Factors associated with physical and sexual violence by police among people who inject drugs in Ukraine: implications for retention on opioid agonist therapy
Factors associated with physical and sexual violence by police among people who inject drugs in Ukraine: implications for retention on opioid agonist therapy
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DOI：
10.7448/ias.19.4.20897
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发表时间：
2016-07-01
影响因子：
6
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Kutsa, Oksana;Marcus, Ruthanne;Altice, Frederick L.
简介：乌克兰是东欧和中亚最大的艾滋病毒流行病之一，其艾滋病毒流行病仍然集中在注射毒品者身上。在估计的310 000名艾滋病毒感染者中，艾滋病毒感染率很高（21.3%至41.8%）。阿片类激动剂治疗（OAT）是最具成本效益的艾滋病毒预防策略，但OAT服务受到负面态度和执法人员对OAT客户和现场工作人员的频繁骚扰的阻碍。本文探讨了乌克兰PWID经历的各种类型的警察暴力和与不同类型暴力相关的因素，以及警察骚扰对OAT保留的可能影响。方法：在2014年至2015年，我们进行了一项横断面调查，在五个乌克兰城市与1613 PWID目前，以前和从来没有对OAT，使用相结合的受访者驱动的抽样，以及随机抽样。我们通过多种因素（包括性别）分析了警察暴力的相关性，以及它们对OAT保留时间的影响。自我报告的警察身体和性暴力是两个主要结果，而OAT的保留被用作次要结果。结果：总体而言，1033名（64.0%）PWID报告受到警察身体攻击，这与目前或以前使用OAT呈正相关（69.1%对60.2%; p
Introduction: Ukraine's volatile HIV epidemic, one of the largest in Eastern Europe and Central Asia, remains concentrated in people who inject drugs (PWID). HIV prevalence is high (21.3% to 41.8%) among the estimated 310,000 PWID. Opioid agonist therapy (OAT) is the most cost-effective HIV prevention strategy there, yet OAT services are hampered by negative attitudes and frequent harassment of OAT clients and site personnel by law enforcement. This paper examines the various types of police violence that Ukrainian PWID experience and factors associated with the different types of violence, as well as the possible implications of police harassment on OAT retention.Methods: In 2014 to 2015, we conducted a cross-sectional survey in five Ukrainian cities with 1613 PWID currently, previously and never on OAT, using a combination of respondent-driven sampling, as well as random sampling. We analysed correlates of police violence by multiple factors, including by gender, and their effects on duration of OAT retention. Self-reported physical and sexual violence by police were the two primary outcomes, while retention on OAT was used as a secondary outcome.Results: Overall, 1033 (64.0%) PWID reported being physically assaulted by police, which was positively correlated with currently or previously being on OAT (69.1% vs. 60.2%; p