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AIDS Behav. 2019 Mar 28. doi: 10.1007/s10461-019-02472-1. [Epub ahead of print]

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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British Columbia Centre On Substance Use, Vancouver, BC, Canada.
Department of Sociology, University of British Columbia, Vancouver, BC, Canada.
British Columbia Centre On Substance Use, Vancouver, BC, Canada.
Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.


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.


Employment transitions; HIV infection; Injection drug use; Socioeconomic marginalization


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