Incarceration among street-involved youth in a Canadian study: Implications for health and policy interventions

Background: Risk factors for incarceration have been well described among adult drug using populations; however, less is known about incarceration among at-risk youth. This study examines the prevalence and correlates of incarceration among street-involved youth in a Canadian setting. Methods: From September 2005 to May 2012, data were collected from the At-Risk Youth Study, a prospective cohort of street-involved youth aged 14-26 who use illicit drugs. Generalized estimating equation (GEE) logistic regression was used to identify factors associated with recent incarceration defined as incarceration in the previous six months. Results: Among 1019 participants, 362 (36%) reported having been recently incarcerated during the study period. In multivariate GEE analysis, homelessness (adjusted odds ratio [AOR] = 1.60), daily crystal methamphetamine use (AOR= 1.56), public injecting (AOR= 1.33), drug dealing (AOR= 1.48) and being a victim of violence (AOR= 1.68) were independently associated with incarceration (all p <0.05). Conversely, female gender (AOR= 0.48), lesbian, gay, bisexual, transgender or two-spirited (LGBTT) identification (AOR= 0.47) and increasing age of first hard drug use (AOR= 0.96) were negatively associated with incarceration (all p <0.05). Conclusion: Incarceration was common among our study sample. Youth who were homeless, used crystal methamphetamine, and engaged in risky behaviors including public injection and drug dealing were significantly more likely to have been recently incarcerated. Structural interventions including expanding addiction treatment and supportive housing for at-risk youth may help reduce criminal justice involvement among this population and associated health, social and fiscal costs. (C) 2013 Elsevier B.V. All rights reserved.