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The Cedar Project: increasing rates of unstable housing and associated health vulnerabilities among young indigenous people who use drugs in two Canadian cities
A. Moniruzzaman1,2, M. Pearce1,2, V. Thomas3,4, M. Schechter1,2, P. Spittal1,2, For the Cedar Project Partnership
The objective of this study was to explore risks associated with unstable housing among young, street-involved Indigenous
people who use drugs in two urban centres in British Columbia.
The Cedar Project is an ongoing prospective study of Indigenous
young people in Vancouver and Prince George who use injection and non-injection
drugs. Unstable housing was defined as sleeping on the streets or living
in transitional housing including single room occupancy hotels or ‘couch
surfing’. This analysis included
data collected at baseline and five follow-up visits between October 2003 and July
2007. Venous blood samples tested
for HIV and HCV antibodies. Generalized
estimating equation (GEE) modeling identified
factors associated with homelessness over the study period. Variables included in multivariable
analysis were chosen because of their importance in the literature and they
reached statistical significance at the p< 0.05
level in univariable analysis. Unadjusted and adjusted odds ratios (UOR/AOR)
and 95% confidence intervals (CI) were calculated.
The proportion of participants
who reported unstable housing increased over the study period from 45.7% at
baseline to 42.4% at follow-up one, 47.1 at follow-up two, 47.3% at follow-up
three, 49.7% at follow-up four and 53.3% at follow-up five. In multivariable analysis factors associated
with unstable housing over the study period included living in Vancouver (AOR:
2.87; 95% CI: 2.20-3.74), ever having been taken from biological parents into
care (AOR: 1.45; 95% CI: 1.11-1.90), injecting drugs in the last six months
(AOR: 1.46; 95% CI: 0.98-2.17) and incarceration in the last 6 months (AOR:
1.62; 95% CI: 1.28-2.05).
Young and at-risk Indigenous
people in unstable housing situations may be coping with unresolved historical
and lifetime trauma, and at increased risk of HIV and HCV infection. Young Indigenous people must be involved
in the design and implementation of safe spaces that are available 24 hours per day.
Abstract no. TUPE0638
“A.Moniruzzaman, et al. The Cedar Project: increasing rates of unstable housing and associated health vulnerabilities among young indigenous people who use drugs in two Canadian cities. : : Abstract no. TUPE0638 “