Policing Practices and Risk of HIV Infection Among People Who Inject Drugs.

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologic Reviews Pub Date : 2020-01-31 DOI:10.1093/epirev/mxaa010
Pieter Baker, Leo Beletsky, Liliana Avalos, Christopher Venegas, Carlos Rivera, Steffanie A Strathdee, Javier Cepeda
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Abstract

Drug-law enforcement constitutes a structural determinant of health among people who inject drugs (PWID). Street encounters between police and PWID (e.g., syringe confiscation, physical assault) have been associated with health harms, but these relationships have not been systematically assessed. We conducted a systematic literature review to evaluate the contribution of policing to risk of human immunodeficiency virus (HIV) infection among PWID. We screened MEDLINE, sociological databases, and gray literature for studies published from 1981 to November 2018 that included estimates of HIV infection/risk behaviors and street policing encounters. We extracted and summarized quantitative findings from all eligible studies. We screened 8,201 abstracts, reviewed 175 full-text articles, and included 27 eligible analyses from 9 countries (Canada, China, India, Malaysia, Mexico, Russia, Thailand, Ukraine, and the United States). Heterogeneity in variable and endpoint selection precluded meta-analyses. In 5 (19%) studies, HIV infection among PWID was significantly associated with syringe confiscation, reluctance to buy/carry syringes for fear of police, rushed injection due to a police presence, fear of arrest, being arrested for planted drugs, and physical abuse. Twenty-one (78%) studies identified policing practices to be associated with HIV risk behaviors related to injection drug use (e.g., syringe-sharing, using a "shooting gallery"). In 9 (33%) studies, policing was associated with PWID avoidance of harm reduction services, including syringe exchange, methadone maintenance, and safe consumption facilities. Evidence suggests that policing shapes HIV risk among PWID, but lower-income settings are underrepresented. Curbing injection-related HIV risk necessitates additional structural interventions. Methodological harmonization could facilitate knowledge generation on the role of police as a determinant of population health.

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警务实践与注射吸毒者感染艾滋病毒的风险。
禁毒执法是注射吸毒者(PWID)健康的结构性决定因素。警察与注射吸毒者之间的街头冲突(如没收注射器、人身攻击)与健康危害有关,但这些关系尚未得到系统评估。我们进行了一项系统性文献综述,以评估警务对吸毒者感染人体免疫缺陷病毒(HIV)风险的影响。我们筛选了 MEDLINE、社会学数据库和灰色文献,以查找 1981 年至 2018 年 11 月期间发表的、包含 HIV 感染/危险行为和街头治安遭遇估计值的研究。我们从所有符合条件的研究中提取并总结了定量研究结果。我们筛选了 8201 篇摘要,审阅了 175 篇全文,并纳入了来自 9 个国家(加拿大、中国、印度、马来西亚、墨西哥、俄罗斯、泰国、乌克兰和美国)的 27 项符合条件的分析。变量和终点选择的异质性排除了荟萃分析。在 5 项(19%)研究中,感染艾滋病病毒的吸毒者与注射器被没收、因害怕警察而不愿购买/携带注射器、因警察在场而匆忙注射、害怕被捕、因种植毒品而被捕以及身体虐待有显著关联。21项(78%)研究发现,治安管理措施与注射吸毒相关的艾滋病风险行为(如共用注射器、使用 "射击场")有关。在 9 项(33%)研究中,治安与注射吸毒者避免使用减少伤害服务有关,包括注射器交换、美沙酮维持治疗和安全消费设施。有证据表明,治安影响了注射吸毒者感染艾滋病毒的风险,但低收入环境中的代表性不足。要遏制与注射相关的艾滋病毒风险,就必须采取更多的结构性干预措施。方法上的统一可以促进关于警察作为人口健康决定因素的作用的知识生成。
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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
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