Boston Medical Center, Department of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, USA.
Prev Med. 2012 Nov;55(5):500-4. doi: 10.1016/j.ypmed.2012.08.015. Epub 2012 Aug 28.
This study examined whether childhood sexual abuse predicts initiation of injection drug use in a prospective cohort of youth.
From October 2005 to November 2010, data were collected from the At Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Inclusion criteria were age 14-26 years, no lifetime drug injection, and non-injection drug use in the month preceding enrollment. Participants were interviewed at baseline and semiannually thereafter. Cox regression was employed to identify risk factors for initiating injection.
Among 395 injection-naïve youth, 81 (20.5%) reported childhood sexual abuse. During a median follow-up of 15.9 months (total follow-up 606.6 person-years), 45 (11.4%) youth initiated injection drug use, resulting in an incidence density of 7.4 per 100 person-years. In univariate analyses, childhood sexual abuse was associated with increased risk of initiating injection (unadjusted hazard ratio [HR], 2.38; 95% confidence interval [CI], 1.29-4.38; p=0.006), an effect that persisted in multivariate analysis despite adjustment for gender, age, aboriginal ancestry and recent non-injection drug use (adjusted HR, 2.71; 95% CI, 1.42-5.20; p=0.003).
Childhood sexual abuse places drug users at risk for initiating injection. Addiction treatment programs should incorporate services for survivors of childhood maltreatment.
本研究旨在考察儿童期性虐待是否会预测青少年前瞻性队列中注射吸毒的开始。
2005 年 10 月至 2010 年 11 月期间，从加拿大温哥华的一项前瞻性队列研究——风险青年研究（ARYS）中收集数据。纳入标准为年龄 14-26 岁，无终生药物注射史，且在入组前一个月内无药物注射。参与者在基线和此后每半年接受一次访谈。采用 Cox 回归分析确定注射起始的危险因素。
在 395 名无注射经验的青少年中，有 81 名（20.5%）报告了儿童期性虐待史。在中位随访 15.9 个月（总随访 606.6 人年）期间，有 45 名（11.4%）青少年开始使用注射毒品，导致发生率密度为 7.4 人年/100 人。在单因素分析中，儿童期性虐待与注射起始风险增加相关（未经调整的危险比[HR]，2.38；95%置信区间[CI]，1.29-4.38；p=0.006），尽管在多变量分析中调整了性别、年龄、原住民血统和近期非注射药物使用，这种关联仍然存在（调整后的 HR，2.71；95% CI，1.42-5.20；p=0.003）。
儿童期性虐待使吸毒者有注射吸毒的风险。成瘾治疗计划应纳入针对儿童期虐待幸存者的服务。
