The impact of compulsory drug detention exposure on the avoidance of healthcare among injection drug users in Thailand
The impact of compulsory drug detention exposure on the avoidance of healthcare among injection drug users in Thailand
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DOI：
10.1016/j.drugpo.2013.05.017
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发表时间：
2014-01-01
影响因子：
4.4
通讯作者：
Wood, Evan
中科院分区：
文献类型：
--
作者：
Kerr, Thomas;Hayashi, Kanna;Wood, Evan
背景：尽管泰国依靠使用强制性毒品拘留中心作为一种策略，试图解决有问题的毒品使用问题，但人们对接触这些中心对注射吸毒者的影响知之甚少。因此，我们进行了这项研究，以探讨暴露于强制性药物拘留是否与泰国IDU逃避医疗保健有关。方法：采用泊松回归分析，研究了曼谷Mitsampan社区研究项目参与者的强制性药物拘留暴露与避免医疗保健之间的关系。结果：435名IDU参与了本研究，其中111名（25.5%）参与者报告逃避医疗保健。在多变量分析中，逃避医疗保健与暴露于强制药物拘留（调整患病率比[APR] = 1.60； 95%可信区间[CI]: 1.16-2.21）、被拒绝医疗保健（APR = 3.46; 95% Cl: 2.61-4.60）和经历与吸毒相关的羞耻感（APR = 1.93; 95% CI: 1.21-3.09）呈正相关。结论：暴露于强制性药物拘留与泰国IDU逃避医疗保健有关，这表明这种拘留制度可能会增加这种情况下IDU可预防疾病的负担。虽然需要进一步的研究来证实这些发现，但这项研究的结果加强了先前的呼吁，即用基于证据的IDU公共卫生干预措施取代强制药物拘留制度。(C) 2013 Elsevier B.V.版权所有
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% Cl: 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. (C) 2013 Elsevier B.V. All rights reserved.