期刊论文详细信息
Harm Reduction Journal
Drug-related harm among people who inject drugs in Thailand: summary findings from the Mitsampan Community Research Project
Thomas Kerr2  Evan Wood2  Paisan Suwannawong3  Karyn Kaplan3  Nadia Fairbairn2  Lianping Ti1  Kanna Hayashi4 
[1] Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada;Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences 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;Interdisciplinary Studies Graduate Program, University of British Columbia, Green College, Green Commons, Room 153A, 6201 Cecil Green Park Rd, Vancouver, BC V6T 1Z1, Canada
关键词: Thailand;    Community-based participatory research;    Harm reduction;    Drug law enforcement;    Injection drug use;   
Others  :  809849
DOI  :  10.1186/1477-7517-10-21
 received in 2012-07-09, accepted in 2013-09-24,  发布年份 2013
PDF
【 摘 要 】

Background

For decades, Thailand has experienced high rates of illicit drug use and related harms. In response, the Thai government has relied on drug law enforcement to address this problem. Despite these efforts, high rates of drug use persist, and Thailand has been contending with an enduring epidemic of human immunodeficiency virus (HIV) among people who inject drugs (IDU).

Methods

In response to concerns regarding drug-related harm in Thailand and a lack of research focused on the experiences and needs of Thai IDU, the Mitsampan Community Research Project was launched in 2008. The project involved administering surveys capturing a range of behavioral and other data to community-recruited IDU in Bangkok in 2008 and 2009.

Results

In total, 468 IDU in Bangkok were enrolled in the project. Results revealed high rates of midazolam injection, non-fatal overdose and incarceration. Syringe sharing remained widespread among this population, driven primarily by problems with access to syringes and methamphetamine injection. As well, reports of police abuse were common and found to be associated with high-risk behavior. Problems with access to evidence-based drug treatment and HIV prevention programs were also documented. Although compulsory drug detention centers are widely used in Thailand, data suggested that these centers have little impact on drug use behaviors among IDU in Bangkok.

Conclusions

The findings from this project highlight many ongoing health and social problems related to illicit drug use and drug policies in Bangkok. They also suggest that the emphasis on criminal justice approaches has resulted in human rights violations at the hands of police, and harms associated with compulsory drug detention and incarceration. Collectively, the findings indicate the urgent need for the implementation of evidence-based policies and programs in this setting.

