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http://cfenet.ubc.ca/vanguard/publications.htm#Papers%20in%20Press%20(accepted%20for%20publication)


Martindale SL; Strathdee SA, Hogg RS; Cornelisse PGA, MSc; Miller ML,  Devlin B; Montaner JSG, O'Shaughnessy MV, Schechter MF (1997). Evidence of Psychologic Distress in a Cohort of Young Gay/Bisexual Men. Paper presented at the Canadian Association for HIV/AIDS Research, May 23, 1997. Internet: http://cfenet.ubc.ca/vanguard/papers_original/CAHR97Steve.html.

MSM = 203 Males.  Information obtained via questionnaire to 1997.

MSM Males, E legibility Criteria: 18 to 30 years old at baseline, Living in Greater Vancouver area, Gay, bisexual and/or MSM, No previous positive HIV test result. "Eligible subjects who agree to participate are asked to complete an annual self-administered questionnaire and submit a blood sample for HIV antibody testing, for which they provide informed consent. The questionnaire includes demographics, sexual behaviour with regular and casual partners, sex-trade involvement, recreational drug use and psycho-social issues... This analysis focuses on the first 203 men who have completed follow-up questionnaires...  As of April 97, follow-up questionnaires and test results had been completed by 203 participants. To date, the return rate for annual follow-up visits is 76%. The median time since the baseline follow-up visit was 13 months. Among the subgroup of 203 men, the median age was 27. Like the overall cohort, most were Caucasian (78%), and most reported not being in a primary relationship since their baseline visit (73%)."

Vanguard Project - Vancouver, B.C.
Results at Follow-Up (N = 203 MSM Males)
 Median age of first "coming out":  19 yrs
 Comfortable with sexual orientation:  77%
 Domestic violence:  18%*
  Gay bashing:  11%*
  Sexual abuse [before age 18]:  25%*
  Suicidal ideation:  55%*
Attempted suicide:  18%*
Diagnosed mood disorder/mental disability:  22%*
Drug/alcohol treatment:  7%*

* ever in lifetime

Vanguard Project - Vancouver, B.C.
Sexual HIV Risk-Takers (RT) vs. Non-Risk Takers (NRT)
 Variables (%N) n/N
For Variables
RTs
(n=55)
 NRTs (n=135)   P-value
 Non-white: 22.1%
42 / 190
 33%
18 / 55
 18%
24 / 135
 0.01
 Sexual abuse < 18: 16.3%
31 / 190
 23%
13 / 55
 13%
18 / 135
 0.08
 Domestic violence: 17.4%
33 / 190
 30%
17 / 55
 12%
16 / 135
 0.004
 Gay bashing: 12.6%
24 / 190
 20%
11 / 55
 10%
13 / 135
 0.04
Mental Health

 Suicide Attempts: 15.8%
30 / 190
 25%
14 / 55
 12%
16 / 135
 0.02
 Suicidal ideation: 52.6%
100 / 190
 60%
33 / 55
 50%
67 / 135
 0.21
 Mood/mental disorder: 23.2%
44 / 190
  25%
14 / 55
 22%
30 / 135
 0.67
 High depression score: 25.8%
49 / 190
30%
17 / 55
 24%
32 / 135
 0.37
 Low self esteem: 27.4%
52 / 190
 31%
17 / 55
 26%
35 / 135
 0.48

*Total: Not given by author. Calculated From RT & NRT Categories.

Relationship Between Being Sexually Abused
before Age 18 Years and Domestic Violence

 -  Sexually abused < 18
 YES  NO

 Domestic  violence

 YES  11 (31.4%)  23 (14%)
 NO  24 (68.6%)  142 (86%)

Chi-square p-value = 0.01
Sexual Abuse experienced before age of 18 years more than
doubles risk (RR = 2.2) for experiencing domestic violence.
Odds Ratio = 2.8, 95% CI: 1.2, 6.5



Heath KV, Cornelisse PG, Strathdee SA, Palepu A, Miller ML, Schechter MT, O'Shaughnessy MV, Hogg RS (1999). HIV-associated risk factors among young Canadian Aboriginal and non-Aboriginal men who have sex with men. International Journal of STD and AIDS, 10(9): 582-7. PubMed Abstract. Draft of Paper:  Heath et al. (1999a). HIV-associated risk factors among young Canadian Aboriginal and non-Aboriginal men who have sex with men. Internet: http://cfenet.ubc.ca/vanguard/papers_original/IJSTDAIDSKate.html.

MSM = 681 Males. Information obtained via questionnaire to May, 1998.

