“Young street people often adopt high-risk behaviour
in terms of contagious diseases, especially sexually transmitted
disease and blood-borne infections,” explains Dr. Nancy
Haley, Full Clinical Professor in the Paediatrics Department
at Université de Montréal, Paediatrician at
Hôpital Sainte-Justine and consulting physician with
the Montréal-Centre Public Health Directorate. For
seven years, Dr. Haley, together with Dr. Élise
Roy of McGill University, has been conducting research on
a cohort of 1,040 young street people aged 14 to 25 years
in Montréal. These young people frequent community
resources such as Bon Dieu dans la rue, the Bunker, the
Refuge des jeunes and other agencies offering assistance
to young persons in difficulty.
In their work, they study risk behaviour in young persons
and the prevalence of HIV, hepatitis and STDs such as gonorrhoea
and chlamydia infection. In 1998 the research team
published a study on the very high mortality rate among
young street people. Their mortality rate is 11 times
higher than the rate for other young people their age. Causes
of death include suicide, overdoses, accidents, and disease.
“A large proportion of young street people suffer from
drug addiction and, simultaneously, have mental health problems.
This combination makes it very difficult for them to get
the health care they need,” says Dr. Haley.
The doctors have shown that 36% of the young street people
in Montréal inject drugs, one of the highest rates
in Canada. They have also documented the prevalence of HIV
(1.9%), hepatitis B (9.2%) and hepatitis C (12.6%)
in this population. The group’s most recent study,
dealing with chlamydia infection, was published in the
International Journal of STD and AIDS recently. They
found that 6.6% of the 302 young people who took part
in the survey were positive. Given the devastating effects
of untreated chlamydia infection (chronic disease, infertility,
ectopic pregnancy), these numbers are a concern, in Dr. Haley’s
opinion. “We also discovered that more than 44% of
young women had gone through a pregnancy.”
Drs Haley and Roy, together with their research team, have
done more than just study the young people they contact
in Montreal’s streets and parks. The also intervene
to improve their access to health services. “When we
discovered the high prevalence of hepatitis B, we realized
that only 10% of the young people had been vaccinated. So
we organized a massive vaccination campaign in which 1,400 young
people participated. More than 80% of them showed up at
their appointments for the second dose and 50% for the third.
Given the nature of the clientele, this was a real success.
However, a lot remains to be done to facilitate access to
the services they need to deal with their many physical
and mental health problems.”
Researcher: Nancy Haley
Telephone: (514) 528-2400, extension 3893
Funding: Ministère de la Santé et des Services
sociaux, Régie régionale de santé publique
de Montréal-centre
