title: Police education as a component of national HIV response: lessons from Kyrgyzstan.
abstract: BACKGROUND
  Recognition of the police's role in shaping HIV spread and prevention among people who inject drugs, sex workers, and other at-risk groups has generated interest in educational interventions targeting law enforcement. With input from civil society, trainings covering HIV prevention science, policy, and occupational safety were developed and delivered to cadets and active-duty police across Kyrgyzstan.
  
  
  METHODS
  We administered a multi-site cross-sectional survey of Kyrgyz police to assess whether having undergone HIV trainings was associated with improved legal and public health knowledge, positive attitudes toward public health programs and policies, occupational safety awareness, and intended practices .
  
  
  RESULTS
  In a 313-officer sample, 38% reported undergoing the training. In a multivariate analysis, training was associated with the officer being significantly more likely to support referring individuals to public health organizations (aOR 2.21; 95%CI 1.33-3.68), expressing no intent to extrajudicially confiscate syringes (aOR 1.92; 95%CI 1.09-3.39), and better understanding sex worker detention procedure (aOR 2.23; 95%CI 1.19-4.46), although trainee knowledge of policy on routine identification checks for sex workers was significantly lower (aOR 3.0; 95%CI 1.78-5.05). Training was also associated with improved occupational safety knowledge (aOR 3.85; 95%CI 1.66-8.95).
  
  
  CONCLUSIONS
  Kyrgyzstan's experience suggest that police trainings have the potential to improve the integration of policing and public health efforts targeting at-risk groups. Regardless of the legal environment, such structural approaches should be considered elsewhere in Central Asia and beyond. As these initiatives gain acceptance, further research is needed to inform their design and tailoring.
authors.affiliation: Northeastern University School of Law and Bouvé College of Health Sciences, Boston, USA; Division of Global Public Health, UCSD School of Medicine, San Diego, USA. Electronic address: leob@alumni.brown.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Beletsky
authors.forename: Rachel
authors.initials: R
authors.lastname: Thomas
authors.forename: Natalya
authors.initials: N
authors.lastname: Shumskaya
authors.forename: Irina
authors.initials: I
authors.lastname: Artamonova
authors.forename: Marina
authors.initials: M
authors.lastname: Smelyanskaya
mesh_terms: D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007707:Kyrgyzstan; D035846:Law Enforcement; D016495:Police / Q000193:education*; D011634:Public Health
keywords: Central Asia; HIV; HIV prevention; Injection drug use; Police training; Policing; Structural interventions
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