【 授权许可】

   
2013 Hayashi et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140709024133345.pdf 629KB PDF download
Figure 2. 34KB Image download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】
  • [1]Reid G, Costigan G: Revisiting the hidden epidemic: a situation assessment of drug use in Asia in the context of HIV/AIDS. Fairfield: The Center for Harm Reduction, The Burnet Institute; 2002.
  • [2]McCoy AW, Read CB, Adams LP II: The politics of heroin in Southeast Asia. New York: Harper Colophon Books; 1972.
  • [3]Global SMART Programme: Patterns and trends of amphetamine-type stimulants and other drugs: Asia and the Pacific. Vienna: United Nations Office on Drugs and Crime (UNODC); 2011.
  • [4]Assanangkornchai S, Aramrattana A, Perngparn U, Kanato M, Kanika N, Na Ayudhya AS: Current situation of substance-related problems in Thailand. J Psych Associ Thai 2008, 53(Supplement 1):24S-36S.
  • [5]National AIDS Prevention and Alleviation Committee: UNGASS Country Progress Report Thailand: Reporting Period: January 2008 - December 2009. Bangkok; 2010. http://data.unaids.org/pub/Report/2010/thailand_2010_country_progress_report_en.pdf webcite
  • [6]Human Rights Watch, Thai AIDS Treatment Action Group: Deadly Denial: Barriers to HIV/AIDS Treatment for People who use Drugs in Thailand. Vol.19. New York: Human Rights Watch; 2007.
  • [7]Kerr T, Kaplan K, Suwannawong P, Jurgens R, Wood E: The global fund to fight AIDS, tuberculosis and malaria: funding for unpopular public-health programmes. Lancet 2004, 364(9428):11-12.
  • [8]World Health Organization (WHO), United Nations Office on Drugs and Crime (UNODC), The Joint United Nations Programme on HIV/AIDS (UNAIDS): 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.
  • [9]Woon laew! Sanub Sanun chai kem upakorn cheed tee sa-ad pongkan karn tid chuea HIV so pid kod mai [Promotion of clean syringes and paraphernalia for HIV prevention found breaching the law] Matichon Online 2011. http://www.matichon.co.th/news_detail.php?newsid=1313497910&grpid=03&catid=&subcatid webcite
  • [10]Thailand AIDS Response Progress Report 2012: Reporting Period: 2010–2011. 2012. http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_TH_Narrative_Report[1].pdf webcite
  • [11]Harm Reduction International: The global state of harm reduction 2012: towards an integrated response. Edited by Stoicescu C. London: Harm Reduction International; 2012.
  • [12]Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, Myers B, Ambekar A, Strathdee SA: HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet 2010, 375(9719):1014-1028.
  • [13]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.
  • [14]Thomson N: Detention as Treatment: Detention of Methamphetamine Users in Cambodia, Laos, and Thailand. New York: International Harm Reduction Development Program, Open Society Institute; 2010.
  • [15]Human Rights Watch: Not Enough Graves: the war on Drugs, HIV/AIDS, and Violations of Human Rights. Vol. 16. New York: Human Rights Watch; 2004.
  • [16]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
  • [17]Thailand Office of the Narcotics Control Board: Roadmap of Drug Surveillance and Establishment of Sustainable Victory Over Drugs 2006–2008. Bangkok; 2006. http://en.oncb.go.th/document/Roadmap06-08.pdf webcite
  • [18]Thailand Office of the Narcotics Control Board: National Narcotics Control Policy on Five Fences Strategy: 2009–2010. Bangkok; 2009. http://en.oncb.go.th/document/e1-info-5Fence.html webcite
  • [19]Hayashi K, Fairbairn N, Suwannawong P, Kaplan K, Wood E, Kerr T: Collective empowerment while creating knowledge: a description of a community-based participatory research project with drug users in Bangkok, Thailand. Subst Use Misuse 2012, 47(5):502-510.
  • [20]Kerr T, Kiatying-Angsule N, Fairbairn N, Hayashi K, Suwannawong P, Kaplan K, Zhang R, Wood E: High rates of midazolam injection among drug users in Bangkok, Thailand. Harm Reduction Journal 2010, 7(1):7. BioMed Central Full Text
  • [21]Kerr T, Fairbairn N, Hayashi K, Suwannawong P, Kaplan K, Zhang R, Wood E: Difficulty accessing syringes and syringe borrowing among injection drug users in Bangkok, Thailand. Drug Alcohol Rev 2010, 29(2):157-161.
  • [22]Hayashi K, Wood E, Suwannawong P, Kaplan K, Qi J, Kerr T: Methamphetamine injection and syringe sharing among a community-recruited sample of injection drug users in Bangkok, Thailand. Drug Alcohol Depend 2011, 115(1–2):145-149.
