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We examined determinants of varying levels of housing instability and explored gender differences in housing instability and associated determinants among PWID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We used baseline data from HEPCO, a community\u2010based cohort of PWID in Montreal, Canada (2011\u20132022). Housing (past 3 months) was categorised as stable, precarious (i.e., temporary accommodation) or unsheltered. Multinomial logistic regression was used to assess relationships between sociodemographic factors, recent drug use, and housing instability. A multivariable model was constructed using the full sample. Gender differences were explored via stratified and unadjusted analyses given the relatively small number of women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 911 PWID (748 men and 163 women) were included. In the multivariable model, not living in a marriage\u2010like relationship, recent incarceration, and not reporting recent heroin use were associated with both precarious housing and being unsheltered, relative to stable housing. Employment, consumption of cocaine, amphetamines, and other opioids were only associated with being unsheltered. In stratified analyses, precarious and unsheltered housing was reported by 14.1% and 23.3% of women and 20.9% and 30.9% of men. Sociodemographic factors and drug use patterns also differed by gender. Although most associations with housing instability were in similar directions for men and women, several estimates differed in magnitude, denoting some signals of gender differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusion<\/jats:title><jats:p>Almost half the sample was unsheltered or precariously housed. Studies with larger samples of women should formally examine the relevance of developing gender\u2010specific responses to housing instability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.14050","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T06:46:38Z","timestamp":1743749198000},"page":"1138-1150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring housing instability through a gender lens among people who inject drugs in Montreal, Canada"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8415-3036","authenticated-orcid":false,"given":"Farzaneh","family":"Vakili","sequence":"first","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"D\u00e9partement de M\u00e9decine Familiale et M\u00e9decine d'Urgence Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Bordier","family":"H\u00f8j","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanor","family":"Minoyan","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"Department of Social and Preventive Medicine School of Public Health, Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Udhesister","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"D\u00e9partement de M\u00e9decine Familiale et M\u00e9decine d'Urgence Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie Martel","family":"Laferri\u00e8re","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"D\u00e9partement de Microbiologie, Infectiologie et Immunologie Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3484-6456","authenticated-orcid":false,"given":"Julie","family":"Bruneau","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"D\u00e9partement de M\u00e9decine Familiale et M\u00e9decine d'Urgence Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-4963","authenticated-orcid":false,"given":"Sarah","family":"Larney","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"D\u00e9partement de M\u00e9decine Familiale et M\u00e9decine d'Urgence Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"43","volume-title":"Final report","author":"Advisory Committee on Homelessness","year":"2018"},{"key":"e_1_2_11_3_1","unstructured":"Shelter Capacity Report [Internet].2023[cited 4 December 2024]. 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