Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Numerous studies have identified injection drug use as a risk factor for the transmission of blood-borne viruses such as HIV and hepatitis C (HCV). Recently, however, research has shown that street-involved non-injection drug users also have high prevalence rates of HIV and HCV infection. Non-injection drug use (particularly crack smoking) appears to be a risk factor for blood-borne virus infection, suggesting a direct association between non-injection drug use and HIV and HCV. Despite this, research on, and public health interventions aimed at, non-injection drug use are lacking. This study will examine social and structural factors that influence and shape the drug use and related health risk behaviours of non-injection drug users. This will be a mixed methods study, using quantitative and in-depth qualitative interviews to collect data from three types of street-involved drug users: 1) those who have never injected, 2) those who formerly injected but no longer do so, 3) those who use drugs by both injection and non-injection methods. Comparison of these 3 forms of drug use will allow for a better understanding of factors and behaviours specifically associated with non-injection drug use. This research has direct and important implications for both public health and health policy. By better understanding how social and structural factors shape the drug use and subsequent health of non-injection drug users, this research will help guide the development of targeted prevention and treatment interventions for non-injection drug users. Further, this research will crucially draw attention to the health inequalities faced by the most vulnerable and marginalized people in our society. The proposed research will also provide evidenced-based input for a public health approach to substance use and addiction.