  • [23]Milloy MJ, Fairbairn N, Hayashi K, Suwannawong P, Kaplan K, Wood E, Kerr T: Overdose experiences among injection drug users in Bangkok, Thailand. Harm Reduction J 2010, 7:9. BioMed Central Full Text
  • [24]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
  • [25]Csete J, Kaplan K, Hayashi K, Fairbairn N, Suwannawong P, Zhang R, Wood E, Kerr T: Compulsory drug detention center experiences among a community-based sample of injection drug users in Bangkok, Thailand. BMC Int Health Human Rights 2011, 11(1):12. BioMed Central Full Text
  • [26]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 Human Rights 2009, 9:24. BioMed Central Full Text
  • [27]Werb D, Hayashi K, Fairbairn N, Kaplan K, Suwannawong P, Lai C, Kerr T: Drug use patterns among Thai illicit drug injectors amidst increased police presence. Subst Abuse Treat Prev Policy 2009, 4:16. BioMed Central Full Text
  • [28]Fairbairn N, Hayashi K, Kaplan K, Suwannawong P, Qi J, Wood E, Kerr T: Factors associated with methadone treatment among injection drug users in Bangkok, Thailand. J Subst Abuse Treat 2012, 43(1):108-113.
  • [29]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
  • [30]Hayashi K, Montaner J, Kaplan K, Suwannawong P, Wood E, Qi J, Kerr T: Low uptake of hepatitis C testing and high prevalence of risk behavior among HIV-positive injection drug users in Bangkok, Thailand. J Acquir Immune Defic Syndr 2011, 56(5):e133-e135.
  • [31]Kerr T, Hayashi K, Fairbairn N, Kaplan K, Suwannawong P, Zhang R, Wood E: Expanding the reach of harm reduction in Thailand: experiences with a drug user-run drop-in centre. Int J Drug Policy 2010, 21(3):255-258.
  • [32]Marshall BD, Wood E, Li K, Kerr T: Elevated syringe borrowing among men who have sex with men: a prospective study. J Acquir Immune Defic Syndr 2007, 46(2):248-252.
  • [33]Pollini RA, Brouwer KC, Lozada RM, Ramos R, Cruz MF, Magis-Rodriguez C, Case P, Burris S, Pu M, Frost SD, et al.: Syringe possession arrests are associated with receptive syringe sharing in two Mexico-US border cities. Addiction 2008, 103(1):101-108.
  • [34]Perngmark P, Celentano DD, Kawichai S: Needle sharing among southern Thai drug injectors. Addiction 2003, 98(8):1153-1161.
  • [35]Perngmark P, Vanichseni S, Celentano DD: The Thai HIV/AIDS epidemic at 15 years: sustained needle sharing among southern Thai drug injectors. Drug Alcohol Depend 2008, 92(1–3):183-190.
  • [36]Martin M, Vanichseni S, Suntharasamai P, Mock PA, Van Griensven F, Pitisuttithum P, Tappero JW, Chiamwongpaet S, Sangkum U, Kitayaporn D, et al.: Drug use and the risk of HIV infection amongst injection drug users participating in an HIV vaccine trial in Bangkok, 1999–2003. Int J Drug Policy 2010, 21(4):296-301.
  • [37]Wattana W, Van Griensven F, Rhucharoenpornpanich O, Manopaiboon C, Thienkrua W, Bannatham R, Fox K, Mock PA, Tappero JW, Levine WC: Respondent-driven sampling to assess characteristics and estimate the number of injection drug users in Bangkok, Thailand. Drug Alcohol Depend 2007, 90(2–3):228-233.
  • [38]Hulse GK, English DR, Milne E, Holman CD: The quantification of mortality resulting from the regular use of illicit opiates. Addiction 1999, 94(2):221-229.
  • [39]Stoove MA, Dietze PM, Aitken CK, Jolley D: Mortality among injecting drug users in Melbourne: a 16-year follow-up of the Victorian Injecting Cohort Study (VICS). Drug Alcohol Depend 2008, 96(3):281-285.
  • [40]Degenhardt L, Bucello C, Mathers B, Briegleb C, Ali H, Hickman M, McLaren J: Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies. Addiction 2011, 106(1):32-51.
  • [41]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.
  • [42]Tyndall M: Harm reduction policies and interventions for injection drug users in Thailand. Bangkok: World Bank; 2011.
  • [43]Martin M, Vanichseni S, Suntharasamai P, Sangkum U, Chuachoowong R, Mock PA, Leethochawalit M, Chiamwongpaet S, Kittimunkong S, Van Griensven F, et al.: Enrollment characteristics and risk behaviors of injection drug users participating in the Bangkok Tenofovir Study, Thailand. PLoS One 2011, 6(9):e25127.
  • [44]Walsh N, Verster A, Doupe A, Vitoria M, Lo Y-R, Wiersma S: 3.1. The silent epidemic: responding to viral hepatitis among people who inject drugs. In Global State of Harm Reduction 2010: Key Issues for Broadening the Response. Edited by Cook C. London: International Harm Reduction Association; 2010.
