Research

Social influences upon injection initiation among street-involved youth in Vancouver, Canada: a qualitative study

Will Small¹ , Danya Fast¹ , Andrea Krusi¹ , Evan Wood^1,2 and Thomas Kerr^1,2

¹  British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrarrd St, Vancouver, BC V6Z 1Y6, Canada

²  Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

author email corresponding author email

Substance Abuse Treatment, Prevention, and Policy 2009, 4:8doi:10.1186/1747-597X-4-8

Published:	30 April 2009

Abstract

Background

Street-involved youth are a population at risk of adopting injection as a route of administration, and preventing the transition to injection drug use among street youth represents a public health priority. In order to inform epidemiological research and prevention efforts, we conducted a qualitative study to investigate the initiation of injection drug use among street-involved youth in Vancouver, Canada.

Methods

Qualitative interviews with street youth who inject drugs elicited descriptions of the adoption of injection as a route of administration. Interviewees were recruited from the At-Risk Youth Study (ARYS), a cohort of street-involved youth who use illicit drugs in Vancouver, Canada. Audio recorded interviews were transcribed verbatim and a thematic analysis was conducted.

Results

26 youth aged 16 to 26 participated in this study, including 12 females. Among study participants the first injection episode frequently featured another drug user who facilitated the initiation of injecting. Youth narratives indicate that the transition into injecting is influenced by social interactions with drug using peers and evolving perceptions of injecting, and rejecting identification as an injector was important among youth who did not continue to inject. It appears that social conventions discouraging initiating young drug users into injection exist among established injectors, although this ethic is often ignored.

Conclusion

The importance of social relationships with other drug users within the adoption of injection drug use highlights the potential of social interventions to prevent injection initiation. Additionally, developing strategies to engage current injectors who are likely to initiate youth into injection could also benefit prevention efforts.