We compared drug-related behaviors, including initiation of drug use, among street youth residing in two adjacent neighborhoods in Vancouver. One neighborhood, the Downtown Eastside (DTES), features a large open-air illicit drug market. In multivariate analysis, having a primary illicit income source (adjusted odds ratio [AOR]=2.64, 95% confidence interval [CI]: 1.16-6.02) and recent injection heroin use (AOR=4.25, 95% CI: 1.26-14.29) were positively associated with DTES residence, while recent non-injection crystal methamphetamine use (AOR: 0.39, 95% CI: 0.16-0.94) was negatively associated with DTES residence. In univariate analysis, dealing drugs (odds ratio [OR]=5.43, 95% CI: 1.24-23.82) was positively associated with initiating methamphetamine use in the DTS compared to the DTES. These results demonstrate the importance of considering neighborhood variation when developing interventions aimed at reducing drug-related harms among street-involved youth at various levels of street entrenchment.
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