Reports of police beating and associated harms among people who inject drugs in Bangkok, Thailand: a serial cross-sectional study

BMC Public Health

Thomas Kerr¹  Evan Wood¹  Paisan Suwannawong³  Karyn Kaplan³  Joanne Csete⁴  Lianping Ti²  Kanna Hayashi⁵ 

[1] Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada;School of Population & Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada;Mitsampan Harm Reduction Center / Thai AIDS Treatment Action Group, 18/89 Vipawadee Rd., soi 40 Chatuchak, Bangkok 10900, Thailand;Global Drug Policy Program, Open Society Foundations, 7th Floor Millbank Tower, 21-24 Millbank, London SW1P 4QP, United Kingdom;Interdisciplinary Studies Graduate Program, University of British Columbia, Green Commons, 6201 Cecil Green Park Road, Vancouver, BC V6T 1Z1, Canada

关键词: Thailand;    Harm reduction;    Injection drug use;    Drug law enforcement;    HIV/AIDS;   

Others  :  1161949
DOI  :  10.1186/1471-2458-13-733

 received in 2013-04-11, accepted in 2013-07-29,  发布年份 2013

【 摘 要 】

Background

Thailand has for years attempted to address illicit drug use through aggressive drug law enforcement. Despite accounts of widespread violence by police against people who inject drugs (IDU), the impact of police violence has not been well investigated. In the wake of an intensified police crackdown in 2011, we sought to identify the prevalence and correlates of experiencing police beating among IDU in Bangkok.

Methods

Community-recruited samples of IDU in Bangkok were surveyed between June 2009 and October 2011. Multivariate log-binomial regression was used to identify factors associated with reporting police beating.

Results

In total, 639 unique IDU participated in this serial cross-sectional study, with 240 (37.6%) participants reporting that they had been beaten by police. In multivariate analyses, reports of police beating were associated with male gender (Adjusted Prevalence Ratio [APR] = 4.43), younger age (APR = 1.69), reporting barriers to accessing healthcare (APR = 1.23), and a history of incarceration (APR = 2.51), compulsory drug detention (APR = 1.22) and syringe sharing (APR = 1.44), and study enrolment in 2011 (APR = 1.27) (all p < 0.05). Participants most commonly reported police beating during the interrogation process.

Conclusions

A high proportion of IDU in Bangkok reported having been beaten by the police. Experiencing police beating was independently associated with various indicators of drug-related harm. These findings suggest that the over-reliance on enforcement-based approaches is contributing to police-perpetrated abuses and the perpetuation of the HIV risk behaviour among Thai IDU.

