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Abstract
BackgroundSince 2003 Thailand has waged an aggressive "war on drugs" campaign focused on arresting and incarcerating suspected drug users and dealers. However, little is known about incarceration experiences among IDU in the wake of the recent war on drugs. Therefore, we sought to examine incarceration experiences among IDU in Bangkok, Thailand.MethodsWe examined the prevalence of incarceration among community-recruited IDU participating in the Mitsampan Community Research Project. Multivariate logistic regression was used to identify factors associated with a self-reported history of incarceration. We also examined the prevalence of injection drug use and syringe sharing within prisons.Results252 IDU were recruited in August 2008; 66 (26.2%) were female and the median age was 36.5 years. In total, 197 (78.2%) participants reported a history of incarceration. In multivariate analyses, reporting a history of incarceration was associated with a history of compulsory drug treatment (adjusted odds ratio [AOR] = 4.93; 95% confidence interval [CI]: 1.95 - 12.48), non-fatal overdose (AOR = 3.69; 95%CI: 1.45 - 9.39), syringe sharing (AOR = 2.20; 95%CI: 1.12 - 4.32), and female gender (AOR = 0.41; 95%CI: 0.20 - 0.82). Among those who reported a history of incarceration, 59 (29.9%) reported injection drug use in prison, and 48 (81.4%) of these individuals reported sharing syringes in prison. Incarceration was not associated with the number of injections performed in the previous week (p = 0.202).ConclusionOver three-quarters of the IDU participating in this study reported a history of incarceration, and 30% of these individuals reported injection drug use within prison. Further, an alarmingly high level of syringe sharing within prison was reported, and incarceration was not associated with reductions in drug use. These findings provide further evidence of the need for community diversion strategies, as well as harm reduction programs, in Thai prisons.
Highlights
Since 2003 Thailand has waged an aggressive "war on drugs" campaign focused on arresting and incarcerating suspected drug users and dealers
A large body of evidence indicates that incarceration is associated with elevated risks of drug-related harm among injection drug users (IDU), including the spread of blood-borne pathogens such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) [610]
Our findings suggest that compulsory drug treatment experience is common among Thai IDU with a history of incarceration
Summary
Since 2003 Thailand has waged an aggressive "war on drugs" campaign focused on arresting and incarcerating suspected drug users and dealers. Injection drug users (IDU) are frequently arrested and incarcerated [3,4,5]. A large body of evidence indicates that incarceration is associated with elevated risks of drug-related harm among IDU, including the spread of blood-borne pathogens such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) [610]. HIV outbreaks associated with injection drug use in prison have been observed in Scotland [11], Lithuania [12], and the Russian Federation [13]. Endemic sharing of injection equipment has been identified as a major factor contributing to high HCV incidence in prisons in Australia [14] and Scotland [15]. The burden of prison-related epidemics of infectious disease is essentially linked with the public health of communities due to high inmate turnover and the potential spread of prisonacquired infections among non-inmate populations
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