Compulsory drug detention exposure is associated with not receiving antiretroviral treatment among people who inject drugs in Bangkok, Thailand: a cross-sectional study
| Autor: | Julio S. G. Montaner, Lianping Ti, Karyn Kaplan, Thomas Kerr, Evan Wood, Paisan Suwannawong, Anchalee Avihingsanon, Kanna Hayashi |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Program evaluation medicine.medical_specialty Multivariate analysis Anti-HIV Agents Cross-sectional study Psychological intervention 030508 substance abuse HIV Infections Health Services Accessibility Young Adult 03 medical and health sciences 0302 clinical medicine Environmental health Health care medicine Humans 030212 general & internal medicine Substance Abuse Intravenous Psychiatry Peer-based intervention business.industry Prisoners Research Health Policy Public health Odds ratio Thailand 16. Peace & justice Compulsory drug detention 3. Good health Psychiatry and Mental health Health psychology Cross-Sectional Studies Injection drug use Female 0305 other medical science business ART |
| Zdroj: | Substance Abuse Treatment, Prevention, and Policy |
| ISSN: | 1747-597X |
| DOI: | 10.1186/s13011-015-0013-6 |
| Popis: | Background Thailand has experienced a longstanding epidemic of HIV among people who inject drugs (PWID). However, antiretroviral treatment (ART) coverage among HIV-positive PWID has historically remained low. While ongoing drug law enforcement involving periodic police crackdowns is known to increase the risk of HIV transmission among Thai PWID, the impact of such drug policy approaches on the ART uptake has been understudied. Therefore, we sought to identify factors associated with not receiving ART among HIV-positive PWID in Bangkok, Thailand, with a focus on factors pertaining to drug law enforcement. Methods Data were collected from a community-recruited sample of HIV-positive PWID in Bangkok who participated in the Mitsampan Community Research Project between June 2009 and October 2011. We identified factors associated with not receiving ART at the time of interview using multivariate logistic regression. Results In total, 128 HIV-positive PWID participated in this study, with 58 (45.3%) reporting not receiving ART at the time of interview. In multivariate analyses, completing less than secondary education (adjusted odds ratio [AOR]: 3.32 ; 95% confidence interval [CI]: 1.48 – 7.45), daily midazolam injection (AOR: 3.22, 95% CI: 1.45 – 7.15) and exposure to compulsory drug detention (AOR: 3.36, 95% CI: 1.01 – 11.21) were independently and positively associated with not receiving ART. Accessing peer-based healthcare information or support services was independently and positively associated with receiving ART (AOR: 0.21, 95% CI: 0.05 – 0.84). Conclusions Approximately half of our study group of HIV-positive PWID reported not receiving ART at the time of interview. Daily midazolam injectors, those with lower education attainment, and individuals who had been in compulsory drug detention were more likely to be non-recipients of ART whereas those who accessed peer-based healthcare-related services were more likely to receive ART. These findings suggest a potentially adverse impact of compulsory drug detention and highlight the need to expand interventions to facilitate access to ART among HIV-positive PWID in this setting. |
| Databáze: | OpenAIRE |
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