title: Law enforcement practices associated with HIV infection among injection drug users in Odessa, Ukraine.
abstract: Despite HIV prevention efforts over the past 10 years in Odessa, Ukraine, HIV rates among injection drug users (IDUs) remain high. We explored whether IDUs' experiences with the police and court system in Odessa were associated with HIV serostatus, after controlling for other factors. Qualitative methods, including semi-structured interviews with the police and members of court (N = 19), and focus groups with IDUs (N = 42), were employed to aid in developing a survey instrument for a larger quantitative phase and to assist in interpreting the findings from the quantitative phase, which included 200 participants who were interviewed and tested for HIV. Overall, 55 % tested positive for HIV. Negative experiences with the police were noted by 86 % and included having preloaded syringes taken (66 %), rushed injections due to fear of the police (57 %), police planting drugs (18 %), paying police to avoid arrest (61 %) and threatened by the police to inform on other IDUs (23 %). HIV positive participants were more likely than those who were negative to report these experiences. In a multiple logistic regression, the most significant correlate of HIV infection was rushed injections due to fear of the police. Police actions in Odessa may be contributing to the continued escalation of HIV among IDUs, underscoring the need for structural interventions.
authors.affiliation: Department of Psychiatry, University of Colorado School of Medicine, Project Safe 1741 Vine Street, Denver, CO, 80206-1119, USA, Robert.booth@ucdenver.edu.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Booth
authors.forename: Sergey
authors.initials: S
authors.lastname: Dvoryak
authors.forename: Min
authors.initials: M
authors.lastname: Sung-Joon
authors.forename: John T
authors.initials: JT
authors.lastname: Brewster
authors.forename: William W
authors.initials: WW
authors.lastname: Wendt
authors.forename: Karen F
authors.initials: KF
authors.lastname: Corsi
authors.forename: Oleg Y
authors.initials: OY
authors.lastname: Semerik
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000328:Adult; D055030:Drug Users / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006301:Health Services Needs and Demand; D006801:Humans; D035846:Law Enforcement / Q000379:methods*; D008297:Male; D016495:Police; D036301:Qualitative Research; D012309:Risk-Taking; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013594:Syringes; D014455:Ukraine / Q000453:epidemiology