title: Health and safety risks associated with public injecting among people who inject drugs in Bangkok, Thailand.
abstract: OBJECTIVE
  The injection of illicit drugs in public spaces is known to pose significant health risks to people who inject drugs (IDU). However, to our knowledge this practice has not been explored in the Asian context. Therefore, we sought to characterise the prevalence of and factors associated with public injecting among a community-recruited sample of IDU in Bangkok, Thailand.
  
  
  METHODS
  Data were derived from the Mitsampan Community Research Project between July and October 2011. Using multivariate logistic regression, this cross-sectional study examined the prevalence and correlates of public injecting within the past six months among 437 IDU participants.
  
  
  RESULTS
  In total, 121 (27.7%) participants reported injecting drugs in a public space within the past six months. In multivariate analyses, public drug injection was independently associated with male gender [adjusted odds ratio (AOR) 2.51, 95% confidence interval (CI)) 1.29-5.22], weekly heroin injection (AOR 2.19, 95% CI 1.27-3.77), assisted injection (AOR 1.93, 95% CI 1.06-3.49), rushed injection (AOR 4.36, 95% CI 2.65-7.24), incarceration (AOR 2.27, 95% CI 1.01-5.04) and noticing police presence where drugs are bought or used (AOR 1.83, 95% CI 1.06-3.19).
  
  
  CONCLUSIONS
  A substantial proportion of Thai IDU in our sample reported recent public drug injection. This behaviour was independently associated with a wide range of individual and contextual factors that pose significant health and safety risks to the IDU. These findings highlight the importance of addressing the broader social and physical risk environment surrounding IDU as a means of preventing negative health outcomes among this population.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Leslie Tze Fung
authors.initials: LT
authors.lastname: Leung
authors.forename: Lianping
authors.initials: L
authors.lastname: Ti
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
authors.forename: Paisan
authors.initials: P
authors.lastname: Suwannawong
authors.forename: Karyn
authors.initials: K
authors.lastname: Kaplan
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D013287:Illicit Drugs; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016495:Police; D015995:Prevalence; D011633:Public Facilities; D012307:Risk Factors; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs
keywords: Thailand; assisted injection; injection drug use; law enforcement; public injecting