Heath-99-aboriginal-non-aboriginal: demographic characteristics


Vanguard Project - Vancouver, B.C. - MSM Males
Aboriginal / Non-Aboriginal: Demographic Associations
Demographic
Attributes
All
n = 681
Aboriginal
n = 57
(8.4%)
Non-Aboriginal
n - 624
(91.6%)
Pearson's p &
Odds Ratios (95%CI)
Unstable Housing
63 / 680
9.3%
19 / 56
33.9%
44 / 624
7.1%
< 0.0000
6.8 (3.6, 12.7)
Income < $10,000

23 / 45
51.1%
159 / 624
25.6%

Income Assistance
132 /
??
102 / 624
16.3%

Unemployed
186 / 666
27.9%
28 / 56
50.0%
158 / 610
25.9%
0.0001
2.9 (1.6, 5.0)
Data Source: Heath et al. (1999), Table 1.



Heath-99-Aborigina-Non-Aboriginal-Risks


Vanguard Project - Vancouver, B.C. - MSM Males
Aboriginal / Non-Aboriginal: Psychosocial Attributes
Variables
n/N For
Variable
(%N)
Aboriginal
n = 57
(8.4%)
Non-Aboriginal
n - 624
(91.6%)
Pearson's p &
Odds Ratios (95%CI)
Forced Sex, Ever
225 / 658
34.2%*
26 / 55
47.3%
199 / 603
33.0%
0.03
1.8 (1.0, 3.2)
Perpetrator is Relative
68 / 659
10.3%*
13 / 56
23.2%
55 / 603
9.1%
0.0009
3.0 (1.5, 5.9)
Forced Sex
Before Age 12
112 /  681
16.4%
15 / 57
26.3%
97 / 624
15.5%
0.036
1.9 (1.0, 3.6)
Age of First
Consensual Sex

14 Years
17 years
< 0.001


Sold Sex, Ever
165 / 681
24.2%
37 / 57
64.9%
128 / 624
20.5%
< 0.0000
7.2 (4.0, 12.8)
Sold Sex, Past Year
99 / 681
14.5%
30 / 57
52.6%
69 / 624
11.1%
< 0.0000
8.9 (5,0, 15,9)
Sold Sex Only Before
One Year Ago
66 /  681
9.7%
7 / 57
12.3%
59 / 624
9.5%
0.490
1.3 (0.58, 3.1)


Alcohol
> 20 Drinks/Week

58 / 681
8.5%
12 / 57
21.1%
46 / 624
7.4%
0.0003
3.4 (1.7, 6.8)
Data Source: Heath et al. (1999), Table 2.
*For a large random sample of 2,881 MSM males living in the largest American cities, Paul et al. (2001) reports a 35.3% lifetime incidence for sexual victimization, the incidence being 20.6% for sexual victimization having occurred/begun before the age of 18 years (CSA). It is also reported that the incidence for CSA involving a relative was 10.2%.


Paul JP, Catania J, Pollack L, Stall R (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men's Health Study. Child Abuse and Neglect, 25(4): 557-84.  PubMed Abstract.



Heath-99-Aboriginal-Non-Aboriginal-Sexual-Risks


Botnick MR, Heath KV, Cornelisse PG, Strathdee SA, Martindale SL, Hogg RS (2002). Correlates of suicide attempts in an open cohort of young men who have sex with men. Canadian Journal of Public Health, 93(1): 59-62. PubMed Abstract. Online PDF Draft of Paper.

MSM Sample = 345. Questionnaire related data intake to April, 1998.


Vanguard Project - Vancouver, B.C. - MSM Males
Attempted Suicide in Lifetime: Associations
Attempted Suicide = 67 / 345 = 19.4% (Part 1)
Attribute
(Attempters Missing)
n/N For
Attribute
(%N)
Attempted
Suicide
Attribute
Attempted
Suicide
Others
Pearson's p &
Odds Ratios (95%CI)
Non-Caucasian
55 / 345
(15.9%)
13 / 55
23.6%
54 / 290
18.6%
0.39
1.3 (0.68, 2.7)
Aboriginal
?
?
?
?
< High School Education 116 / 345
(33.6%)
32 / 116
27.6%
35 / 229
15.3%
0.0063
2.1 (1.2, 3.6)
Income: < $10,000 (3)
73 / 322
(21.2%)
24 / 73
32.9%
40 / 249
16.1%
0.0015
2.6 (1.4, 4.6)





Forced/Coerced Sex: < Age 12
56 / 345
16.2%
18 / 56
32.1%
49 / 289
17.0%
0.0085
2.3 (1.2, 4.4)
Forced/Coerced Sex: Age 12-17
37 / 345
10.7%
16 / 37
43.2%
51 / 308
16.6%
0.0001
3.8 (1.9, 7.9)
Forced/Coerced Sex: < age 18
93 / 345
27.0%
34 / 93
36.6%
33 / 252
13.1%
< 0.0000
3.8 (2.2, 6.7)
Forced/Coerced Sex: >Age 17
54 / 345
15.6%
14 / 54
25.9%
53 / 291
18.2%
0.1882
1.6 (0.80, 3.1)
Sex Trade, Ever
61 / 341
17.9%
21 / 61
34.4%
46 / 280
16.4%
0.0013
2.7 (1.4, 4.9)





