title: Human rights abuses and suicidal ideation among male injecting drug users in Delhi, India.
abstract: BACKGROUND
  Human rights abuses, denial of care, police surveillance, and violence directed at IDUs have been found to impact HIV prevention efforts due to decreased attendance in harm reduction programs. The association of mental health status with rights abuses has not been examined extensively among drug users. In India, drug control laws are often in conflict with harm reduction policies, thus increasing the likelihood of rights abuses against IDUs. The purpose of this study was to describe human rights abuses occurring among IDUs in Delhi and examine their association with suicidal ideation.
  
  
  METHODS
  343 IDUs were recruited in two research sites in Delhi through respondent driven sampling and were interviewed with a cross sectional survey questionnaire that included items on human rights and socio demographics.
  
  
  RESULTS
  IDUs in the study experienced many human rights abuses. Notably among these were denial of admission into hospital (38.5%), denial of needles and syringes (20%), police arrests for carrying needles and using drugs (85%), verbal abuse (95%) and physical abuse (88%). Several human rights abuses were associated with suicidal ideation. These include being denied needles and syringes (OR: 7.28, 95% CI: 3.03-17.49); being arrested by police for carrying needles and using drugs (OR: 2.53, 95% CI: 1.06-6.03), and being physically abused (OR: 1.66, 95% CI: 1.05-2.23). The likelihood of suicidal ideation is also strongly related to the cumulative number of abuses.
  
  
  CONCLUSIONS
  These findings demonstrate that there is a high prevalence of human rights abuses among IDUs in Delhi. Given the alarming rate of suicidal ideation and its close relationship with human rights abuses it is essential that IDU interventions are executed within a rights-based framework.
authors: The Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E5039, Baltimore, MD 21205, USA. esarin@jhsph.edu
authors: Enisha
authors: E
authors: Sarin
authors: Luke
authors: L
authors: Samson
authors: Michael
authors: M
authors: Sweat
authors: Chris
authors: C
authors: Beyrer
mesh_terms: D000293:Adolescent; D000328:Adult; D003415:Crime; D003430:Cross-Sectional Studies; D003717:Denial, Psychological; D055030:Drug Users / Q000523:psychology*; D006297:Health Services Accessibility; D045809:Human Rights Abuses / Q000523:psychology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007407:Interviews as Topic; D035846:Law Enforcement; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016017:Odds Ratio; D011287:Prejudice; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology*; D059020:Suicidal Ideation; D014505:Urban Population; D014754:Violence; D055815:Young Adult