Richardson Lindsey, DeBeck Kora, Feng Cindy, Kerr Thomas, Wood Evan
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; Faculty of Medicine, University of British Columbia, Room 10203-2775 Laurel St., Vancouver, BC, Canada, V5Z 1M9.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6; School of Public Policy, Simon Fraser University, SFU Harbour Centre, 515 West Hastings Street, Suite 3271, Vancouver, BC, Canada, V6B 5K3.
Prev Med. 2014 Sep;66:56-9. doi: 10.1016/j.ypmed.2014.05.022. Epub 2014 Jun 2.
Youth unemployment has been associated with labour market and health disparities. However, employment as a determinant of high-risk health behaviour among marginalized young people has not been well described. We sought to assess a potential relationship between employment status and initiation of intravenous drug use among a prospective cohort of street-involved youth.
We followed injecting naïve youth in the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada, and employed Cox regression analyses to examine whether employment was associated with injection initiation.
Among 422 injecting naïve youth recruited between September 2005 and November 2011, 77 participants transitioned from non-injection to injection drug use, for an incidence density of 10.3 (95% confidence interval [CI]: 8.0-12.6) per 100 person years. Results demonstrating that employment was inversely associated with injection initiation (adjusted hazard ratio: 0.53; 95% CI: 0.33-0.85) were robust to adjustment for a range of potential confounders.
A lack of employment among street-involved youth was associated with the initiation of injection drug use, a practice that predisposes individuals to serious long-term health consequences. Future research should examine if reducing barriers to labour market involvement among street-involved youth prevents transitions into high-risk drug use.
青年失业与劳动力市场及健康差异有关。然而，就业作为边缘化年轻人高风险健康行为的一个决定因素，尚未得到充分描述。我们试图评估在一个涉及街头的青年前瞻性队列中，就业状况与静脉注射吸毒开始之间的潜在关系。
我们追踪了“高危青年研究”中从未注射过毒品的青年，该队列是加拿大温哥华一群年龄在14至26岁、涉及街头的青年，并采用Cox回归分析来检验就业是否与开始注射毒品有关。
在2005年9月至2011年11月招募的422名从未注射过毒品的青年中，有77名参与者从非注射毒品转变为注射毒品，发病密度为每100人年10.3（95%置信区间[CI]：8.0 - 12.6）。在对一系列潜在混杂因素进行调整后，结果表明就业与开始注射毒品呈负相关（调整后的风险比：0.53；95% CI：0.33 - 0.85），该结果具有稳健性。
涉及街头的青年中就业不足与开始注射毒品有关，这种行为会使个体面临严重的长期健康后果。未来的研究应探讨减少涉及街头的青年进入劳动力市场的障碍是否能防止他们转变为高风险吸毒行为。
