title: The association between law enforcement encounters and syringe sharing among IDUs on skid row: a mixed methods analysis.
abstract: The legal environment is one factor that influences injection drug users' (IDUs) risk for HIV and other bloodborne pathogens such as hepatitis C virus (HCV). We examined the association between law enforcement encounters (i.e., arrests and citations) and receptive syringe sharing among IDUs in the context of an intensified policing effort. We conducted a mixed methods analysis of 30 qualitative and 187 quantitative interviews with IDUs accessing services at a Los Angeles, CA syringe exchange program from 2008 to 2009. Qualitative findings illustrate concerns related to visibility, drug withdrawal, and previous history of arrest/incarceration. In quantitative analysis, the number of citations received, current homelessness, and perceiving that being arrested would be a "big problem" were independently associated with recent syringe sharing. Findings illustrate some of the unintended public health consequences associated with intensified street-level policing, including risk for HIV and HCV transmission.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0849, La Jolla, CA, 92093-0849, USA, kdwagner@ucsd.edu.
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wagner
authors.forename: Rebecca
authors.initials: R
authors.lastname: Simon-Freeman
authors.forename: Ricky N
authors.initials: RN
authors.lastname: Bluthenthal
mesh_terms: D000328:Adult; D000368:Aged; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D035846:Law Enforcement / Q000379:methods; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000331:legislation & jurisprudence*; D016495:Police; D011204:Poverty Areas; D011634:Public Health / Q000331:legislation & jurisprudence; D011640:Public Policy / Q000331:legislation & jurisprudence; D036301:Qualitative Research; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations