Evaluating methamphetamine use and risks of injection initiation among street youth: the ARYS study.

TLDR

Canadian cities face ongoing infectious disease and overdose epidemics among injection drug users, worsened by rising methamphetamine use, prompting renewed focus on preventing injection initiation, especially in Vancouver where extensive HIV prevention infrastructure exists amid widespread methamphetamine use among street youth. The At Risk Youth Study (ARYS) was initiated in Vancouver to investigate factors influencing injection drug use initiation and assess the impact of HIV prevention programs on non‑injection drug users, while also outlining the study’s methodology and the epidemiology of illicit drug use among street youth. ARYS employs a prospective cohort design of street.

Abstract

Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDU). These health concerns have recently been exacerbated by the increasing availability and use of methamphetamine. The challenges of reducing health-related harms among IDU have led to an increased recognition that strategies to prevent initiation into injection drug use must receive renewed focus. In an effort to better explore the factors that may protect against or facilitate entry into injection drug use, the At Risk Youth Study (ARYS) has recently been initiated in Vancouver, Canada. The local setting is unique due to the significant infrastructure that has been put in place to reduce HIV transmission among active IDU. The ARYS study will seek to examine the impact of these programs, if any, on non-injection drug users. In addition, Vancouver has been the site of widespread use of methamphetamine in general and has seen a substantial increase in the use of crystal methamphetamine among street youth. Hence, the ARYS cohort is well positioned to examine the harms associated with methamphetamine use, including its potential role in facilitating initiation into injection drug use. This paper provides some background on the epidemiology of illicit drug use among street youth in North America and outlines the methodology of ARYS, a prospective cohort study of street youth in Vancouver, Canada.