Journal
AIDS AND BEHAVIOR
Volume 23, Issue 12, Pages 3267-3276Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-019-02472-1
Keywords
Injection drug use; Employment transitions; HIV infection; Socioeconomic marginalization
Funding
- US National Institutes of Health [U01-DA0251525, U01DA038886]
- Canadian Institutes of Health Research (CIHR) [MSH 217672, MSH 141971, MSH 360816]
- Michael Smith Foundation for Health Research
- CIHR Foundation Grant [FDN-154320]
- Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine
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The potential for changes in socio-economic status, such as employment exits, to increase HIV infection risk are not well examined among people who inject illicit drugs (PWID). We used longstanding cohort data from Vancouver, Canada, to longitudinally assess associations between employment cessation and outcomes with documented linkages to HIV infection risk among PWID. From 2005 to 2015, 1222 participants reported 1154 employment exits. Employment exits were significantly associated with transitions into unstable housing; moving to the inner-city; initiating informal, prohibited or illegal income generation; high risk drug use practices; and exiting methadone maintenance therapy. HIV infection rates were higher among participants with lower long-term labour market engagement. These findings suggest that employment cessation coincides with initiating exposure to aspects of socioeconomic marginalization and drug use associated with HIV infection risk. Support for employment retention that prevents poverty entrenchment and harmful drug use could contribute to HIV prevention measures for PWID.
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