Social Support: Low vs. High
?
?
?
?
Rosenberg
Self-Esteem: Low/Moderate vs High
117 / 340
34.4%
41 / 117
35.0%
26 / 223
11.7%
< 0.0000
4.0 (2.3, 7.1)
Popper Use: Past year (1)
97 / 342
28.4%
29 / 97
29.9%
37 / 244
15.2%
0.0022
2.3 (1.3, 4.1)
Data Source: Botnick et al. (2002)


Vanguard Project - Vancouver, B.C. - MSM Males
Attempted Suicide in Lifetime: Associations
Attempted Suicide = 67 / 345 = 19.4% (Part 2)
Attribute
(Attempters Missing)
n/N For
Attribute
(%N)
Attempted
Suicide
Attribute
Attempted
Suicide
Others
Pearson's p &
Odds Ratios (95%CI)
Social Support: Low vs. High*
?
?
?
< 0.001
Rosenberg
Self-Esteem: Low/Moderate vs High*
117 / 340
34.4%
41 / 117
35.0%
26 / 223
11.7%
< 0.0000
4.0 (2.3, 7.1)
Popper Use: Past year (1)*
97 / 342
28.4%
29 / 97
29.9%
37 / 244
15.2%
0.0022
2.3 (1.3, 4.1)





CES-D Depression: Median Score

14
12
< .001
Mood Disorder / Mental Disability
Diagnosis
72 / 341
21.1%
24 / 72
33.3%
43 / 269
16.0%
2.6 (1.5, 4.7)
Psychiatric Ward, Ever (4)
16 / 322
5.0%
11 / 16
68.8%
52 / 306
17.0%
0.0000
10.7 (3.6, 32.2)
Detox Centre, Ever (6)
7 / 321
6 / 7
85.7%
55 / 314
17.5%
< 0.0000
28.2 (3.3, 239.4)
CAGE: Alcoholic vs. Others
95 / 342
27.8%
31 / 95
32.6%
36 / 247
14.6%
0.0001
2.8 (1.6, 4.9)





Sex Orientation Comfort: Not
Comfortable vs. Somewhat/Totally (3)
7 / 339
2.1%
3 / 7
42.9%
61 / 332
18.4%
0.1014
3.3 (0.73, 3.6)
Data Source: Botnick et al. (2002)
* Independent Predictors in Logistic Regression



Ratner PA, Johnson JL, Shoveller JA, Chan K, Martindale SL, Schilder AJ, Botnick MR, Hogg RS (2003). Non-consensual sex experienced by men who have sex with men: prevalence and association with mental health. Patient Education and Counseling, 49(1): 67-74.  PubMed Abstract. Full Text.

Vanguard Cohort Study Sampling Up To January 2000:"The Vanguard Project, started in May 1995, is an ongoing study of HIV rates and risk factors in young men who have sex with men in the Greater Vancouver area of British Columbia, Canada... Men with homosexual and bisexual behavior, aged 19–30 years, recruited through physicians’ offices, walk-in medical clinics, and community outreach, are eligible to participate if they have not previously tested HIV-positive, and if they self-identify as gay or bisexual, or have sex with other men. Participants complete self-administered questionnaires and agree to HIV testing on an annual basis. The analyses reported here are based on all participants who completed the questionnaire between January 1998 and January 2000 to permit a sufficient sample and consistency in data (i.e. same question format)... The study participants (N=358) ranged in age from 19 to 35 years (M=28.6; S.D.=3.6). Most (85.2%) had at least a high school education and most (89.3%) were employed. Their annual income, including funds from salaries, the sex trade, and drug trafficking, ranged from less than CAD$ 5000 to more than CAD$ 50,000 (median earned CAD$ 25,000—29,999). Almost all (96.1%) lived in stable housing (i.e. owned or rented) while the remainder lived in hotels, rooming houses, shelters, hostels, or on the street. The majority of the respondents described themselves as white (72.6%), as single and never married (70.6%), and 87.7% considered themselves gay or homosexual... One-half of the respondents (50%) were currently not involved in an intimate relationship."

MSM = 340 Males. Questionnaire related data intake from January 1998 to January, 2000.


Vanguard Project - Vancouver, B.C. - MSM Males
Risk Related Odd Ratios: Attempted Suicide, Lifetime
Lifetime Attempted Suicide Incidence For MSM Males: 18.8%

-
N's in Yes / No
Categories
% Incidence
Attempted
Suicide
Odd Ratio For Having
Attempted Suicide
:
Unadjusted OR, 95% CI
Vanguard: suicide-attempt-csa-prostitution
Source: Ratner et al. (2003), Table 3, p. 71.
Lifetime Attempted Suicide Incidence = 18.8%

Juvenile Prostitution: 8.8% - Childhood Sexual Abuse: 14.1%
Adult Non-Consensual Sex: 14.9% - Any Non-Consensual Sex: 35%



O'Connell JM, Lampinen TM, Weber AE, Chan K, Miller ML, Schechter MT, Hogg RS (2004). Sexual risk profile of young men in Vancouver, British Columbia, who have sex with men and inject drugs. AIDS and Behavior, 8(1): 17-23. PubMed Abstract. Full Text.

