Grant: Travel Awards - Institute Community Support

Crystal methamphetamine has become one of the most commonly used illicit drugs worldwide, with significant potential for addiction and transmission of HIV and other blood-borne infections. Despite the wide range of social and health-related harms associated with injection drug use, risk factors for injecting crystal methamphetamine remain understudied and poorly understood. This study therefore aimed to investigate risk factors for initiating crystal methamphetamine injection among women sex workers in Vancouver, Canada. Sex workers were invited to participate through outreach to outdoor locations and hidden indoor and online venues across Metro Vancouver and completed bi-annual interviewer-administered questionnaires and HIV/STI (sexually transmitted infection) testing by a project nurse between 2010 and 2013. This study used Cox regression analyses to identify predictors of initiating crystal methamphetamine injection over three years follow-up. The following risk factors were found to be significantly associated with first time injection of crystal methamphetamine among sex workers: injection heroin use, occupational violence, being HIV positive, and a history of childhood abuse. The study findings underscore the urgent need for integrated violence and HIV prevention efforts in mitigating the risk for initiating injection drug use and for novel, evidence-based addictions treatment tailored specifically for sex workers.