• Scott E Hadland, Dan Werb, Thomas Kerr, Eric Fu, Hong Wang, Julio S Montaner, and Evan Wood.
• Boston Medical Center, Department of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, USA.
• Prev Med. 2012 Nov 1; 55 (5): 500-4.

ObjectiveThis study examined whether childhood sexual abuse predicts initiation of injection drug use in a prospective cohort of youth.MethodFrom October 2005 to November 2010, data were collected from the At Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Inclusion criteria were age 14-26 years, no lifetime drug injection, and non-injection drug use in the month preceding enrollment. Participants were interviewed at baseline and semiannually thereafter. Cox regression was employed to identify risk factors for initiating injection.ResultsAmong 395 injection-naïve youth, 81 (20.5%) reported childhood sexual abuse. During a median follow-up of 15.9 months (total follow-up 606.6 person-years), 45 (11.4%) youth initiated injection drug use, resulting in an incidence density of 7.4 per 100 person-years. In univariate analyses, childhood sexual abuse was associated with increased risk of initiating injection (unadjusted hazard ratio [HR], 2.38; 95% confidence interval [CI], 1.29-4.38; p=0.006), an effect that persisted in multivariate analysis despite adjustment for gender, age, aboriginal ancestry and recent non-injection drug use (adjusted HR, 2.71; 95% CI, 1.42-5.20; p=0.003).ConclusionChildhood sexual abuse places drug users at risk for initiating injection. Addiction treatment programs should incorporate services for survivors of childhood maltreatment.Copyright © 2012 Elsevier Inc. All rights reserved.

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