Abstract
ObjectiveTo assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico.MethodsIDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing).ResultsOf 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug.ConclusionsIDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs.
Highlights
A growing body of literature about the risk of HIV and other blood-borne infections among injection drug users (IDUs) has focused on the influence of risk environments that shape individual behaviors [1,2,3,4]
Studies from a number of countries, including the US (United States), UK (United Kingdom), Australia, Russia, Ukraine, Mexico, and Canada have found that police pressure and policing practices are associated with high risk injection behaviors among IDUs [13,15,16]
We studied potential factors associated with the effects of policing practices on simultaneous drug-related harms among IDUs in Tijuana, Mexico in an effort to guide future intervention efforts
Summary
A growing body of literature about the risk of HIV (human immunodeficiency virus) and other blood-borne infections among injection drug users (IDUs) has focused on the influence of risk environments that shape individual behaviors [1,2,3,4]. These approaches stem from the understanding that IDUs’ behaviors are a product of individuals’ behaviors and their shared environments [2,3,4]. Qualitative studies have examined the effects of direct and indirect policing practices on IDUs, emphasizing the adverse effects of these practices from a human rights perspective [19,20]
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