Vanguard Cohort Study Sampling Up To September 2000: "Between May 1995 and September 2000, HIV seronegative MSM were recruited into an ongoing prospective study of HIV incidence and risk behaviors that has been previously described (Strathdee et al., 1998, 2000). In brief, men were eligible to participate if they were between 15 and 30 years of age at baseline, lived in the Greater Vancouver region, had not previously tested HIV-positive, and self-identified as gay/bisexual or as ever having had sex with other men. Participants were recruited through outreach at gay community events and community health clinics, local physicians, and the gay and mainstream media. Eligible participants were referred to local HIV testing clinics, the study’s research nurse, or their physician’s office, where they completed a confidential self-administered questionnaire and provided a blood sample for HIV antibody testing. Standard survey and testing techniques were used at each location to limit potential biases that might arise from differences between sites. Follow-up visits were conducted annually... Enrolment visit data collected from 910 participants were eligible for this analysis. Of these 910 MSM, 106 (12%) had injected drugs in the previous year and 804 (88%) had not. HIV serologic testing showed 9 of 106 MSM/IDU (8.5%) and 16 of 795 MSM (2.0%) were HIV-positive (p = .001). MSM/IDU were significantly younger, more likely to be Aboriginal, less educated, unemployed, living in unstable housing, and making less than $10,000 per year..."

Vanguard Project - Vancouver, B.C. - MSM Males
Injection Drug Use (IDU) in Past Year
Ethnicity
MSM
N = 910
MSM / IDU
n = 106
MSM, Non-IDU
n = 804
All
891
106 / 910 = 11.6%
804 / 910 =  88.4%
White - 71.2%
643
74 / 643 = 11.5%
569 / 643 = 88.5%
Aboriginal - 10.3%
92
20 / 92 = 21.7%*
72 / 92 = 78.3%
Other - 17.5%
156
7 / 156 = 4.5%
149 / 156 = 95.5%
Non-Aboriginal - 89.7%
799
81 / 799 = 10.1%
718 / 799 = 89.9%
All** - 100%
891
101 / 891 = 11.3%
790 / 891 = 88.7%
Data Source: O'Connell et al. (2004). Calculation Based On Counts Given

** All who supplied ethnicity information.
*Walters (2006) reports that, to 2003, American Indian (AI) MSMs account for 73% of AI AIDS cases,
56% Non IDU users, and 17% IDU users. Therefore, 23.4% of AI MSM AIDS in the US are IDU users.
Compare to Others, Aboriginal MSM are more at risk for IDU: 21.7% vs. 10.1%
RR = 2.1, 95%CI: 1.4, 3.3 - OR = 2.5, 95%CI: 1.4, 4.2 - p = 0.0008

Walters KL (2006). “My Spirit In My Heart”:  Identity Expressions and Challenges Among American Indian Two-Spirit Women - Mixed Methodology: The Honor Project -: Two-Spirit Health Study: 5-Year Multi-Site National Study 2002-2007. PowerPoint Presentation. [Walters K, Evans-Campbell T, Simoni J, Ronquillo T, Bhuyan R ( 2006). “My Spirit in My Heart”: Identity Experiences and Challenges among American Indian Two-Spirit Women. Journal of Lesbian Studies, 10(2/3): 125-149. Abstract]



Schilder AJ, Miller ML, Martindale S, Chan K, Weber A, Braitstein P, Spittal PM, Hogg RS (2001). Correlates of childhood sexual abuse in gay and bisexual men in Vancouver. Poster presentation at both the 10th Annual Canadian Conference on HIV/AIDS Research in Toronto in June 2001, and at the AIDS Impact conference in Brighton, England, in July 2001. Internet: http://cfenet.ubc.ca/vanguard/papers_original/CAHR01arn3.html.

MSM = 459 Males. Questionnaire related data intake from September 1998 to October 2000.


