Factors Associated with Employment Among a Cohort of Injection Drug Users

Introduction and Aims: One of the most substantial costs of drug use is lost productivity and social functioning, including holding of a regular job. However, little is known about employment patterns of injection drug users (IDU). We sought to identify factors that were associated with legal employment among IDU. Design and Methods: We describe the employment patterns of participants of a longitudinal cohort study of IDU in Vancouver, Canada. We then use generalized estimating equations (GEE) to determine statistical associations between legal employment and various intrinsic, acquired, behavioural and circumstantial factors. Results: From June 1, 1999 to November 30, 2003, 330 (27.7%) of 1190 participants reported having a job at some point during follow-up. Employment rates remain somewhat stable throughout the study period (9.0% to 12.4%). Factors positively and significantly associated with legal employment in multivariate analysis were male gender (adjusted odds ratio [AOR]=2.78) and living outside the Downtown Eastside (AOR=1.85). Factors negatively and significantly associated with legal employment included older age (AOR=0.97); Aboriginal ethnicity (AOR=0.72); HIV-positive serostatus (AOR=0.32); HCV-positive serostatus (AOR=0.46); daily heroin injection (AOR=0.73); daily crack use (AOR=0.77); public injecting (AOR=0.50); sex trade involvement (AOR=0.49); recent incarceration (AOR=0.56); and unstable housing (AOR=0.57). Discussion and Conclusions: Our results suggest a stabilising effect of employment for IDU and socio-demographic, drug use and risk-related barriers to employment. There is a strong case to address these barriers and to develop innovative employment programming for high-risk drug users.Arts, Faculty ofMedicine, Faculty ofOther UBCNon UBCMedicine, Department ofSociology, Department ofReviewedFacult