【 授权许可】

   
2013 Hayashi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]United Nations Office on Drugs and Crime: 2008 World drug report. Vienna: United Nations Office on Drugs and Crime; 2008.
• [2]Kerr T, Small W, Wood E: The public health and social impacts of drug market enforcement: a review of the evidence. Int J Drug Policy 2005, 16(4):210-220.
• [3]Global Commission on Drug Policy: The war on drugs and HIV/AIDS: how the criminalization of drug use fuels the global pandemic. Rio de Janeiro; 2012. http://globalcommissionondrugs.org/wp-content/themes/gcdp_v1/pdf/GCDP_HIV-AIDS_2012_REFERENCE.pdf webcite
• [4]Jürgens R, Csete J, Amon JJ, Baral S, Beyrer C: People who use drugs, HIV, and human rights. Lancet 2010, 376(9739):475-485.
• [5]World Health Organization, United Nations Office on Drugs and Crime, Joint United Nations Programme on HIV/AIDS: WHO, UNODC, UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva: World Health Organization; 2009.
• [6]Assanangkornchai S, Aramrattana A, Perngparn U, Kanato M, Kanika N, Na Ayudhya AS: Current situation of substance-related problems in Thailand. J Psychiatr Assoc Thai 2008, 53(Supplement 1):24S-36S.
• [7]National AIDS Prevention and Alleviation Committee: UNGASS country progress report Thailand: reporting period: January 2008 - December 2009. 2010. http://data.unaids.org/pub/Report/2010/thailand_2010_country_progress_report_en.pdf webcite
• [8]Pearshouse R: Compulsory drug treatment in Thailand: observations on the Narcotic Addict Rehabilitation Act B.E. 2545 (2002). Toronto: Canadian HIV/AIDS Legal Network; 2009.
• [9]Office of the Narcotics Control Board of Thailand: Roadmap of drug surveillance and establishment of sustainable victory over drugs 2006–2008. 2006. http://en.oncb.go.th/document/Roadmap06-08.pdf webcite
• [10]Narcotics Control Board of Thailand: Narcotics Control Board’s Order No. 1 / B.E. 2552 (2009) on national narcotics control mechanisms under the five fences strategy. 2009. http://en.oncb.go.th/document/NCB%20ORDER1-52.pdf webcite
• [11]Vejjajiva A: Prime Minister’s Order No. 249/2552 (2009): the national strength to overcome drugs under five-defensive fences strategy phase II (November 2009 – September 2010). 2009. http://en.oncb.go.th/document/ORDER249-2552.pdf webcite
• [12]Office of the Narcotics Control Board of Thailand: National narcotics control policy on kingdom’s unity for victory over drugs strategy. 2011. http://en.oncb.go.th/file/information_policy.html webcite
• [13]Human Rights Watch: Not enough graves: the war on drugs, HIV/AIDS, and violations of human rights. New York: Human Rights Watch; 2004. Volume 16.
• [14]Harm Reduction International, Human Rights Watch: Thailand’s ‘war on drugs’. 2008. http://www.hrw.org/news/2008/03/12/thailand-s-war-drugs webcite
• [15]Fairbairn N, Kaplan K, Hayashi K, Suwannawong P, Lai C, Wood E, Kerr T: Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok. Thailand. BMC Int Health Hum Rights 2009, 9:24. BioMed Central Full Text
• [16]Rakrun N: Husband relives hell of wife’s killing. Bangkok: Bangkok Post; 2012.
• [17]Human Rights Watch: Thailand: police blamed for killing drug suspect: parliamentary findings demand strong action to combat police brutality. New York: Human Rights Watch; 2012. http://www.hrw.org/news/2012/03/16/thailand-police-blamed-killing-drug-suspect webcite
• [18]Human Rights Watch, Thai AIDS Treatment Action Group: Deadly denial: barriers to HIV/AIDS treatment for people who use drugs in Thailand. New York: Human Rights Watch; 2007. Volume 19.
• [19]Cooper H, Moore L, Gruskin S, Krieger N: The impact of a police drug crackdown on drug injectors’ ability to practice harm reduction: A qualitative study. Soc Sci Med 2005, 61(3):673-684.
• [20]Small W, Kerr T, Charette J, Schechter MT, Spittal PM: Impacts of intensified police activity on injection drug users: evidence from an ethnographic investigation. Int J Drug Policy 2006, 17(2):85-95.
• [21]Maher L, Dixon D: The cost of crackdowns: policing Cabramatta’s herion market. Current Issues Crim Just 2001, 13(1):5-22.
• [22]HIV and AIDS Data Hub for Asia‒Pacific: Law, policy & HIV in Asia and the Pacific: implications on the vulnerability of men who have sex with men, female sex workers and injecting drug users. 2009. http://aidsdatahub.org/dmdocuments/Law_Policy_HIV_2009_HADH.pdf webcite
• [23]Hayashi K, Milloy MJ, Fairbairn N, Kaplan K, Lai C, Wood E, Kerr T: Incarceration experiences among a community-recruited sample of injection drug users in Bangkok. Thailand. BMC Public Health 2009, 9(1):492. BioMed Central Full Text
• [24]Ti L, Hayashi K, Kaplan K, Suwannawong P, Fu E, Wood E, Kerr T: HIV testing and willingness to get HIV testing at a peer-run drop-in centre for people who inject drugs in Bangkok. Thailand. BMC Public Health 2012, 12(1):189. BioMed Central Full Text
• [25]Cooper H, Moore L, Gruskin S, Krieger N: Characterizing perceived police violence: implications for public health. Am J Public Health 2004, 94(7):1109-1118.
• [26]McNutt LA, Wu C, Xue X, Hafner JP: Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 2003, 157(10):940-943.
• [27]Spiegelman D, Hertzmark E: Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol 2005, 162(3):199-200.
• [28]Deddens JA, Petersen MR: Approaches for estimating prevalence ratios. Occup Environ Med 2008, 65(7):481. 501–486
• [29]Barrett ME, Perngparn U: Rapid assessment and response: preparation for the scale-up of comprehensive harm reduction services in Thailand: Bangkok province. Bangkok: Asian Harm Reduction Network & Public Health Sciences College, Chulalongkorn University; 2010. http://new.ahrn.net/wp-content/uploads/2010/06/RAR2010_Pub_ENG_BKK.pdf webcite
• [30]Hoonsara S, Kijchalong T, Jaichalard P: Govt to respond to Queen’s concerns about drugs. Bangkok: The Nation; 2011.
• [31]Bangkok Post: Top cop orders blitz on drugs. Bangkok: Bangkok Post; 2011.
• [32]Booth RE, Dvoryak S, Anderson C, Brewster JT, Strathdee SA: Police brutality is independently associated with sharing injection equipment among injection drug users in Odessa, Ukraine. Presented at The 18th International AIDS Conference. Vienna, Austria; 2010. http://www.iasociety.org/Abstracts/A200737978.aspx webcite
• [33]Strathdee SA, Hallett TB, Bobrova N, Rhodes T, Booth R, Abdool R, Hankins CA: HIV and risk environment for injecting drug users: the past, present, and future. Lancet 2010, 376(9737):268-284.
• [34]Hayashi K, Ti L, Buxton JA, Kaplan K, Suwannawong P, Kerr T: The effect of exposures to policing on syringe sharing among people who inject drugs in Bangkok, Thailand. AIDS Behav 2013. [Epub ahead of print]
• [35]Constitution Drafting Commission: Constitution of the Kingdom of Thailand B.E. 2550 (2007). Bangkok: Bureau of Printing Services, Secretariat of the House of Representatives; 2007.
• [36]Maher L, Dixon D: Policing and public health: law enforcement and harm minimization in a street-level drug market. Br J Criminol 1999, 39(4):488-512.
• [37]Burris S, Blankenship KM, Donoghoe M, Sherman S, Vernick JS, Case P, Lazzarini Z, Koester S: Addressing the “risk environment” for injection drug users: the mysterious case of the missing cop. Milbank Q 2004, 82(1):125-156.
• [38]Sharma M, Chatterjee A: Partnering with law enforcement to deliver good public health: the experience of the HIV/AIDS Asia regional program. Harm Reduct J 2012, 9(1):24. BioMed Central Full Text
• [39]Midford R, Acres J, Lenton S, Loxley W, Boots K: Cops, drugs and the community: establishing consultative harm reduction structures in two Western Australian locations. Int J Drug Policy 2002, 13(3):185-192.
• [40]Jardine M, Crofts N, Monaghan G, Morrow M: Harm reduction and law enforcement in Vietnam: influences on street policing. Harm Reduct J 2012, 9(1):27. BioMed Central Full Text
• [41]Csete J, Cohen J: Health benefits of legal services for criminalized populations: the case of people who use drugs, sex workers and sexual and gender minorities. J Law Med Ethics 2010, 38(4):816-831.