Grant: Doctoral Research Award: Canada Graduate Scholarships

Two-Spirit, lesbian, gay, bisexual, transgender, and other queer (2SLGBTQ+) youth are known to face many social challenges, including bullying, rejection from family and friends, homophobia, and transphobia. These social determinants place 2SLGBTQ+ youth at much higher risk of homelessness and substance use. Alarmingly, 2SLGBTQ+ people are estimated to make up as much as 40% of the overall homeless youth population in Canada. Of further concern, those who use drugs experience inequitably high rates of drug-related harms, including overdose, sexually transmitted and blood-borne infections, and criminalization. In British Columbia, these negative outcomes are poised to be exacerbated by intersecting public health crises related to opioid overdoses, housing affordability, and COVID-19. In response to these crises, innovative health policy and programming interventions in BC are now underway, including the provision of a safer drug supply, the scale-up of outreach-based harm reduction services, and expansion of housing shelters and subsidies. Yet, it remains unclear how these services can be tailored to best serve homeless 2SLGBTQ+ youth who use drugs - a critical research gap, given inequities and public health challenges faced. This study addresses this gap by using community-based, critical ethnographic approaches to examine the drug-, housing-, and broader health-related experiences of homeless 2SLGBTQ+ youth who use drugs, with particular attention to how these experiences are influenced by features of healthcare services and broader socio-structural environments. Set in Vancouver, British Columbia, this study will include intensive qualitative interviews and arts-based photovoice methods with 40 homeless 2SLGBTQ+ youth who use drugs. Findings from this study will identify how interventions (e.g., clinical, programming, structural policies) can best be used to reduce drug-related harms and improve health and social outcomes for this priority population.