{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:18:19Z","timestamp":1791872299930,"version":"4.3.4"},"reference-count":36,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,5,13]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study examined associations between childhood maltreatment, colonial harms and sex\/drug-related risks for HIV and hepatitis C virus (HCV) infection among young Indigenous people who use drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The Cedar Project is a cohort involving young Indigenous people who use drugs in British Columbia (BC), Canada. Indigenous collaborators, collectively known as the Cedar Project Partnership, govern the entire research process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Vancouver is a large city on the traditional territory of the Coast Salish peoples. Prince George is a mid-sized city, on the traditional territory of Lheidli T\u2019enneh First Nation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>420 participants completed the Childhood Trauma Questionnaire and returned for follow-up from 2003 to 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary\/secondary outcome measures<\/jats:title><jats:p>Primary outcomes were HIV and HCV infection over the study period. Secondary outcomes included sex and substance use-related risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of childhood maltreatment was 92.6% experienced any maltreatment; 73.4% experienced emotional abuse; 62.6% experienced physical abuse; 60.3% experienced sexual abuse; 69.5% experienced emotional neglect and 79.1% experienced physical neglect. We observed significant associations between childhood maltreatment and apprehensions into residential schools and foster care. All maltreatment types were associated with higher odds of sex\/substance use-related risks; sexual abuse was associated with higher odds of HCV infection (adjusted OR: 1.67; 95%\u2009CI 1.05 to 2.66; p=0.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings reflect high prevalence of childhood maltreatment and their associations with HIV\/HCV risk and HCV infection. Public health prevention and treatment initiatives must be trauma informed and culturally safe to support healing, health, and well-being.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-042545","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T15:58:24Z","timestamp":1625759904000},"page":"e042545","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["The Cedar Project: exploring the role of colonial harms and childhood maltreatment on HIV and hepatitis C infection in a cohort study involving young Indigenous people who use drugs in two Canadian cities"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1563-8029","authenticated-orcid":false,"given":"Margo E","family":"Pearce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Jongbloed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherri","family":"Pooyak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenecwtsin M","family":"Christian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaxswxw Gibuu (White Wolf) Mary","family":"Teegee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine R","family":"Caron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Earl","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin T","family":"Schechter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M","family":"Spittal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2024102810413243000_11.7.e042545.1","unstructured":"Million D . 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