  • [45]World Health Organization Regional Office for Europe (WHO-EURO): 6. Management of hepatitis C and HIV coinfection. In HIV/AIDS Treatment and Care: Clinical Protocols for the WHO European Region. Edited by Eramova I, Matic S, Munz M. Copenhagen: WHO-EURO; 2007.
  • [46]Sulkowski MS, Thomas DL: Hepatitis C in the HIV-infected person. Ann Intern Med 2003, 138(3):197-207.
  • [47]Broadhead RS, Heckathorn DD, Weakliem DL, Anthony DL, Madray H, Mills RJ, Hughes J: Harnessing peer networks as an instrument for AIDS prevention: results from a peer-driven intervention. Public Health Rep 1998, 113(Suppl 1):42-57.
  • [48]Grund JP, Blanken P, Adriaans NF, Kaplan CD, Barendregt C, Meeuwsen M: Reaching the unreached: targeting hidden IDU populations with clean needles via known user groups. J Psychoactive Drugs 1992, 24(1):41-47.
  • [49]Latkin CA: Outreach in natural settings: the use of peer leaders for HIV prevention among injecting drug users’ networks. Public Health Rep 1998, 113(Suppl 1):151-159.
  • [50]Needle RH, Burrows D, Friedman SR, Dorabjee J, TouzÈ G, Badrieva L, Grund J-PC, Kumar MS, Nigro L, Manning G, Latkin C: Effectiveness of community-based outreach in preventing HIV/AIDS among injecting drug users. I J Drug Policy 2005, 16(Supplement 1):45-57.
  • [51]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.
  • [52]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.
  • [53]Jurgens R: Effectiveness of Interventions to Address HIV in Prisons. Geneva: World Health Organization (WHO), United Nations Office on Drugs and Crime (UNODC), and Joint United Nations Programme on HIV/AIDS (UNAIDS); 2007.
  • [54]Friedman SR, Cooper HL, Tempalski B, Keem M, Friedman R, Flom PL, Des Jarlais DC: Relationships of deterrence and law enforcement to drug-related harms among drug injectors in US metropolitan areas. AIDS 2006, 20(1):93-99.
  • [55]Maher L, Li J, Jalaludin B, Wand H, Jayasuriya R, Dixon D, Kaldor JM: Impact of a reduction in heroin availability on patterns of drug use, risk behaviour and incidence of hepatitis C virus infection in injecting drug users in New South Wales, Australia. Drug Alcohol Depend 2007, 89(2–3):244-250.
  • [56]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.
  • [57]Sarang A, Rhodes T, Sheon N, Page K: Policing drug users in Russia: risk, fear, and structural violence. Subst Use Misuse 2010, 45(6):813-864.
  • [58]Department of Corrections, Ministry of Justice, Thailand: Number of Convicted Prisoners by Type of Offences. http://www.correct.go.th/eng/number_by_type_of_offences.html webcite
  • [59]Beyrer C, Jittiwutikarn J, Teokul W, Razak MH, Suriyanon V, Srirak N, Vongchuk T, Tovanabutra S, Sripaipan T, Celentano DD: Drug use, increasing incarceration rates, and prison-associated HIV risks in Thailand. AIDS Behav 2003, 7(2):153-161.
  • [60]Choopanya K, Des Jarlais DC, Vanichseni S, Kitayaporn D, Mock PA, Raktham S, Hireanras K, Heyward WL, Sujarita S, Mastro TD: Incarceration and risk for HIV infection among injection drug users in Bangkok. J Acquir Immune Defic Syndr 2002, 29(1):86-94.
  • [61]Buavirat A, Page-Shafer K, Van Griensven GJP, Mandel JS, Evans J, Chuaratanaphong J, Chiamwongpat S, Sacks R, Moss A: Risk of prevalent HIV infection associated with incarceration among injecting drug users in Bangkok, Thailand: case–control study. Br Med J 2003, 326(7384):308.
  • [62]Darke S, Hall W: Heroin overdose: research and evidence-based intervention. J Urban Health 2003, 80(2):189-200.
  • [63]Punsuwan N, Namwat C, Tanpradech S, Pratheepkaew N, Yodreaun K, Jarupan S: Correlates of HIV infection among injection drug users in Bangkok Metropolitan Regions, Chiangmai and Songkhla, Thailand [abstract]. In The 10th International Congress on AIDS in Asia and the Pacific: 26–30 Augusut 2011. Busan, Korea: SuPA042; 209.
  • [64]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.
  • [65]Weatherby NL, Needle R, Cesari H, Booth R, McCoy CB, Watters JK, Williams M, Chitwood DD: Validity of self-reported drug use among injection drug users and crack cocaine users recruited through street outreach. Eval Program Plann 1994, 17(4):347-355.
  • [66]Darke S: Self-report among injecting drug users: a review. Drug Alcohol Depend 1998, 51(3):253-263. discussion 267–258
  文献评价指标  
  下载次数:11次 浏览次数:41次