Vanguard Project - Vancouver, B.C. - MSM Males
Child Sexual Abuse (CSA): Demographic Associations
Demographic
Attributes
CSA Incidence for
Demographic Attribute
CSA Incidence
Others
p
Aboriginal
16.5%
Non-Aboriginal
4.9%
< 0.001
Live Unstable Housing
17.9%
Stable Housing
7.6%
 0.001
Less Than High School Education
24.2%
> = High School
9.0%
< 0.001
Unemployed
38.4%
Employed
19.3%
< 0.001
Data Source: Schilder et al. (2001)



Vanguard Project - Vancouver, B.C. - MSM Males
Child Sexual Abuse (CSA) Associations
Attributes
n/N For
Attribute
(%N)
CSA
n = 166
36.3%
Non-CSA
n = 293
63.7%
Pearson's p &
Odds Ratios (95%CI)

Behaviors

Injecting Drugs (IDU), Ever
69/ 459
15.0%
43 / 166
25.9%
26 / 293
8.9%
< 0.0000
3.6 (2.1, 6.1)
Injecting Drugs (IDU), Past Year
52 / 459
11.3%
30 / 166
18.1%
22 / 293
7.5%
0.0006
2.7 (1.5, 4.9)
Injecting Drugs, Only Before Past Year* 17 / 459
3.7%
13 / 166
7.8%
4 / 293
1.4%
0.0004
6.1 (2.0, 19.1)
Sold Sex, Ever
144 / 459
31.4%
82 / 166
49.4%
62 / 293
21.2%
< 0.0000
3.6 (2.4, 5.5)
Sold Sex, Past Year
80 / 459
17.4%
44 / 166
26.5%
36 / 293
13.3%
0.0001
2.6 (1.6, 4.2)
Sold Sex, Only Before One Year Ago*
64 / 459
13.9%
38 / 166
22.9%
26 / 293
8.9%
< 0.0000
3.0 (1.8, 5.2)
Consensual Sex Before
The Age 18 Years**
217 / 444
48.9%
113 / 151
74.8%
104 / 293
35.5%
< 0.0000
5.4 (3.5, 8.4)
Casual Sex Partner, Last Year**
344 / 436
78.9%
132 /. 153
86.3%
212 / 283
74.9%
0.005
2.1 (1.2, 3.6)
Regular Partner, Last year**
340 / 444
76.6%
119 / 157
75.8%
221 / 287
77.0%
0.774
0.94 (0.59, 1.5)
Life Events

Group Home, Ever**
52 / 432
12.0%
38 / 152
25.0%
14 / 280
5.0%
< 0.0000
6.3 (3.3, 12.1)
Been In Detox Centre, Ever**
45 / 435
10.3%
31 / 155
20.0%
14 / 280
5.0%
< 0.0000
4.8 (2.4, 9.2)
Been in Psychiatric Ward, Ever**
20 / 425
7.1%
16 / 145
11.0%
14 / 280
5.0%
0.02
2.4 (1.1, 5.0)
Mood Disorder Diagnosis, Ever**
128 / 447
28.6%
57 / 163
35.0%
71 / 284
25.0%
0.02
1.6 (1.1, 2.4)





Attempted Suicide, Ever** 248 / 458
54.1%
105 / 165
63.6%
143 / 293
48.8%
0.002
1.8 (1.2, 2.7)





Data Source: Schilder et al. (2001)
* Category Calculated by Author: Subtracting "Past Year" Counts from "Ever" counts.
** Counts Estimated from Percentages Given. Therefore, a close estimate.


Multivariate Logistic Regression Model: Predictors of Child Sexual Abuse
Predictors of Child Sexual Abuse
(< 18 Years)
Unadjusted
Odds Ratios
95%
CI
Adjusted
Odds  Ratios
95%
CI
Consensual Sex Before Age 18 Years 5.2
3.4, 8.1
4.6
2.9, 7.4
Been in a Group Home
6.3
3.3, 12.1
4.4
2.2, 8.9
Casual Partner, Past Year
1.9
1.3, 3.1
2.0
1.1, 3.6
Data Source: Regression Model Generated by Schilder et al. (2001), Table 3.



Weber AE, Craib KJ, Chan K, Martindale S, Miller ML, Schechter MT, Hogg RS (2001). Sex trade involvement and rates of human immunodeficiency virus positivity among young gay and bisexual men. International Journal of Epidemiology, 30(6): 1449-54. PubMed Abstract. Discussion 1455-6.  Full Text.

Vanguard Cohort Study Sampling Up To September 2000: "The Vanguard Project is an ongoing prospective study of over 900 gay and bisexual men in the Greater Vancouver region. Men were eligible to participate if they were aged 18–30 years, lived in the Greater Vancouver region, had not previously tested HIV-positive, and self-identified as gay or bisexual or reported having sex with other men. Potential participants were recruited through community outreach at gay community events, community health clinics or local physicians, and through the gay and mainstream media... Of the 761 eligible participants, 126 (16%) reported that they were involved in sex work. Comparison of sex trade workers versus non-sex trade workers revealed significant differences with respect to socio-demographic characteristics... Sex trade workers were younger (median: 23 years versus 26 years, P < 0.001), more likely to be Aboriginal (29% versus 6%, P = 0.001), and to have less than a high school education (40% versus 12%, P < 0.001). Sex trade workers were more likely to report living in unstable housing (45% versus 4%, P < 0.001), to have an annual income of less than $10 000 (58% versus 26%, P < 0.001), and to have ever been in a psychiatric ward (32% versus 6%, P < 0.001). Further, sex trade workers were found to have a high depression score (82% versus 50%, P < 0.001) and to have ever been in jail (54% versus 6%, P < 0.001) compared with non-sex trade workers."


