Year: 2010
Type: dissertation
Abstract: Background: The objectives of this thesis were to describe the impacts of drug-related street disorder on street-based injection drug users (IDU) in Vancouver, Canada and to explore the potential impacts of three policy interventions (low-threshold supportive housing, low-threshold employment, and supervised inhalation facilities) on the reduction of street disorder. Methods: Data for these studies were derived from the Vancouver Injection Drug Users Study (VIDUS) which is a community recruited prospective cohort of IDU. Study participants were invited on bi-annual bases to complete an interviewer-administered questionnaire. Various multivariate regression techniques were utilized to assess factors associated with exposure to drug-related street disorder, socializing in Vancouver’s open drug scene, engaging in disorderly income generation activities, and smoking crack cocaine in public areas. Further multivariate analyses were conducted to assess willingness to reduce engagement in behaviours that contribute to drug-related street disorder. Results: At baseline, 21% of the study sample reported spending over 15 hour per day in Vancouver’s open drug scene on average. Drug scene exposure was found to be associated in a dose-dependent fashion with higher intensity drug use and multiple markers of vulnerability to adverse health outcomes. In further analyses, 43% of participants reported socializing in the open drug scene for 3 or more hours per day, and having limited access to private space was the factor most strongly associated with this behaviour. Among this group 65% reported being willing to relocate if given access to more private space. 47% of participants who engaged in disorderly income generation activities were willing to forgo these income sources if given low-threshold employment, and 71% of crack cocaine smokers who reported recently using in public areas were willing to visit a supervised inhalation facility. Conclusions: These studies highlight the importance of viewing street disorder in the context of current political, economic, and social conditions and provide a compelling body of evidence indicating that structural and environmental level interventions, specifically in the areas of housing (i.e., provision of private space), employment and supervised drug consumption facilities, are likely to have a positive influence on public health and reduce engagement in drug-related street disorder.
DOI: 10.14288/1.0071578
Author: DeBeck, Kora
Institution: University of British Columbia
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2295344344