Factors associated with premature mortality among young injection drug users in Vancouver
<p>Abstract</p> <p>Background</p> <p>Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mor...
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| Format: | Article |
| Language: | English |
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BMC
2007-01-01
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| Series: | Harm Reduction Journal |
| Online Access: | http://www.harmreductionjournal.com/content/4/1/1 |
| _version_ | 1818230093491732480 |
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| author | Strathdee Steffanie A Kerr Thomas Miller Cari L Li Kathy Wood Evan |
| author_facet | Strathdee Steffanie A Kerr Thomas Miller Cari L Li Kathy Wood Evan |
| author_sort | Strathdee Steffanie A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs.</p> <p>Methods</p> <p>Since 1996, 572 young (≤29 years) IDUs have been enrolled in the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and hepatitis C (HCV). Mortality data have been continually updated through linkages with the Provincial Coroner's Office. Crude and age-specific mortality rates, standardized mortality ratios, and life expectancy measures were calculated using person-time methods. Predictors of mortality were identified using Cox regression analyses.</p> <p>Findings</p> <p>Twenty-two participants died prior to age 30 years during the follow-up period for an overall crude mortality rate of 1,368 per 100,000 person-years. Overall, young IDUs were 16.4 times (95% confidence interval [CI]; 9.1–27.1) more likely to die; young women IDUs were 54.1 times (95%CI; 29.6–90.8) and young men IDUs were 12.9 times (95%CI; 5.5, 25.3) more likely to die when compared to the Canadian non-IDU population of the same age. The leading observed cause of death among females was: homicide (N = 9); and among males: suicide (N = 3) and overdose (N = 3). In Cox regression analyses, factors associated with mortality were, HIV infection (Hazard Ratio [HR]: 4.55; CI: 1.92–10.80) and sex work (HR: 2.76; CI: 1.16–6.56).</p> <p>Interpretation</p> <p>Premature mortality was 13 and 54 times higher among young men and women who use injection drugs in Vancouver than among the general population in Canada. The majority of deaths among the women were attributable to homicide, suggesting that interventions should occur not only through harm reduction services but also through structural interventions at the legal and policy level.</p> |
| first_indexed | 2024-12-12T10:29:01Z |
| format | Article |
| id | doaj.art-da33524824b949c1b1317e5a6f92be93 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-12-12T10:29:01Z |
| publishDate | 2007-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-da33524824b949c1b1317e5a6f92be932022-12-22T00:27:24ZengBMCHarm Reduction Journal1477-75172007-01-0141110.1186/1477-7517-4-1Factors associated with premature mortality among young injection drug users in VancouverStrathdee Steffanie AKerr ThomasMiller Cari LLi KathyWood Evan<p>Abstract</p> <p>Background</p> <p>Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs.</p> <p>Methods</p> <p>Since 1996, 572 young (≤29 years) IDUs have been enrolled in the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and hepatitis C (HCV). Mortality data have been continually updated through linkages with the Provincial Coroner's Office. Crude and age-specific mortality rates, standardized mortality ratios, and life expectancy measures were calculated using person-time methods. Predictors of mortality were identified using Cox regression analyses.</p> <p>Findings</p> <p>Twenty-two participants died prior to age 30 years during the follow-up period for an overall crude mortality rate of 1,368 per 100,000 person-years. Overall, young IDUs were 16.4 times (95% confidence interval [CI]; 9.1–27.1) more likely to die; young women IDUs were 54.1 times (95%CI; 29.6–90.8) and young men IDUs were 12.9 times (95%CI; 5.5, 25.3) more likely to die when compared to the Canadian non-IDU population of the same age. The leading observed cause of death among females was: homicide (N = 9); and among males: suicide (N = 3) and overdose (N = 3). In Cox regression analyses, factors associated with mortality were, HIV infection (Hazard Ratio [HR]: 4.55; CI: 1.92–10.80) and sex work (HR: 2.76; CI: 1.16–6.56).</p> <p>Interpretation</p> <p>Premature mortality was 13 and 54 times higher among young men and women who use injection drugs in Vancouver than among the general population in Canada. The majority of deaths among the women were attributable to homicide, suggesting that interventions should occur not only through harm reduction services but also through structural interventions at the legal and policy level.</p>http://www.harmreductionjournal.com/content/4/1/1 |
| spellingShingle | Strathdee Steffanie A Kerr Thomas Miller Cari L Li Kathy Wood Evan Factors associated with premature mortality among young injection drug users in Vancouver Harm Reduction Journal |
| title | Factors associated with premature mortality among young injection drug users in Vancouver |
| title_full | Factors associated with premature mortality among young injection drug users in Vancouver |
| title_fullStr | Factors associated with premature mortality among young injection drug users in Vancouver |
| title_full_unstemmed | Factors associated with premature mortality among young injection drug users in Vancouver |
| title_short | Factors associated with premature mortality among young injection drug users in Vancouver |
| title_sort | factors associated with premature mortality among young injection drug users in vancouver |
| url | http://www.harmreductionjournal.com/content/4/1/1 |
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