Reports of police beating and associated harms among people who inject drugs in Bangkok, Thailand: a serial cross-sectional study.
BACKGROUND
Thailand has for years attempted to address illicit drug use through aggressive drug law enforcement. Despite accounts of widespread violence by police against people who inject drugs (IDU), the impact of police violence has not been well investigated. In the wake of an intensified police crackdown in 2011, we sought to identify the prevalence and correlates of experiencing police beating among IDU in Bangkok.


METHODS
Community-recruited samples of IDU in Bangkok were surveyed between June 2009 and October 2011. Multivariate log-binomial regression was used to identify factors associated with reporting police beating.


RESULTS
In total, 639 unique IDU participated in this serial cross-sectional study, with 240 (37.6%) participants reporting that they had been beaten by police. In multivariate analyses, reports of police beating were associated with male gender (Adjusted Prevalence Ratio [APR] = 4.43), younger age (APR = 1.69), reporting barriers to accessing healthcare (APR = 1.23), and a history of incarceration (APR = 2.51), compulsory drug detention (APR = 1.22) and syringe sharing (APR = 1.44), and study enrolment in 2011 (APR = 1.27) (all p < 0.05). Participants most commonly reported police beating during the interrogation process.


CONCLUSIONS
A high proportion of IDU in Bangkok reported having been beaten by the police. Experiencing police beating was independently associated with various indicators of drug-related harm. These findings suggest that the over-reliance on enforcement-based approaches is contributing to police-perpetrated abuses and the perpetuation of the HIV risk behaviour among Thai IDU.
Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
Kanna
K
Hayashi
Lianping
L
Ti
Joanne
J
Csete
Karyn
K
Kaplan
Paisan
P
Suwannawong
Evan
E
Wood
Thomas
T
Kerr
D000293:Adolescent; D000328:Adult; D000374:Aggression; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D035846:Law Enforcement; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D016495:Police / Q000592:standards / Q000706:statistics & numerical data*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult