title: Syringe access, syringe sharing, and police encounters among people who inject drugs in New York City: a community-level perspective.
abstract: BACKGROUND
  Injection drug user (IDU) experience and perceptions of police practices may alter syringe exchange program (SEP) use or influence risky behaviour. Previously, no community-level data had been collected to identify the prevalence or correlates of police encounters reported by IDUs in the United States.
  
  
  METHODS
  New York City IDUs recruited through respondent-driven sampling were asked about past-year police encounters and risk behaviours, as part of the National HIV Behavioural Surveillance study. Data were analysed using multiple logistic regression.
  
  
  RESULTS
  A majority (52%) of respondents (n=514) reported being stopped by police officers; 10% reported syringe confiscation. In multivariate modelling, IDUs reporting police stops were less likely to use SEPs consistently (adjusted odds ratio [AOR]=0.59; 95% confidence interval [CI]=0.40-0.89), and IDUs who had syringes confiscated may have been more likely to share syringes (AOR=1.76; 95% CI=0.90-3.44), though the finding did not reach statistical significance.
  
  
  CONCLUSIONS
  Findings suggest that police encounters may influence consistent SEP use. The frequency of IDU-police encounters highlights the importance of including contextual and structural measures in infectious disease risk surveillance, and the need to develop approaches harmonizing structural policing and public health.
authors.affiliation: Northeastern University School of Law and Bouvé College of Health Sciences, 400 Huntington Avenue, Boston, MA 02115, USA; Division of Global Public Health, UCSD School of Medicine, La Jolla, CA, USA. Electronic address: leob@alumni.brown.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Beletsky
authors.affiliation: New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, USA.
authors.forename: Daliah
authors.initials: D
authors.lastname: Heller
authors.affiliation: Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Jenness
authors.affiliation: New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Neaigus
authors.affiliation: National Development and Research Institutes, 71 West 23rd Street, New York, NY 10010, USA.
authors.forename: Camila
authors.initials: C
authors.lastname: Gelpi-Acosta
authors.affiliation: New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D035846:Law Enforcement; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000523:psychology* / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs; D009519:New York City; D016495:Police / Q000706:statistics & numerical data*; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D055815:Young Adult
keywords: Barriers; Injection drug use; Policing; Public health surveillance; Structural factors; Syringe exchange programs
references.citation: Am J Public Health. 2004 Jul;94(7):1109-18
references.pmid: 15226128
references.citation: Public Health Rep. 2007;122 Suppl 1:32-8
references.pmid: 17354525
references.citation: J Urban Health. 2007 May;84(3):423-35
references.pmid: 17265133
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Sep 1;10(1):82-9
references.pmid: 7648290
references.citation: Soc Sci Med. 2005 Aug;61(3):673-84
references.pmid: 15899325
references.citation: Harm Reduct J. 2011 Apr 08;8:7
references.pmid: 21477299
references.citation: Am J Public Health. 2011 Nov;101(11):2012-5
references.pmid: 21940924
references.citation: Drug Alcohol Depend. 2011 Dec 1;119(1-2):145-9
references.pmid: 21705159
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Aug 15;18(5):505-11
references.pmid: 9715848
references.citation: Int J Drug Policy. 2008 Aug;19(4):332-8
references.pmid: 17900888
references.citation: J Urban Health. 2013 Apr;90(2):284-98
references.pmid: 22806453
references.citation: Am J Public Health. 2005 Aug;95(8):1439-44
references.pmid: 15985649
references.citation: AIDS. 2006 Jan 2;20(1):117-8
references.pmid: 16327327
references.citation: Int J Drug Policy. 2011 Mar;22(2):161-6
references.pmid: 21439808
references.citation: J Health Care Poor Underserved. 2005 Nov;16(4 Suppl B):48-56
references.pmid: 16327107
references.citation: AIDS. 2006 Nov 14;20(17):2217-23
references.pmid: 17086062
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Sep 1;10(1):104-5
references.pmid: 7648280
references.citation: Addiction. 2009 Sep;104(9):1441-6
references.pmid: 19215605
references.citation: Med Anthropol. 1997 Dec;18(1):61-83
references.pmid: 9458668
references.citation: AIDS. 1987 May;1(1):39-44
references.pmid: 3122788
references.citation: J Psychoactive Drugs. 2003 Oct-Dec;35(4):419-26
references.pmid: 14986870
references.citation: J Acquir Immune Defic Syndr. 2008 Mar 1;47(3):369-76
references.pmid: 18176320
references.citation: Public Health Rep. 2007;122 Suppl 1:48-55
references.pmid: 17354527
references.citation: Soc Sci Med. 2003 Jul;57(1):39-54
references.pmid: 12753815
references.citation: J Acquir Immune Defic Syndr. 2004 Jan 1;35(1):82-8
references.pmid: 14707797
references.citation: Addiction. 2008 Jan;103(1):101-8
references.pmid: 18028520
references.citation: Subst Abuse Treat Prev Policy. 2008 May 07;3:11
references.pmid: 18462491
references.citation: AIDS. 2006 Jan 2;20(1):93-9
references.pmid: 16327324
references.citation: PLoS One. 2011 Apr 25;6(4):e19048
references.pmid: 21541349
references.citation: Soc Sci Med. 2008 Feb;66(4):911-21
references.pmid: 18155336
references.citation: AIDS Behav. 2010 Aug;14(4):922-31
references.pmid: 18270809
references.citation: BMC Int Health Hum Rights. 2009 Oct 07;9:24
references.pmid: 19811653
references.citation: J Health Care Poor Underserved. 2004 Aug;15(3):319-35
references.pmid: 15453172
references.citation: J Urban Health. 2012 Aug;89(4):678-96
references.pmid: 22585448
references.citation: Am J Public Health. 2005 Feb;95(2):233-6
references.pmid: 15671455
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Jun 1;12(2):202-7
references.pmid: 8680893
references.citation: Addiction. 2009 Nov;104(11):1864-73
references.pmid: 19681800
references.citation: Harm Reduct J. 2012 May 16;9:17
references.pmid: 22591836
references.citation: J Public Health Policy. 1994 Winter;15(4):460-9
references.pmid: 7883946
references.citation: Health Hum Rights. 2012 Dec 15;14(2):34-48
references.pmid: 23568946
references.citation: Harm Reduct J. 2009 Jul 14;6:16
references.pmid: 19602236
references.citation: Subst Use Misuse. 2010 May;45(6):813-64
references.pmid: 20397872
references.citation: Ann N Y Acad Sci. 2010 Feb;1187:370-402
references.pmid: 20201863
references.citation: Milbank Q. 2004;82(1):125-56
references.pmid: 15016246
references.citation: Am J Public Health. 2000 Jul;90(7):1112-6
references.pmid: 10897190
references.citation: J Urban Health. 2006 Sep;83(5):911-25
references.pmid: 16855880
references.citation: J Law Med Ethics. 2002 Winter;30(4):548-59
references.pmid: 12561263
references.citation: Addiction. 2011 Feb;106(2):357-65
references.pmid: 21054615
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18 Suppl 1:S71-5
references.pmid: 9663627