The Impact of Police Violence on HIV Risks among People Who Inject Drugs in Thailand Kanna Hayashi1, 2 Lianping Ti1 Karyn Kaplan3 Paisan Suwannawong3 Kate Shannon1, 4 Evan Wood1, 4 Thomas Kerr1, 4 1British Columbia Centre for Excellence in HIV/AIDS 2Interdisciplinary Studies Graduate Program, the University of British Columbia 3Thai AIDS Treatment Action Group/Mitsampan Harm Reduction Center 4Department of Medicine, the University of British Columbia
HIV Epidemic among Thai IDU Source: Thailand Bureau of Epidemiology, HIV Total Sentinel Survellance, Ministry of Public Health (2012)
Thai Drug Policy Intensified police crackdowns in recent years Kingdom's Unity for Victory over Drugs strategy in 2011 Targeting 400,000 drug users into drug treatment War on drugs in 2003 2,800 extrajudicial killings Photo from : Mahitthirook, A., Laohong, K.-O., 2012. Phones, CDs seized at prison. Bangkok Post, May 18.
Study Objectives • To identify the prevalence and correlates of experiencing police violence among IDU in Bangkok • To describe circumstances of police violence Police violence: Ever beaten by police Photo by Rico Gustav
Mitsampan Community Research Project • Acollaborative research effort involving: • Serial cross-sectional • mixed-methods study • 32 former/active drug users • trained as peer researchers • Peer researchers involved in • all stages of the project Thai AIDS Treatment Action Group Mitsampan Harm Reduction Center Chulalongkorn University June 2008, Bangkok, Thailand
Data & Study Sample • Cross-sectional data collected through interviewer-administered questionnaires • Adult IDU in Bangkok or in adjacent provinces • Recruited through peer outreach and word-of-mouth 307 IDU (June-July 2009) 332 IDU (July-October 2011) 639 unique participants
Statistical Analyses • Univariate statistics & multivariate logistic regression • Variables: • Sociodemographic information • Drug use patterns • HIV risk behaviour • Experiences with drug law enforcement • Experiences with accessing healthcare • Health problems • Calendar year of study enrolment
Descriptive Statistics “Have you ever been beaten by police?” Participants in 2011 (n=144) most commonly experienced police violence while: Being interrogated (68.1%) Being arrested (43.1%) Being searched (22.9%) In police holding cells (22.9%) A community-recruited sample of IDU in Bangkok, June 2009 - October 2011 (n=639)
Interpretations • A high proportion of community-recruited IDU in Bangkok reported being beaten by police. • Police violence appears to have increased in recent years. • Experiencing police violence was independently associated with indicators of drug-related harm.
Limitations • Unable to infer causation from this observational study • Self-reported data may be affected affected by socially desirable responding or recall bias • Sample not randomly selected, findings may not be generalizable to Thai IDU at large
Conclusions • The emphasis on law enforcement-based approaches may be contributing to: • Ongoing human rights violations at the hands of police • The perpetuation of the HIV epidemic among Thai IDU • A need for: • Greater police oversight • A shift toward the implementation of evidence-based policies and programs specific to HIV/AIDS and illicit drug use
Acknowledgments • MSCRP participants • Staff & volunteers at TTAG, Mitsampan Harm Reduction Center & O-Zone House:JirasakSripramong, KamonUppakaew, AmnatChamchern, VipawanSuwannawong, WiwatChotichatmala, and PrapatsaraKaewkoon • Chulalongkorn University:Dr. NiyadaKiatying-Angsulee • BC CfE staff: Tricia Collingham, Cameron Dilworth,Deborah Graham, Caitlin Johnston, Daniel Miles Kane,Calvin Lai, Cristy Power, and Peter Vann • Research assistants:PrempreedaPramoj Na Ayutthaya, ArphatsapornChaimongkon, SattaraHattirat, and PuripakornPakdirat