Abstract
Background: In Canada, Aboriginal women and youth continue to be overrepresented amongst new cases of HIV, and are considered at increased risk for sex and drug-related harm. Young women involved in sex work are particularly vulnerable. The purpose of this study is to determine HIV-related vulnerabilities associated with sex work amongst young Aboriginal women in two Canadian cities. Methods: This study is based on a community-based cohort of Aboriginal young people (status and non-status First Nations, Inuit and Métis) between the ages of 14 and 30 who used injection or non-injection illegal drugs (street drugs) in the previous month. Participants lived in Vancouver, Canada, or Prince George, a remote, northern Canadian city. Between October 2003 and July 2005, 543 participants were recruited by word of mouth, posters, and street outreach. A baseline questionnaire was administered by Aboriginal interviewers, and trained nurses drew blood samples for HIV and HCV antibodies and provided pre- and post-test counselling. This study included 262 young women who participated at baseline. Analyses were conducted to compare socio-demographics, drug use patterns, injection practices, sexual experiences, and HIV and HCV prevalence between young women who reported being involved in sex work in the last 6 months (n = 154) versus young women who did not (n = 108). Logistic regression was used to identify factors independently associated with recent sex work involvement. Results: Both sexual violence and drug using patterns were found to be markedly different for women having recently been involved in sex work. Multivariate analysis revealed daily injection of cocaine (AOR = 4.4; 95% CI: 1.9, 10.1 and smoking crack (AOR = 2.9; 95% CI: 1.6, 5.2) in the previous 6 months, and lifetime sexual abuse (AOR = 2.5; 95% CI: 1.4, 4.4) to be independently associated with sex work. Interpretation: Harm reduction and treatment programs that address historical and lifetime trauma amongst Aboriginal people and prioritize emotional and physical safety for young Aboriginal women involved in sex work are required. Crown
| Original language | English |
|---|---|
| Pages (from-to) | 159-168 |
| Number of pages | 10 |
| Journal | International Journal of Drug Policy |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2008 |
| Externally published | Yes |
Bibliographical note
Funding Information:We are indebted to the study participants for their continued participation in the Cedar Project. Our study staff, Caitlin Johnston, Vicky Thomas, Teresa George, Kat Norris, Sidney Crosby, Steve Kain, Kathy Churchill and Jamie Larson, must be thanked for their continued conviction and contributions. Special thanks to the Cedar Project Partnership; the Prince George Friendship Centre, Carrier Sekani Family Services, the Northern Health Authority, Positive Living North, The Red Road Aboriginal HIV/AIDS Network, Central Interior Native health, and Vancouver Native Health, for their conviction and for holding us accountable to the voices of Aboriginal youth. We must also thank the elders, Violet Bozoki and Earl Henderson, who support the study. The study was supported by a grant from the Institute for Aboriginal Peoples Health, of the Canadian Institutes for Health Research (CIHR). Dr. Spittal is the recipient of the CIHR New Investigator Career Award. Dr. Schechter holds a Canada Research Chair in HIV/AIDS and Urban Population Health.
ASJC Scopus Subject Areas
- Medicine (miscellaneous)
- Health Policy
