Thomas Kerr1, Kanna Hayashi2, Lianping Ti2, Karyn Kaplan3, Paisan Suwannawong3, Evan Wood4. 1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada; Department of Medicine, University of British Columbia, Canada. Electronic address: uhri-tk@cfenet.ubc.ca. 2. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada. 3. Thai AIDS Treatment Action Group, Thailand. 4. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada; Department of Medicine, University of British Columbia, Canada.
Abstract
BACKGROUND: Although Thailand has relied on the use of compulsory drug detention centres as a strategy to try to address problematic drug use, little is known about the effects of exposure to these centres on people who inject drugs (IDU). Therefore, we undertook this study to explore whether exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU. METHODS: Using Poisson regression analyses, we examined the relationship between compulsory drug detention exposure and avoiding healthcare among participants in the Mitsampan Community Research Project based in Bangkok. RESULTS: 435 IDU participated in this study, including 111 (25.5%) participants who reported avoiding healthcare. In multivariate analyses, avoiding healthcare was positively associated with exposure to compulsory drug detention (adjusted prevalence ratio [APR]=1.60; 95% confidence interval [CI]: 1.16-2.21), having been refused healthcare (APR=3.46; 95% CI: 2.61-4.60), and experiencing shame associated with one's drug use (APR=1.93; 95% CI: 1.21-3.09). CONCLUSION: Exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU, suggesting that this system of detention may be contributing to the burden of preventable morbidity among IDU in this setting. Although further research is needed to confirm these findings, the results of this study reinforce previous calls to replace the system of compulsory drug detention with evidence-based public health interventions for IDU.
BACKGROUND: Although Thailand has relied on the use of compulsory drug detention centres as a strategy to try to address problematic drug use, little is known about the effects of exposure to these centres on people who inject drugs (IDU). Therefore, we undertook this study to explore whether exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU. METHODS: Using Poisson regression analyses, we examined the relationship between compulsory drug detention exposure and avoiding healthcare among participants in the Mitsampan Community Research Project based in Bangkok. RESULTS: 435 IDU participated in this study, including 111 (25.5%) participants who reported avoiding healthcare. In multivariate analyses, avoiding healthcare was positively associated with exposure to compulsory drug detention (adjusted prevalence ratio [APR]=1.60; 95% confidence interval [CI]: 1.16-2.21), having been refused healthcare (APR=3.46; 95% CI: 2.61-4.60), and experiencing shame associated with one's drug use (APR=1.93; 95% CI: 1.21-3.09). CONCLUSION: Exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU, suggesting that this system of detention may be contributing to the burden of preventable morbidity among IDU in this setting. Although further research is needed to confirm these findings, the results of this study reinforce previous calls to replace the system of compulsory drug detention with evidence-based public health interventions for IDU.
Authors: Mina Psichogiou; George Giallouros; Katerina Pantavou; Eirini Pavlitina; Martha Papadopoulou; Leslie D Williams; Andria Hadjikou; Eleni Kakalou; Athanasios Skoutelis; Konstantinos Protopapas; Anastasia Antoniadou; George Boulmetis; Dimitrios Paraskevis; Angelos Hatzakis; Samuel R Friedman; Georgios K Nikolopoulos Journal: AIDS Care Date: 2019-04-02
Authors: Anh T Vo; Christopher Magana; Matthew Hickman; Annick Borquez; Leo Beletsky; Natasha K Martin; Javier A Cepeda Journal: Int J Drug Policy Date: 2021-08-11
Authors: Kora DeBeck; Tessa Cheng; Julio S Montaner; Chris Beyrer; Richard Elliott; Susan Sherman; Evan Wood; Stefan Baral Journal: Lancet HIV Date: 2017-05-14 Impact factor: 12.767
Authors: M Eugenia Socías; Kate Shannon; Julio S Montaner; Silvia Guillemi; Sabina Dobrer; Paul Nguyen; Shira Goldenberg; Kathleen Deering Journal: Can J Gastroenterol Hepatol Date: 2015-10-22
Authors: Annick Borquez; Leo Beletsky; Bohdan Nosyk; Steffanie A Strathdee; Alejandro Madrazo; Daniela Abramovitz; Claudia Rafful; Mario Morales; Javier Cepeda; Dimitra Panagiotoglou; Emanuel Krebs; Peter Vickerman; Marie Claude Boily; Nicholas Thomson; Natasha K Martin Journal: Lancet Public Health Date: 2018-08-17