Vanguard Project - Vancouver, B.C. - MSM Males
Involvement in the Sex Trade
Ethnicity
MSM
N = 761
MSM: Sex Trade
n = 125
MSM, No Sex Trade
n = 636
All
761
125 / 761 = 16.4%
636 / 761 =  83.6%
White - 71.0%
540
72 / 540 = 13.3%
468 / 540 = 86.7%
Aboriginal - 9.5%
72
36 / 72 = 50%
36 / 72 = 50%
Other - 19.5%
149
17 / 149 = 11.4%
132 / 149 = 88.6%
Non-Aboriginal - %
689
89 / 689 = 12.9%
600 / 689 = 87.1%
Data Source: Weber et al. (2001). Calculation Based On Counts Given

Compare to Others, Aboriginal MSM are more like to be involved in sex trade: 50.0% vs. 12.9%
RR = 3.9, 95%CI: 2.9, 5.2 - OR = 6.7, 95%CI: 4.0, 11.3 - p = 0.0000
Aboriginal Males: 36 / 89 = 40.4% of Males Reporting Sex Trade.
McIntyre (2005), from a study of 37 young male prostitutes in Alberta,
reports that 54% of this population are of Aboriginal heritage

McIntyre S (2005). Under the Radar: The Sexual Exploitation of Young Men. Internet: http://www.child.gov.ab.ca/whatwedo/pcse/pdf/undertheradar.pdf.



Braitstein P, Asselin J, Chan K, Li K, Schilder A, Spittal P, Tyndall M, Schechter MT, RS Hogg1 RS (2002). Differential patterns of sexual violence among men who have sex with men (MSM) versus injection drug using (IDU) men. Poster presentation at the 11th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, April 25-28, 2002. Internet: http://cfenet.ubc.ca/vanguard/abstracts/PaulaPoster2002.pdf.

Data Source:  - Sexual minority data, Vanguard Project, a prospective cohort of young gay and bisexual men in the Greater Vancouver area - 1999 to 2000 self administered survey. - Injection drug user data, Vancouver Injection Drug Users Study (VIDUS), a cohort of injection drug users in the Greater Vancouver area - interviewer-administered baseline questionnaire.

Analysis:  Age-specific analyses based on self-reported age at first incident were constructed as: (1) child sexual abuse (CSA) (aged less than 13 years), (2) adolescence (aged between 13 and 17), and (3) adulthood (aged 18 years or more). -- The data is reported separately for each cohort. -- Multivariate logistic regression was used to determine the magnitude of effect of sexual violence ever and in each age category on each outcome by entering into each model the age category of first sexual violence (and ever experiencing sexual violence) and all fixed sociodemographics (i.e. ethnicity and age and education baseline). The reference category for all regression analyses was never having experienced any sexual violence.

Vanguard Project - Vancouver, B.C. - MSM Males
Lifetime Sexual Abuse/Violence (SA)
Ethnicity
n/N
(%N)
Sexual Abuse
n = 131
(27.2%)
No Sexual
Abuse - n = 351
(78.8%)
Pearson's p &
Odds Ratios (95%CI)
Aboriginal
38 / 482
(7.9%)
17 / 38
44.7%
21 / 38
55.3%

Non-Aboriginal
444 / 482
(92.1%)
114 / 444
25.7%
330 / 444
74.3%

CA Risk: Aboriginal  vs. Non-Aboriginal
0.01
2.3 (1.2, 4.6)
Data Source: Braitstein et al. (2002)



Vancouver Injection Drug Users Study (VIDUS):
Males -
Lifetime Sexual Abuse/Violence (SA)
Ethnicity
n/N
(%N
)
Sexual Abuse
n = 173
(18.6%)
No Sexual
Abuse - n = 759
(81.4%)
Pearson's p &
Odds Ratios
(95%CI)
Non Aboriginal*
659 / 932
(70.7%)
118 / 659
17.9%
541 / 659
82.1%

Aboriginal*
273 / 932
(29.3)
55 / 273
20.1%
218 / 273
79.9%

CA Risk: Aboriginal  vs. Non-Aboriginal
0.64
  1.26 (0.81, 1.7)
Data Source: Braitstein et al. (2002) -
* Groups Reversed-Labeled in Poster Presentation. See Kuyper et al. (2004)



Vanguard Project & VIDUS: Most Significant Odd Ratios
For Lifetime Sexual Abuse/Violence Effects

Braitstein-02-odd-ratios-regression-results
Data Source: Braitstein et al. (2002)


