title: Incarceration experiences among a community-recruited sample of injection drug users in Bangkok, Thailand.
abstract: BACKGROUND
  Since 2003 Thailand has waged an aggressive "war on drugs" campaign focused on arresting and incarcerating suspected drug users and dealers. However, little is known about incarceration experiences among IDU in the wake of the recent war on drugs. Therefore, we sought to examine incarceration experiences among IDU in Bangkok, Thailand.
  
  
  METHODS
  We examined the prevalence of incarceration among community-recruited IDU participating in the Mitsampan Community Research Project. Multivariate logistic regression was used to identify factors associated with a self-reported history of incarceration. We also examined the prevalence of injection drug use and syringe sharing within prisons.
  
  
  RESULTS
  252 IDU were recruited in August 2008; 66 (26.2%) were female and the median age was 36.5 years. In total, 197 (78.2%) participants reported a history of incarceration. In multivariate analyses, reporting a history of incarceration was associated with a history of compulsory drug treatment (adjusted odds ratio [AOR] = 4.93; 95% confidence interval [CI]: 1.95 - 12.48), non-fatal overdose (AOR = 3.69; 95%CI: 1.45 - 9.39), syringe sharing (AOR = 2.20; 95%CI: 1.12 - 4.32), and female gender (AOR = 0.41; 95%CI: 0.20 - 0.82). Among those who reported a history of incarceration, 59 (29.9%) reported injection drug use in prison, and 48 (81.4%) of these individuals reported sharing syringes in prison. Incarceration was not associated with the number of injections performed in the previous week (p = 0.202).
  
  
  CONCLUSIONS
  Over three-quarters of the IDU participating in this study reported a history of incarceration, and 30% of these individuals reported injection drug use within prison. Further, an alarmingly high level of syringe sharing within prison was reported, and incarceration was not associated with reductions in drug use. These findings provide further evidence of the need for community diversion strategies, as well as harm reduction programs, in Thai prisons.
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada. kanna.hayashi@gmail.com
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
authors.forename: M-J
authors.initials: MJ
authors.lastname: Milloy
authors.forename: Nadia
authors.initials: N
authors.lastname: Fairbairn
authors.forename: Karyn
authors.initials: K
authors.lastname: Kaplan
authors.forename: Paisan
authors.initials: P
authors.lastname: Suwannawong
authors.forename: Calvin
authors.initials: C
authors.lastname: Lai
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D013785:Thailand