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Employment Cessation, Long Term Labour Market Engagement and HIV Infection Risk Among People Who Inject Drugs in an Urban Canadian Setting

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Abstract

The potential for changes in socio-economic status, such as employment exits, to increase HIV infection risk are not well examined among people who inject illicit drugs (PWID). We used longstanding cohort data from Vancouver, Canada, to longitudinally assess associations between employment cessation and outcomes with documented linkages to HIV infection risk among PWID. From 2005 to 2015, 1222 participants reported 1154 employment exits. Employment exits were significantly associated with transitions into unstable housing; moving to the inner-city; initiating informal, prohibited or illegal income generation; high risk drug use practices; and exiting methadone maintenance therapy. HIV infection rates were higher among participants with lower long-term labour market engagement. These findings suggest that employment cessation coincides with initiating exposure to aspects of socioeconomic marginalization and drug use associated with HIV infection risk. Support for employment retention that prevents poverty entrenchment and harmful drug use could contribute to HIV prevention measures for PWID.

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Acknowledgements

The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff. The study was supported by the US National Institutes of Health (U01DA038886). Lindsey Richardson, Kanna Hayashi, and M-J Milloy are supported by New Investigator Awards from the Canadian Institutes of Health Research (CIHR; MSH 217672, MSH 141971, MSH 360816) and Scholar Awards from the Michael Smith Foundation for Health Research. Lindsey Richardson’s research is additionally supported by a CIHR Foundation Grant (FDN-154320). M-J Milloy is also supported by the US National Institutes of Health (U01-DA0251525). His institution has received an unstructured gift to support him from NG Biomed, Ltd., a private firm applying for a government license to produce cannabis. He holds the Canopy Growth professorship in cannabis science which was established through unstructured gifts to the University of British Columbia from Canopy Growth, a licensed producer of cannabis, and the Ministry of Mental Health and Addictions of the Government of British Columbia. This research was undertaken, in part, thanks to funding from the Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine, which supports Dr. Evan Wood, Director of the BC Centre on Substance Use.

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Authors and Affiliations

  1. British Columbia Centre On Substance Use, Vancouver, BC, Canada

    Lindsey Richardson, Mitchell Mammel, M-J Milloy & Kanna Hayashi

  2. Department of Sociology, University of British Columbia, Vancouver, BC, Canada

    Lindsey Richardson

  3. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada

    M-J Milloy

  4. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Kanna Hayashi

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  1. Lindsey Richardson
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Richardson, L., Mammel, M., Milloy, MJ. et al. Employment Cessation, Long Term Labour Market Engagement and HIV Infection Risk Among People Who Inject Drugs in an Urban Canadian Setting. AIDS Behav 23, 3267–3276 (2019). https://doi.org/10.1007/s10461-019-02472-1

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