Kuyper LM, Lampinen TM, Li K, Spittal PM, Hogg RS, Schechter MT, Wood E (2004). Factors associated with sex trade involvement among male participants in a prospective study of injection drug users. Sexually Transmitted Infections, 80(6): 531-5. PubMed Abstract. Full Text.
"Among the 995 male participants recruited into the VIDUS cohort between 1996 and 2003, the median age was 35 (interquartile range (IQR) 28–41), 191 (19%) were Aboriginal, 623 (63%) reported residing in unstable housing, 184 (19%) were HIV seropositive, and 108 (11%) reported being involved in the sex trade at enrolment." Aboriginal: 191 / 995 = 19.2%
Craib KJP, Spittal PM,K Li K, Heath K, Laliberte N, Tyndall M, O’Shaughnessy MV, Schechter1 MT (2002). Comparison of HIV Incidence Rates Among Aboriginal and Non-Aboriginal Participants in a Cohort of Injection Drug Users in Vancouver. Internet Conference Abstract: http://www.pulsus.com/cahr2002/abs/abs315.htm.
"To compare cumulative HIV incidence rates among aboriginal and non-aboriginal participants in a cohort of injection drug users (IDUs).
Methods: The Vancouver Injection Drug User Study (VIDUS) is a prospective study of IDUs. This analysis was based on 941 participants (230 aboriginals and 711 non-aboriginals) who were recruited between 05/96 and 12/00.."  Aboriginal: 230 / 941 = 24.4%
"Aboriginal participants were significantly younger (33 vs. 35 years; p=0.017). The mean duration of self-reported injection drug use was similar in both groups (11.8 vs. 13.2 years; p=0.215). As of 12/01, 44 of 230 aboriginal participants had seroconverted compared to 68 of 711 non-aboriginals. After 44 months of follow-up, the cumulative incidence of HIV infection was significantly higher among aboriginal participants (19.9% vs. 10.2%; p<0.001). Cumulative incidence was significantly higher among male aboriginals compared to male non-aboriginals (19.4% vs. 9.2%; p=0.007). Cumulative incidence was significantly higher among female aboriginal participants compared to female non-aboriginals (20.2% vs. 9.4%; p=0.007)."
Craib KJ, Spittal PM, Wood E, Laliberte N, Hogg RS, Li K, Heath K, Tyndall MW, O'Shaughnessy MV, Schechter MT (2003). Risk factors for elevated HIV incidence among Aboriginal injection drug users in Vancouver. CMAJ: Canadian Medical Association Journal, 168(1): 19-24. PubMed Abstract.
"A total of 1437 participants were recruited and completed the enrolment questionnaire between May 1996 and December 2000. Of these, 941 were found to be HIV negative at enrolment and completed at least one follow-up visit during the observation period. Of the 941 participants, 230 (24.4%) were Aboriginal and 711 (75.6%) non-Aboriginal. Among the Aboriginal participants 101 (43.9%) reported being Aboriginal, 97 (42.2%) First Nations and 32 (13.9%) Métis. The proportion of participants who enrolled in 1996/97 was similar in the Aboriginal and non-Aboriginal groups (80% and 82% respectively; p = 0.87)."

Vancouver Injection Drug Users Study: VIDUS
Aboriginal/Non-Aboriginal Males
HIV-Negative At Study Enrolment
Variables
n/N
(%N) For
Variables
Aboriginal
n = 103
(16.8%)
Non-Aboriginal
n = 522
(85.2%)
Pearson's p &
Odds Ratios (95%CI)
Aboriginal vs. Others
Nonconsensual
Sex, Ever
114 / 625
18.2%
23 / 103
22.3%
91 / 522
17.4%
0.24
1.4 (0.81, 2.3)
Sex Trade
53 / 625
8.5%
6 / 103
5.8%
47 / 522
9.0%
0.29
0.62 (0.26, 1.5)
Data Source: Craib et al. (2003)

Note: For Aboriginal Males, OR for HIV seroconversion as related to Sex Trade = 2.7 (0.6–12.5)

