309765
Cedar Project: The effects of childhood maltreatment on HIV risk among young Indigenous people who use drugs in three Canadian cities
Methods: The Cedar Project is a cohort of young Indigenous people (aged 14-30) who use drugs in Vancouver, Prince George, and Chase, BC. Childhood trauma was measured using the Childhood Trauma Questionnaire (CTQ) with categorical cut-scores. Generalized linear mixed models explored associations between abuse types and HIV risk between 2003-2012, adjusting for confounders. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated.
Results: Overall, 266 participants (53% women) completed the CTQ and at least one follow-up. Most (86%) experienced at least one form of maltreatment; 38.7% reported severe sexual abuse, 41.4% severe physical abuse, 33.8% severe emotional abuse, and 60.9% severe neglect. Significantly more participants in Prince George reported severe sexual (p=0.017) and emotional abuse (p=0.030). Severe sexual abuse increased the odds for injection drug use (AOR:2.765; 95%CI:1.023-7.472), high frequency cocaine injection (AOR:2.688; 95%CI: 1.309-5.521), binge injection (AOR: 2.907, 95%CI: 1.525-5.541), and sex work (AOR:4.975; 95%CI: 1.849-13.382). Severe physical abuse increased the odds for homelessness (AOR:1.548; 95%CI: 1.001-2.393), binge injection (AOR:3.107; 95%CI: 1.707-5.654), and inconsistent condom use (AOR:2.681; 95%CI: 1.393-5.161). Severe emotional abuse increased the odds for homelessness (AOR:2.084; 95%CI:1.215-3.577), binge injection (AOR: 2.172 ; 95%CI:1.111-4.247), and inconsistent condom use (AOR:2.417; 95%CI: 1.084-5.389).
Conclusion: The severity of childhood maltreatment among Cedar Project participants continues to have grave consequences for HIV risk. Prevention programming must consider the legacies of traumas among young Indigenous people who use drugs.
Learning Areas:
EpidemiologySocial and behavioral sciences
Learning Objectives:
Describe the effects of early childhood maltreatment on HIV risk behaviours among young, urban Indigenous people who use drugs in Canada.
Keyword(s): Child Abuse, HIV Risk Behavior
Organization/institution whose products or services will be discussed: n/a
Qualified on the content I am responsible for because: I am a PhD Candidate at the University of British Columbia School of Population and Public Health. My work focuses on early childhood maltreatment, resilience, and HIV risk behaviours among young Aboriginal people who use drugs. I have received funding for my studies from multiple federal and provincial funding agencies including the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.