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The Cedar Project: vulnerabilities associated with sex work involvement over a five-year study period among young Indigenous women who use drugs in two Canadian cities
P. Spittal1,2,3, K. Joseph1,4, N. Chavoshi1,2,3, K. Patterson1,5, M. Schechter1,2,3, For the Cedar Project Partnership
This study explored vulnerabilities associated with
sex work involvement among young Indigenous women who use drugs in two cities 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. Sex work involvement was defined as having exchanged
sex for money, drugs, food or shelter in the previous six months. This analysis included data collected
between October 2003 and July 2007. Venous blood samples tested for HIV and HCV antibodies.
Generalized estimating equation (GEE) modeling identified factors associated with sex work
involvement over the study period. Variables included in multivariable analysis were chosen
because of their importance in the literature and because 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.
In total, 292 women contributed
979 observations over the five-year study period. In multivariable analysis,
women involved in sex work over the study period were more likely to be younger
(AOR: 0.935; 95%CI: 0.89-0.98), to have a bisexual sexual identity (AOR: 2.55;
95%CI: 1.46-4.46), to report homelessness in the past six months (AOR: 1.70;
95%CI: 1.27-2.28), to need help injecting drugs in the past six months (AOR:
1.58; 95%CI: 1.00-2.48), to smoke crack daily in the past six months (AOR:
3.35, 95%CI: 2.15-5.22) and to inject cocaine daily in the past six months (AOR:
2.49; 95%CI: 1.49-4.14). Sexual assault in the past six months was marginally
significant (AOR: 1.67; 95%CI: 0.93-2.99).
The young Indigenous women
involved in sex work in this study are vulnerable to multiple serious
health outcomes. Developing
interventions based on Indigenous strategies for healing that incorporate historical
trauma and harm reduction approaches are essential for the safety and survival
of these women.
Abstract no. TUPE0350
“P.Spittal, et al. The Cedar Project: vulnerabilities associated with sex work involvement over a five-year study period among young Indigenous women who use drugs in two Canadian cities. : : Abstract no. TUPE0350 “