Injection drug use among homeless adults with mental illness: a gender-based analysis

Increasing evidence suggests that women are disproportionately vulnerable to the serious health and social harms associated with injection drug use (IDU). This research examines the prevalence and health correlates of IDU, by gender, among a cohort of homeless adults with mental illness. The Vancouver At Home study is a research demonstration project investigating interventions for people who are homeless and living with mental illness. Participants completed a baseline questionnaire eliciting information on a detailed set of clinical, health, social and substance use measures. In multivariable models adjusting for severity of homelessness, and additionally sex work among females, IDU was positively associated with infectious disease and less severe mental illness. In addition, IDU was associated with the increased use of health and social services, but only among men. These findings suggest that gender-specific harm reduction, prevention and treatment strategies for IDU women should be prioritised as an important public health issue.