Miller CL, Strathdee SA, Spittal PM, Kerr T, Li K, Schechter MT, Wood E (2006). Elevated rates of HIV infection among young Aboriginal injection drug users in a Canadian setting. Harm Reduction Journal, 3:9. PubMed Abstract. Full Text.
Note: Males and Females Combined For Ananlsyis. "Between May 1996 and May 2003, 1548 participants were recruited into the VIDUS study among whom there were 291 (19%) participants aged ≤24 years. Overall, 80 (27%) of the youth were Aboriginal and 211 (73%) were non-Aboriginal... there was no statistical difference between Aboriginal and non-Aboriginal youth with respect to age [median 16 (IQR: 14–18) vs. 17 (IQR: 15–19) respectively (p = 0.114)]; however, Aboriginal youth had, on average, been injecting longer [median number of years since first injection was 5 (IQR: 2–8) vs. 3 (IQR: 1–5)] than non-Aboriginal youth (p =< 0.001). Aboriginal youth were more likely to be female (OR: 2.22 [CI: 1.31–3.79]), report a history of sexual abuse (OR: 1.78 [CI: 1.06–2.99]), work in the sex trade (OR: 2.90 [CI: 1.70–4.94]), report a recent STI (OR: 1.73 [CI: 1.03–2.93]) and inject cocaine (OR: 2.00 [CI: 1.17–3.42]) and speedballs (OR: 2.07 [CI: 1.06–4.02]) on a frequent basis... In the multi-variable analysis that adjusted for all variables significant in the univariate analysis, independent associations with Aboriginal ethnicity were HIV positivity (OR: 2.54 [CI: 1.25–5.16]), HCV positivity (OR: 1.91 [CI: 1.00–3.65]), and sex trade involvement (OR: 2.08 [CI: 1.15–3.77])."
Weber AE, Chan K, George C, Hogg RS, Remis RS, Martindale S, Otis J, Miller ML, Vincelette J, Craib KJ, Masse B, Schechter MT, LeClerc R, Lavoie R, Turmel B, Parent R, Alary M (2001a). Risk factors associated with HIV infection among young gay and bisexual men in Canada. Journal of Acquired Immune Deficiency Syndromes, 28(1):1-8. PubMed AbstractFull Text.
"The Vanguard Project and the Omega Cohort are prospective cohort studies of gay and bisexual men ongoing in Vancouver and Montreal, respectively.... Men who were HIV-seropositive at baseline (n = 48) were more likely to report living in unstable housing, to have had less than a high school education, and to have been unemployed than those who were HIV-negative (n = 1325). HIV-positive men were also more likely to report having engaged in sexual risk behavior, including having had consensual sex at a younger age, having had at least 6 partners during the previous year, ever having been involved in the sex trade, and having engaged in unprotected receptive anal intercourse... Compared with HIV-negative men, men who seroconverted were more likely to report ever having been involved in the sex trade and engaging in unprotected receptive anal intercourse...."

The Vancouver Vanguard Project Cohort &
Montreal Omega Cohort Studies - MSM Males

Involvement in the Sex Trade / Baseline HIV Status
Variables
n/N
(%N) For
Variable
HIV -
n = 1,325
(97.3%)
HIV +
n = 48
(2.7%)
Pearson's p &
Odds Ratios (95%CI)
For Sex Trade Involvement
&
Becoming HIV +
Sex Trade
Involvement
344 / 1,350
25.5%
320 / 1,303
24.6%
24 / 47
51.1%
< .0000
3.2 (1.8, 5.8)*
Data Source: Weber et al. (2001a)
* "Multivariate logistic regression analysis was used to assess risk factors associated with HIV-positive serostatus (Table 4). For all men, having less than a high school education [OR = 2.2], history of cocaine use [OR = 2,2], and having ever been involved in the sex trade were independently associated with HIV-positive serostatus." Or For Sex Trade & Seroconversion = 2.08, 95% CI: 1.05, 4.00.


The Vancouver Vanguard Project Cohort &
Montreal Omega Cohort Studies - MSM Males

Involvement in the Sex Trade / HIV Seroconversion
Variables
n/N
(%N) For
Variable
HIV -
n = 1,325
(97.3%)
HIV +
n = 26
(2.7%)
Pearson's p &
Odds Ratios (95%CI)
For Sex Trade Involvement &
Becoming HIV +
Sex Trade
Involvement
333 / 1,329
25.1%
320 / 1,303
24.6%
13 / 26
50.0%
0.003
3.1 (1.4, 6.7) *
Data Source: Weber et al. (2001a)
" "After adjusting for cohort, analysis of baseline predictors of seroconversion revealed that for all men, having ever been involved in the sex trade was associated with a threefold increase in the odds of seroconversion (odds ratio [OR]  3.08, 95% confidence interval [CI]: 1.41–6.73)."


Weber AE, Otis J, Chan K, Lavoie R, Martindale S, Leclerc R, Miller ML, Turmel B, Craib KJP, Alary M, Schechter MT, Hogg RS (2002). Comparison of Sexual Risk Behavior Among Gay and Bisexual Men - A Two-City Comparison. Internet: http://cfenet.ubc.ca/vanguard/posters/AmyPoster3.pdf.

The Vancouver Vanguard Project Cohort &
Montreal Omega Cohort Studies
Young MSM Males - Age = 16-30 Years
Aboriginal,
Sex Trade & Bisexual Incidences
Variable
Vanguard Cohort
Omega Cohort
Aboriginal
67 / 618 =  10.8%
1 / 305 = 0.33%
Sex Trade
Involvement
139 / 628 = 22.1%
31 / 347 = 8.9%
Sex With Males & Females
In Previous Year
161 / 633 = 25.4%
54 / 359 = 15.0%
Data Source: Weber et al. (2002)





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