Shooting Gallery Attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: Correlates, Prevention Opportunities, and the Role of the Environment

Philbin, Morgan M.; Pollini, Robin A.; Ramos, Rebecca; Lozada, Remedios; Brouwer, Kimberly C.; Ramos, María Elena; Firestone-Cruz, Michelle; Case, Patricia; Strathdee, Steffanie A.

doi:10.1007/s10461-008-9372-6

Cited by 43 publications

(45 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that nearly half of this sample of PWIDs had experienced at least one non-fatal overdose in their lifetime, consistent with other research (Bradvik et al, 2007; Latkin et al, 2004; Philbin et al, 2008; Pollini et al, 2006; Seal et al, 2001; Sergeev et al, 2003; Sherman et al, 2007). Further, we found that 8% of the sample had experienced a non-fatal overdose in the previous six months.…”

Section: Discussionsupporting

confidence: 90%

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Wagner

Liu

Davidson

et al. 2015

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background Accidental overdose, driven largely by opioids, is a leading cause of death among people who inject drugs (PWIDs). We conducted secondary analysis of data from a cohort of PWIDs to identify venues where high-risk PWID could be targeted by overdose education/naloxone distribution (OEND) programs. Methods 573 PWIDs completed a quantitative survey between June, 2012 and January, 2014, which was analyzed using multivariable logistic regression. The dependent variable was a dichotomous indicator of experiencing a heroin/opioid-related overdose in the past six months. Independent variables included: demographics, drug use behavior, and encounters with two venues – the health care and criminal justice systems – that could serve as potential venues for OEND programs. Results Almost half (41.5%) reported ever experiencing a heroin/opioid overdose, and 45 (7.9%) reported experiencing at least one heroin/opioid overdose in the past six months. In the final multivariable model, receiving care in a hospital in the past six months (Adjusted Odds Ratio [AdjOR] 4.08, 95% Confidence Interval [C.I.] 2.07 -- 8.04, p<0.001) and being arrested for drug possession in the past six months (AdjOR 5.17, 95% C.I. 2.37 – 11.24, p<0.001) were associated with experiencing an opioid overdose in the past six months. Conclusions Identifying venues outside of those that traditionally target services to PWIDs (i.e., syringe exchange programs) will be critical to implementing OEND interventions at a scale sufficient to address the growing epidemic of heroin/opioid related deaths. Clinical settings, such as hospitals, and drug-related encounters with law enforcement officers are promising venues for the expansion of OEND programs.

show abstract

Section: Discussionsupporting

confidence: 90%

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Wagner

Liu

Davidson

et al. 2015

Drug and Alcohol Dependence

View full text Add to dashboard Cite

show abstract

“…This parallels previous research in this region, highlighting the role of actual and perceived police practices as facilitators of risk behaviors and barriers to protective behaviors, including pharmacy-based syringe access. 18,29,33,36,50,52,53 Women in this sample may encounter additional risks stemming from syringe confiscation in the realm of sexual transmission. Literature suggests that police officers often use drug and syringe possession and commercial sex activity to extort sexual services, 2,5,16,18,51,54 a paradigm clearly accentuated by our finding that syringe confiscation was independently associated with police sexual abuse.…”

Section: Discussionmentioning

confidence: 99%

“…Although police officers may perceive syringe confiscation as deterring drug use and furthering occupational safety, 31 evidence suggests that it instead triggers HIV risk behaviors: IDUs may react to confiscation by sharing syringes with others, rushing injection and injecting in public places most proximate to drug acquisition points, and using services of hit doctors or shooting galleries. 23,24,32,33 Syringe confiscation may also deter IDUs from carrying syringes to avoid detection, extortion, and abuse, meanwhile encouraging dangerous injection behaviors designed to conceal track marks, including groin injection. 5,29,33 More broadly, extra-judicial police practices undermine IDU trust in the laws authorizing syringe possession and erode the credibility of community health providers who promote syringe access.…”

