Crack cocaine use and risky behaviours: street youth
Background: Crack cocaine use is increasing among Montréal street youth. This project aimed to estimate prevalence of crack cocaine use among these youths and to evaluate the association between crack cocaine use and risky behaviours that lead to sexually transmitted and blood-borne infections (STI). Methods: Analyses were realised on data collected during a cohort study conducted among Montréal street youth. Youths aged 14 to 23 years old (n=858) completed an interviewer-administered questionnaire. We estimated lifetime and recent (last six months before the study) proportions of use. We used multiple logistic regression to evaluate the association between crack cocaine use and concomitant sexual and psychoactive substances use behaviours. Results: Lifetime use prevalence was 66.6%, 95% confidence interval [63.4-69.8]; recent use prevalence was 38.0% [34.7-41.3]. Controlling for potential confounders, street youth using crack cocaine were more at risk of prostituting themselves (odds ratio (OR) 3.6 [2.4-5.5]), of having more than two sexual partners (OR 2.3 [1.7-3.1]), of having a sexual partner who had HIV (OR 8.4 [1.6-43.5]), who was a man prostituting himself (OR 6.4 [3.1-13.1]), who was a woman prostituting herself (OR 3.1 [2.0-4.9]) or who was a man having homosexual relations (OR 3.3 [1.9-4.8]). Youth using crack cocaine were also more at risk of having consumed alcohol during the last month (OR 2.0 [1.2-3.1]), of having injected drugs (OR 3.0 [2.1-4.1]) and of having used more than one drug (OR 10.3 [5.3-20.0]). Conclusions: Crack cocaine use is widespread among Montreal street youth. Those who use it have more STI risk behaviours. Future studies should investigate risk factors of initial use in order to ultimately identify appropriate prevention measures.