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/AIDS2Interdisciplinary Studies Graduate Program, the University of British Columbia

3Thai AIDS Treatment Action Group/Mitsampan Harm Reduction Center4Department 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

War on drugs in 20032,800 extrajudicial killings

Kingdom's Unity for Victory over Drugs strategy in 2011Targeting 400,000 drug users into drug treatment

Photo from : Mahitthirook, A., Laohong, K.-O., 2012. Phones, CDs seized at prison. Bangkok Post, May 18.

Intensified police crackdowns in recent years

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

Methods

Mitsampan Community Research Project

• A collaborative research effort involving:

• Serial cross-sectional mixed-methods study

• 32 former/active drug users trained as peer researchers

• Peer researchers involved inall stages of the project

Thai AIDS Treatment Action GroupMitsampan Harm Reduction Center

ChulalongkornUniversity

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:

o Sociodemographic informationo Drug use patternso HIV risk behaviouro Experiences with drug law enforcemento Experiences with accessing healthcareo Health problemso Calendar year of study enrolment

Results

Descriptive Statistics“Have you ever been beaten by police?”

A community-recruited sample of IDU in Bangkok, June 2009 -

October 2011 (n=639)

Participants in 2011 (n=144) most commonly experienced police violence while:1. Being interrogated (68.1%)2. Being arrested (43.1%)3. Being searched (22.9%) 4. In police holding cells

(22.9%)

Multivariate Analyses

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:o Ongoing human rights violations at the hands of policeo The perpetuation of the HIV epidemic among Thai IDU

• A need for:o Greater police oversighto 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: Jirasak Sripramong, Kamon Uppakaew, Amnat Chamchern, Vipawan Suwannawong, Wiwat Chotichatmala, and Prapatsara Kaewkoon

Chulalongkorn University: Dr. Niyada Kiatying-Angsulee

BC CfE staff: Tricia Collingham, Cameron Dilworth, Deborah Graham, Caitlin Johnston, Daniel Miles Kane, Calvin Lai, Cristy Power, and Peter Vann

Research assistants: Prempreeda Pramoj Na Ayutthaya, Arphatsaporn Chaimongkon, Sattara Hattirat, and Puripakorn Pakdirat