Section: Introductionmentioning

confidence: 99%

“…23,24,32,33 Syringe confiscation may also deter IDUs from carrying syringes to avoid detection, extortion, and abuse, meanwhile encouraging dangerous injection behaviors designed to conceal track marks, including groin injection. 5,29,33 More broadly, extra-judicial police practices undermine IDU trust in the laws authorizing syringe possession and erode the credibility of community health providers who promote syringe access. 22 On a systems level, syringe confiscation runs counter to HIV prevention initiatives, such as SEPs, pharmacy-based distribution, and related syringe access services.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Syringe Confiscation as an HIV Risk Factor: The Public Health Implications of Arbitrary Policing in Tijuana and Ciudad Juarez, Mexico

Lozada²,

et al. 2012

Self Cite

View full text Add to dashboard Cite

Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/ STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over the counter without a prescription, but police practices are often at odds with the law. FSWIDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48 %. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR]=2.54, 95 % confidence interval [CI]=1.11-5.80), reporting sexual abuse by police (aOR=12.76, 95 % CI=6.58-24.72), engaging in groin injection (aOR=1.84, 95 % CI=1.15-2.93), injecting in public (aOR=1.64; 95 % CI=1.14-2.36), and obtaining syringes from pharmacies (aOR=1.54; 95 % CI=1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR= 0.92, 95 % CI=0.87-0.98) as was frequent injection with clients within the last month (aOR=0.64,). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

show abstract

“…We propose that risk environments are "racialized" when the presence of a particular protective or harmful feature varies across geographic areas according to their racial/ethnic composition. Drug-related arrests exemplify such a feature of the risk environment: The threat of arrest imperils injectors' ability to engage in harm reduction, [37][38][39][40][41][42][43][44][45][46][47][48] and drug-related arrest rates are higher in predominately Latino and/or Black communities, particularly those that are impoverished. 49,50 We posit that spatial access to pharmacies selling OTC syringes is another racialized feature of injectors' risk environments.…”

Section: Introductionmentioning

confidence: 99%

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

et al. 2009

View full text Add to dashboard Cite

Pharmacies that sell over-the-counter (OTC) syringes are a major source of sterile syringes for injection drug users in cities and states where such sales are legal. In these cities and states, however, black injectors are markedly less likely to acquire syringes from pharmacies than white injectors. The present analysis documents spatial and temporal trends in OTC pharmacy access in New York City health districts over time (2001)(2002)(2003)(2004)(2005)(2006) and investigates whether these trends are related to district racial/ ethnic composition and to local need for OTC pharmacies. For each year of the study period, we used kernel density estimation methods to characterize spatial access to OTC pharmacies within each health district. Higher values on this measure indicate better access to these pharmacies. "Need" was operationalized using two different measures: the number of newly diagnosed injection-related AIDS cases per 10,000 residents (averaged across 1999-2001), and the number of drug-related hospital discharges per 10,000 residents (averaged across 1999-2001). District sociodemographic characteristics were assessed using 2000 US decennial census data. We used hierarchical linear models (HLM) for descriptive and inferential analyses and investigated whether the relationship between need and temporal trajectories in the Expanded Syringe Access Demonstration Program access varied by district racial/ethnic composition, controlling for district poverty rates. HLM analyses indicate that the mean spatial access to OTC pharmacies across New York City health districts was 12.71 in 2001 and increased linearly by 1.32 units annually thereafter. Temporal trajectories in spatial access to OTC pharmacies depended on both need and racial/ethnic composition. Within high-need districts, OTC pharmacy access was twice as high in 2001 and increased three times faster annually, in districts with higher proportions of non-Hispanic white residents than in districts with low proportions of these residents. In low-need districts, "whiter" districts had substantially greater baseline access to OTC pharmacies than districts with low proportions of non-Hispanic white residents. Access remained stable thereafter in low-need districts, regardless of racial/ethnic composition. Conclusions were consistent across both measures of "need" and persisted after controlling for local poverty rates. In both high-and low-need districts, spatial access to OTC pharmacies was greater in "Whiter" districts in 2001; in high-need 929districts, access also increased more rapidly over time in "whiter" districts. Ensuring equitable spatial access to OTC pharmacies may reduce injection-related HIV transmission overall and reduce racial/ethnic disparities in HIV incidence among injectors.

show abstract

Shooting Gallery Attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: Correlates, Prevention Opportunities, and the Role of the Environment

Cited by 43 publications

References 47 publications

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Syringe Confiscation as an HIV Risk Factor: The Public Health Implications of Arbitrary Policing in Tijuana and Ciudad Juarez, Mexico

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

Contact Info

Product

Resources

About