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We sought to characterize longitudinal trajectories of injection drug use and identify associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Data were derived from the Vancouver Injection Drug Users Study and AIDS Care Cohort to evaluate the Exposure to Survival Services study, two prospective cohorts involving people who inject drugs in Vancouver, Canada between 1996 and 2017. Growth mixture modeling was applied to identify distinct injection drug use trajectories. Multinomial logistic regression was used to identify baseline factors associated with each trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2057 participants who reported having used illicit drugs via injection in the past 6\u00a0months at the baseline visit were included in the study. The median time since first injection drug use at baseline was 14.8\u00a0years (quartile 1\u2013quartile 3: 6.5\u201324.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Information regarding self\u2010reported injection drug use during the past 6\u00a0months was collected at baseline and semi\u2010annually thereafter via interviewer\u2010administered questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Participants were followed for a median of 113.4\u00a0months (quartile 1\u2013quartile 3: 63.4\u2013161.7). Five trajectories were identified: persistent high frequency injection (507, 24.6%); high frequency injection with late decrease (374, 18.2%); gradual cessation (662, 32.2%); early cessation with late relapse (227, 11.0%); and early cessation (287, 14.0%). Factors found to be associated with distinct trajectories included: daily heroin injection, binge injection drug use, age, not being in a stable relationship and year of study enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>People who used drugs in Vancouver, Canada from 1996 to 2017 appeared to follow five drug use trajectories, ranging from persistent high frequency use to early cessation. Almost 25% of participants remained high\u2010frequency injectors over the study period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.14756","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T04:19:50Z","timestamp":1563769190000},"page":"2173-2186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Trajectories of injection drug use among people who use drugs in Vancouver, Canada, 1996\u20132017: growth mixture modeling using data from prospective cohort studies"],"prefix":"10.1111","volume":"114","author":[{"given":"Huiru","family":"Dong","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"School of Population and Public Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-2928","authenticated-orcid":false,"given":"Kanna","family":"Hayashi","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Singer","sequence":"additional","affiliation":[{"name":"School of Population and Public Health University of British Columbia  Vancouver British Columbia Canada"},{"name":"Providence Healthcare Research Institute Centre for Health Evaluation and Outcome Sciences  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3821-6221","authenticated-orcid":false,"given":"Michael John","family":"Milloy","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2045-1653","authenticated-orcid":false,"given":"Kora","family":"DeBeck","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"School of Public Policy Simon Fraser University  Burnaby British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Wood","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-7153","authenticated-orcid":false,"given":"Thomas","family":"Kerr","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance use  Vancouver British Columbia Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,16]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.People who inject drugs. 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