The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Trends in homelessness and injection practices among young urban and suburban people who inject drugs: 1997-2017
Drug Alcohol Depend. 2021 Aug 1;225:108797. doi: 10.1016/j.drugalcdep.2021.108797.Epub 2021 May 29.
Anna Hotton1, Mary-Ellen Mackesy-Amiti2, Basmattee Boodram3
Author information
1Department of Medicine, University of Chicago, Chicago, IL, United States. Electronic address: ahotton@medicine.bsd.uchicago.edu.
2Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.
3Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States; Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.
Abstract
Background: Among young people who inject drugs (PWID) homelessness is associated with numerous adverse psychosocial and health consequences, including risk of relapse and overdose, psychological distress and suicidality, limited treatment access, and injection practices that increase the risk of HIV and hepatitis C (HCV) transmission. Homeless PWID may also be less likely to access sterile syringes through pharmacies or syringe service programs.
Methods: This study applied random-effects meta-regression to examine trends over time in injection risk behaviors and homelessness among young PWID in Chicago and surrounding suburban and rural areas using data from 11 studies collected between 1997 and 2017. In addition, subject-level data were pooled to evaluate the effect of homelessness on risk behaviors across all studies using mixed effects logistic and negative binomial regression with random study effects.
Results: There was a significant increase in homelessness among young PWID over time, consistent with the general population trend of increasing youth homelessness. In mixed-effects regression, homelessness was associated with injection risk behaviors (receptive syringe sharing, syringe mediated sharing, equipment sharing) and exchange sex, though we detected no overall changes in risk behavior over time.
Conclusions: Increases over time in homelessness among young PWID highlight a need for research to understand factors contributing to youth homelessness to inform HIV/STI, HCV, and overdose prevention and intervention services for this population.