Characterising the increasing prevalence of crystal methamphetamine use in Vancouver, Canada, from 2006–2017: A gender‐based analysis

Introduction Methamphetamine use is increasing in North America and is associated with numerous negative health effects and social harms. As drug‐related harms are often gendered, this study sought to examine the differential impacts of gender on the trends, risk factors and health implications of crystal methamphetamine use among a Canadian cohort of people with high rates of injection polysubstance use. Methods Data were collected from two prospective cohorts of people who inject drugs in Vancouver, Canada. We examined trends in reported crystal methamphetamine use from 2006–2017 using the Cochrane‐Armitage test for trend. We used multivariable generalised estimating equations, stratified by gender, to determine independent risk factors and health outcomes associated with crystal methamphetamine use. Results In total, 1984 participants were included in the study, including 694 (35%) women. The prevalence of reported crystal methamphetamine use within the previous 6 months rose from 19% in 2006 to 36% in 2017, with a rise seen in both genders (P