2,3, M. Schechter1,2,3, P. Spittal1,2,3, For the Cedar Project Partnership
This study sought
to describe over-time health and social outcomes related to antecedent
childhood sexual abuse between ages 0-15 (CSA) among young Indigenous men and
women who use drugs.
The Cedar Project is an ongoing prospective study of
young Indigenous people in Vancouver and Prince George who use injection and
non-injection drugs. This analysis included data from October 2003-July
2007. Venous blood samples tested
for HIV and HCV antibodies. Generalized
estimating equation (GEE) models investigated the effect of antecedent CSA on a
priori health and social outcomes while adjusting for demographic and
historical trauma factors. Separate models were carried out for men and women. Unadjusted and adjusted odds ratios
(OR) and 95% confidence intervals (CI) were calculated.
In total, 264 (43.6%) of 605
participants enrolled at baseline reported CSA, 61.6%
of which were women. Overall, 292
women contributed 978 observations and 313 men contributed 938 observations
over the study period. The median
age of first experiencing CSA was 6.
In univariable analysis: women who had experienced CSA were more likely
to report sexual assault (UOR: 6.12; 95%CI: 2.48-15.10), to inject cocaine
daily (UOR: 1.45, 95%CI: 1.01-2.10) and to be HIV positive (UOR: 1.15, 95%CI:
1.08-1.22); men were more likely to be HIV positive (UOR: 1.10; 95%CI:
1.04-1.17) and HCV positive (UOR: 1.78; 95%CI: 1.06-3.00). In multivariable analysis: women who
had experienced CSA were more likely to report recent sexual assault (AOR:
6.17; 95%CI: 2.4-15.84) and men were more likely to report sex work (AOR: 2.40;
95%CI: 0.98-5.91) and sexually transmitted infections (AOR: 2.96, 95%CI:
1.36-6.44) over the study period.
risk of sexual vulnerabilities and HIV and HCV infection among young at-risk
Indigenous people who have experienced CSA is distressing. Meaningfully addressing CSA among Indigenous young
people requires community based, client-driven healing programs that
incorporate traditional and western approaches.
Abstract no. TUPE0523
“M.Pearce, et al. The Cedar Project: childhood sexual abuse and over-time HIV vulnerability among young indigenous men and women who use drugs in two Canadian cities. : : Abstract no. TUPE0523 “