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Cedar Project: Psychological distress and HIV vulnerability among young Indigenous people who use drugs in three Canadian cities
Methods: The Cedar Project is a cohort study of young Indigenous people aged 14-30 who use drugs in Vancouver, Prince George, and Chase, BC. Eligibility for this analysis included: completed a baseline Symptom Checklist-90-Revised (average measure for severity of psychological distress) and the Childhood Trauma Questionnaire, and returned for at least one follow-up between 2010-2012. Adjusted linear mixed-effects models (LME) estimated the effect of the size (B) and 95% confidence intervals (CI) of study variables on mean change in psychological distress scores.
Results: Among 202 eligible participants, 53% were women, the mean age was 28. Baseline psychological distress scores were higher for women (1.25) than men (0.81), (p<0.001). For men, adjusted factors associated with increased psychological distress included: emotional abuse (B=0.57; 95%CI:0.21-0.93), physical abuse (B=0.48; 95%CI:0.14-0.82), physical neglect (B=0.41; 95%CI:0.01-0.82), blackouts from drinking (B=0.24; 95%CI: 0.05-0.44), and sex work (B=0.95; 95%CI: 0.44-1.47); living by traditional culture was associated with reduced psychological distress (B=-0.20; 95%CI:-0.39,-0.01). For women, adjusted factors associated with increased psychological distress included: emotional abuse (B=0.60; 95%CI:0.29-0.91), physical abuse (B=0.37; 95%CI:0.06-0.68), physical neglect (B=0.55; 95%CI:0.26-0.83), blackouts from drinking (B=0.30; 95%CI;0.05-0.55), sex work (B=0.32; 95%CI:0.12-0.52), and sexual assault (B=0.50; 95%CI:0.30-0.70); having tried to quit using drugs was associated with reduced psychological distress (B=-0.25; 95%CI:-0.47,-0.02).
Conclusion: Culturally-safe mental health supports that address harmful coping patterns which exacerbate psychological distress are urgently required for young Indigenous people who use drugs.
Learning Areas:
EpidemiologyPublic health or related research
Learning Objectives:
Describe the risk and protective factors associated with psychological distress among young, urban Indigenous people who use drugs in Canada.
Keyword(s): Mental Health, HIV/AIDS
Qualified on the content I am responsible for because: Kate Jongbloed is a PhD Candidate in UBCâs School of Population and Public Health. She is investigating mHealth for HIV treatment and prevention among young Indigenous people in BC who use illicit drugs living in Prince George and Vancouver, BC as part of the Cedar Project.
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.