The relationship between violence and engagement in drug dealing and sex work among street-involved youth

OBJECTIVES: Street-involved youth are highly vulnerable to violence. While involvement in income-generating activities within illicit drug scenes is recognized as shaping youths' vulnerability to violence, the relative contributions of different income-generating activities remain understudied. We sought to examine the independent effects of drug dealing and sex work on experiencing violence among street-involved youth. METHODS: Data were derived from a prospective cohort of street-involved youth aged 14-26 who used drugs in Vancouver, British Columbia, between September 2005 and May 2014. Multivariable generalized estimating equations were used to examine the impact of involvement in drug dealing and sex work on experiencing violence. RESULTS: Among 1,152 participants, including 364 (31.6%) women, 740 (64.2%) reported having experienced violence at some point during the study period. In multivariable analysis, involvement in drug dealing but not sex work remained independently associated with experiencing violence among females (adjusted odds ratio [AOR]: 1.43; 95% confidence interval [CI]: 1.08-1.90) and males (AOR: 1.50; 95% CI: 1.25- 1.80), while involvement in sex work only was not associated with violence among females (AOR: 1.15; 95% CI: 0.76-1.74) or males (AOR: 1.42; 95% CI: 0.81-2.48). CONCLUSION: Findings indicate that involvement in drug dealing is a major factor associated with experiencing violence among our sample. In addition to conventional interventions, such as addiction treatment, novel approaches are needed to reduce the risk of violence for drug-using youth who are actively engaged in drug dealing. The potential for low-threshold employment and decriminalization of drug use to mitigate violence warrants further study. KEY WORDS: Drug abuse; drug trafficking; sex workers; violence; homeless youth OBJECTIFS : Les jeunes de la rue sont tres vulnerables a la violence. On reconnait que la participation a des activites generatrices de revenus dans le monde de la drogue influence la vulnerabilite des jeunes a la violence, mais la contribution relative de diverses activites generatrices de revenus demeure sous-etudiee. Nous avons voulu examiner les effets independants du trafic de stupefiants et du travail du sexe sur l'experience de la violence chez les jeunes de la rue. METHODE : Nos donnees ont ete obtenues aupres d'une cohorte prospective de jeunes de la rue de 14 a 26 ans consommant de la drogue a Vancouver (Colombie-Britannique) entre septembre 2005 et mai 2014. Des equations d'estimation generalisees multivariees ont servi a examiner l'impact de la participation au trafic de stupefiants et au travail du sexe sur l'experience de la violence. RESULTATS : Sur les 1 152 participants, dont 364 femmes (31,6%), 740 (64,2%) ont declare avoir connu la violence durant la periode de l'etude. Selon l'analyse multivariee, la participation au trafic de stupefiants mais non au travail du sexe restait independamment associee a l'experience de la violence chez les femmes (rapport de cotes ajuste [RCa] : 1,43; intervalle de confiance de 95% [IC] : 1,08-1,90) et les hommes (RCa : 1,50; IC de 95% : 1,25-1,80), tandis que la participation au travail du sexe seulement n'etait associee a la violence ni chez les femmes (RCa : 1,15; IC de 95% : 0,76-1,74), ni chez les hommes (RCa : 1,42; IC de 95% : 0,81-2,48). CONCLUSION : Ces constatations indiquent que la participation au trafic de stupefiants est un important facteur associe a l'experience de la violence dans notre echantillon. En plus d'interventions classiques comme le traitement des toxicomanies, il faudrait des approches novatrices pour reduire le risque de violence chez les jeunes qui consomment de la drogue et qui sont activement impliques dans le trafic des stupefiants. La possibilite que les emplois faiblement qualifies et la decriminalisation de la consommation de drogue attenuent la violence meriterait d'etre etudiee davantage. MOTS CLES : abus de drogue; trafic de stupefiants; travailleuses ou travailleurs du sexe; violence; jeunes sans abri La traduction du resume se trouve a la fin de l'article. Can J Public Health 2016;107(1):e88-e93 doi: 10.17269/CJPH.107.5219
Typically unstably housed, street-involved youth are vulnerable to an array of health-related harms, including violence and the associated adverse health consequences. (1) The number of street-involved youth in Canada has [...]