Urban renewal, drug related disorder and displacement: implications for health and HIV risk behaviour among injection drug using populations

It is estimated that 269,000 Canadians have injected drugs in the past year; statistics reveal that almost 20 per cent of all newly-recorded HIV infections are associated with injection drug use. High risk behaviours associated with injection drug use have made injection drug user populations especially vulnerable to HIV infection. This is particularly evident in Vancouver’s Downtown Eastside, which has experienced an explosive HIV epidemic among local injection drug users. For several years, this neighbourhood has felt the effects of new developments squeezing out older, low-income housing. This ongoing revitalization of Canada’s poorest postal code will soon be coupled with the upcoming 2010 Olympics. It is also expected that targeted policy interventions will be initiated to reduce the appearance of public disorder, particularly open illicit drug scenes. The implications for current residents are significant. The coming years have the potential to bring a massive displacement of injection drug users out of the Downtown Eastside, away from where most of their health and social services are currently situated. Kora DeBeck is monitoring how public policy changes related to urban revitalization affect risky behaviours and health among injection drug users. She is analyzing data from established cohort studies, which currently follow more than 2,000 injection drug users. Not only will DeBeck’s work help local policy makers respond to changing health service needs within Vancouver, it will also inform other cities experiencing similar urban transitions.

An examination of illicit drug use and sexual risk behaviours among a cohort of street-involved youth in Vancouver

Injection drug use has significant health consequences, including high rates of HIV and hepatitis C transmission. These problems have been exacerbated in recent years by the use of crystal methamphetamine (commonly called crystal meth), particularly in BC. Methamphetamine use is becoming increasingly common among marginalized youth, particularly those whose social and economic environment is the street. It is estimated there are between 45,000 to 150,000 street-involved youth in Canada, most of whom live in the large urban centres of Toronto, Montreal and Vancouver. Illicit drug use and unsafe sexual practices, including unprotected sex and sex trade work, increase susceptibility to HIV infection among street-involved youth. Brandon Marshall is one of the few researchers investigating the relationship between illicit drug use and sexual risk behaviours among street-involved youth. Using data collected from the B.C. Centre for Excellence in HIV/AIDS At-Risk Youth Study, he will examine how different social, structural, and environmental factors impact sexual practices. Specific factors include the age of first sexual experience, sexual orientation, illicit drug use, sexual relationships with older partners, access to health services, and involvement in the Downtown Eastside community of Vancouver, where drug use and poverty are prominent. This research will improve our understanding of illicit drug use and sexual activity in marginalized youth and will play an important role in developing sexual health education and prevention programs for youth at-risk.