Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis

Ahmed, Tanvir; Long, Thanh Nguyen; Huong, Phan Thi Thu; Stewart, Donald Edwin

doi:10.1186/s12889-015-1404-3

Cited by 32 publications

(24 citation statements)

References 44 publications

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“…75 Police presence was associated with unsafe rushed injection among PWID in Bangkok in a multivariate analysis, 133 and a small sample of PWID in Hai Phong, Vietnam, reported greater likelihood of needle sharing and other risky practices when police were present or their presence was feared. 134 …”

Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

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Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

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Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

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“…Such policing practices are especially pervasive in settings where drug use is highly criminalized and stigmatized (e.g. United States (Beletsky et al, 2014), Mexico (Pinedo et al, 2015; Pollini et al, 2008), Russia (Sarang et al, 2006), Ukraine (Izenberg et al, 2013), Vietnam (Ahmed et al, 2015), and Malaysia (Michalopoulos et al, 2016)). These are some of the same settings where HIV prevalence among PWID is much higher than in the general population.…”

Section: Introductionmentioning

confidence: 99%

Assessing police officers’ attitudes and legal knowledge on behaviors that impact HIV transmission among people who inject drugs

Cepeda

Strathdee

Arredondo

et al. 2017

International Journal of Drug Policy

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Background Policing practices such as syringe confiscation and arrest can act as important social-structural drivers of HIV risk among people who inject drugs (PWID). However, police referral to treatment and other services may improve the health of PWID. Little is known about the role of modifiable attitudinal and knowledge factors in shaping officer behavior. Using baseline findings from a police education program (PEP), we assessed relationships between drug policy knowledge and attitudes towards public health interventions with self-reported syringe confiscation, drug arrest, and service referral among street-level police in Tijuana, Mexico. Methods Between February, 2015 and May, 2016 we surveyed 1,319 police officers who reported syringe contact. The self-administered survey focused on attitudes, knowledge, and behaviors related to drug policy, public health, and occupational safety. We used ordinal logistic regression to model the odds of syringe confiscation, arrest for heroin possession, and referring PWID to health/social programs. Results The sample was mostly male (87%) and had at least a high school education (80%). In the last six months, a minority reported always/sometimes confiscating syringes (49%), arresting someone for heroin possession (43%), and referring PWID to health and social programs (37%). Those reporting needlestick injuries (NSI) had 1.38 (95% CI: 1.02–1.87) higher odds of reporting syringe confiscation. Officers who had favorable views on laws that treat addiction as a public health issue had lower odds (aOR= 0.78; 95% CI: 0.59–1.03) of arresting PWID. Those agreeing that it was their role to refer PWID to health and social programs had higher odds of reporting such referrals (aOR: 3.32, 95% CI: 2.52–4.37). Legal knowledge was not associated with these practices. Conclusion Changing drug policy and knowledge may be insufficient in shifting police behavior. Modifying officers’ occupational risks and attitudes towards harm reduction interventions can facilitate efforts to align police practices with PWID health.

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“…It has an estimated population of 10,000 PWID and has experienced a very high prevalence of HIV among PWID, reaching 68% in 2006 (Ahmed et al, 2015). Around 3500 people were treated with methadone in 2014.…”

Section: Introductionmentioning

confidence: 99%

Intravenous heroin use in Haiphong, Vietnam: Need for comprehensive care including methamphetamine use-related interventions

Laurent

Jarlais

Thi

et al. 2017

Drug and Alcohol Dependence

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Background The aim of this study was to describe patterns among people who inject drugs (PWID), risk-related behaviours and access to methadone treatment, in order to design a large-scale intervention aiming to end the HIV epidemic in Haiphong, Vietnam. Methods A respondent-driven sampling (RDS) survey was first conducted to identify profiles of drug use and HIV risk-related behaviour among PWID. A sample of PWID was then included in a one-year cohort study to describe access to methadone treatment and associated factors. Results Among the 603 patients enrolled in the RDS survey, 10% were female, all were injecting heroin and 24% were using methamphetamine, including 3 (0.5%) through injection. Different profiles of risk-related behaviours were identified, including one entailing high-risk sexual behaviour (n = 37) and another involving drug-related high-risk practices (n = 22). High-risk sexual activity was related to binge drinking and methamphetamine use. Among subjects with low sexual risk, sexual intercourse with a main partner with unknown serostatus was often unprotected. Among the 250 PWID included in the cohort, 55.2% initiated methadone treatment during the follow-up (versus 4.4% at RDS); methamphetamine use significantly increased. The factors associated with not being treated with methadone after 52 weeks were fewer injections per month and being a methamphetamine user at RDS. Conclusion Heroin is still the main drug injected in Haiphong. Methamphetamine use is increasing markedly and is associated with delay in methadone initiation. Drug-related risks are low but sexual risk behaviours are still present. Comprehensive approaches are needed in the short term.

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Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis

Cited by 32 publications

References 44 publications

Public health and international drug policy

Public health and international drug policy

Assessing police officers’ attitudes and legal knowledge on behaviors that impact HIV transmission among people who inject drugs

Intravenous heroin use in Haiphong, Vietnam: Need for comprehensive care including methamphetamine use-related interventions

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