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Factors associated with drug-related harms related to policing in Tijuana, Mexico.doc

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Factors associated with drug-related harms related to policing in Tijuana, Mexico

Volkmannetal.HarmReductionJournal2011,8:7 /content/8/1/7 RESEARCH OpenAccess Factorsassociatedwithdrug-relatedharms relatedtopolicinginTijuana,Mexico TysonVolkmann1,RemediosLozada2,ChristyMAnderson1,ThomasLPatterson1,AliciaVera1and SteffanieAStrathdee1* Abstract Objective:Toassessfactorsassociatedwithdrug-relatedharmsrelatedtopolicingamonginjectiondrugusers (IDUs)inTijuana,Mexico. Methods:IDUswhowereover18yearsoldandhadinjecteddrugswithinthelastsixmonthswererecruitedvia respondent-drivensamplingandunderwentquestionnairesandtestingforHIV(humanimmunodeficiencyvirus), syphilisandTB(tuberculosis).Randomeffectslogisticregressionwasusedtosimultaneouslymodelfactors associatedwithfivedrug-relatedharmsrelatedtopolicingpracticesinthepriorsixmonths(i.e.,policeledthemto rushinjections;affectedwheretheyboughtdrugs;affectedlocationswheretheyuseddrugs;fearedthatpolicewill interferewiththeirdruguse;receptivesyringesharing). Results:Of727IDUs,85%weremale;medianagewas38years.Withinthelast6months,231(32%)ofIDUs reportedthatpolicehadledthemtorushinjections,affectedwheretheyboughtoruseddrugsorwerevery afraidpolicewouldinterferewiththeirdruguse,orsharedsyringes.Factorsindependentlyassociatedwithdrug- relatedharmsrelatedtopolicingwithinthelastsixmonthsincluded:recentarrest,homelessness,higher frequenciesofdruginjection,useofmethamphetamine,usingthelocalneedleexchangeprogramandperceiving adecreaseinthepurityofatleastonedrug. Conclusions:IDUswhoexperienceddrug-relatedharmsrelatedtopolicingwerethosewhoweremostaffected byothermicroandmacroinfluencesinthephysicalriskenvironment.Policeeducationprogramsareneededto ensurethatpolicingpracticesdonotexacerbateriskybehaviorsordiscourageprotectivebehaviorssuchasneedle exchangeprogramuse,whichunderminestherighttohealthforpeoplewhoinjectdrugs. Background micro-level factors, such as discriminatory access to A growing body of literature about the risk of HIV antiretroviraltherapy[6]andproblematicpolicingprac- (humanimmunodeficiencyvirus)andotherblood-b