Canadian Street Youth and Substance Use

Executive Summary Key Findings Introduction Purpose Methods Analysis Analysis Terms Laboratory Methods Limitations Demographic Profile of E-SYS Participants Substance Use Smoking Alcohol Use Recent Alcohol Intoxication General Drug Use Patterns Non-Injection Drug Use Injection Drug Use Injection Drug Use and Hepatitis C Sexual Behaviours and STIs Implications Conclusions References

Findings from Enhanced Surveillance
of Canadian Street Youth, 1999-2003
(November 2007)

5. Sexual Behaviours and STIs

Often street youth are unaware of or express being unconcerned about the effects of drug use on their health or other dangers related to addiction and substance use. Drug use, especially injection drug use, is often associated with other high-risk behaviours, such as involvement in the sex trade, criminal activity, unsafe sex and sharing needles.³²

The proportion of street youth who reported having sex while intoxicated with alcohol has remained consistently high: 56.8% in 1999, 59.5% in 2001 and 58.0% in 2003. There was no significant§ difference between gender and age group. Almost one-third (30.9%) of street youth report having received substances such as cigarettes, drugs or alcohol and then felt obliged to have sex.

Figure 16 describes the sexual behaviours of street youth who reported using injection or non-injection drugs. The proportion of youth who reported trading sex in the previous 3 months was 37.7% in 2001 and 36.3% in 2003. In addition, approximately, 60% of street youth reported that their sexual partner used alcohol regularly in 2001 and 2003. Half of the study participants also reported that their sexual partners were “high” on drugs during sex in 2003. A larger proportion of street youth also reported that their sexual partners used non-injection drugs (82.3% in 2001 and 78.5% in 2003).

Figure 16. Sexual behaviours in the previous 3 months among street youth who reported drug use (injection and non-injection) (2001 and 2003)

*Question not asked in 1999

Overall, STI rates were not found to be significantly^§ higher in street youth with a recent history of alcohol intoxication than in those without such a history. In 1999, the rate of chlamydia was found to be significantly^§ higher in youth who reported use of crystal methamphetamine than those who did not (17.2% vs. 8.2%), especially among females (33.3% vs. 9.4%). In 2003, the rate of gonorrhea was significantly§ higher in street youth who reported using crystal methamphetamine than those who did not (6.9% vs. 2.8%), while the rate of genital herpes (HSV-2) was significantly higher in street youth who reported any drug use (whether by injection or not) than those who reported no drug use (26.8% vs. 16.7%).

The proportion of youth who reported that their sexual partner had ever been told they had an STI remained high: 21.8% in 2001 and 16.2% in 2003 among youth who reported drug use, compared to 13.6% in 2001 and 11.6% in 2003 among youth who reported never using drugs.

Consistent with their greater risk-taking behaviour, injection drug users compared to non-injection drug users were almost twice as likely to have had an STI. They also had a greater number of sexual partners over their lifetime; were more likely to be sexually involved with high-risk partners, such as other injection drug users, individuals with STIs and sex trade workers; and reported a higher rate of unwanted sex, obligatory sex and the sex trade (Table 3).

Table 3. Sexual history of street youth with and without a history of injection drug use (2003)

Sexual History	IDU *† N=370 (%)	Never-IDU *† N=1291 (%)
Ever had sexual activities, %	99	96
Any same sex behaviour, %	34	20
Mean number of lifetime sexual partners, n	73.4	19.5
Did not use a barrier during most recent sexual encounter(s), %	59	49
Ever had an STI, %	38	23
Ever had unwanted sex, %	27	15
Ever had obligatory sex, %	32	14
Ever traded sex, %	37	15

IDU=injection drug use
*Percentages are based on the number of non-missing observations..
†Percentages are significantly different at a p value of <0.05.

Furthermore, a greater proportion of injection drug users reported not using a barrier for protection during their most recent sexual encounter(s), and a greater proportion of injection drug users reported having same-sex partners.