title: Stigma and Human Rights Abuses against People Who Inject Drugs in Russia--A Qualitative Investigation to Inform Policy and Public Health Strategies.
abstract: BACKGROUND
  Drug policing practices in the Russian Federation (Russia) are often punitive and have been shown to be associated with HIV risk behaviors among people who inject drugs (PWID). Less is known about strategies to address the problem in that setting, where substance use stigma is highly persistent. A better understanding of forms, causes and consequences of drug policing in Russia could inform drug policy in a context of substantial policy resistance. This qualitative study's goal is to characterize the phenomenon of police involvement with Russian PWID and to explore strategies for drug policing in the Russian country context.
  
  
  METHODS
  Using a semi-structured interview guide, we collected data from a purposive sample of 23 key informants including PWID, police officers, and experts from civil society and international organizations in Russia. We used a thematic analysis approach to inductively generate new insight into the phenomenon of police involvement and potential strategies to address it.
  
  
  RESULTS
  Policing practices involving PWID include unjustified arrests, planting of false evidence and extrajudicial syringe confiscations, and often constitute human rights violations. Russian PWID personally experienced police violence as ubiquitous, taking on various forms such as beating, unjustified arrests, verbal harassment, and coercion. The persistent societal stigma dehumanizes PWID, and such stigmatization facilitates police abuse. To address stigma and overcome the PWID-police adversity, study participants suggested fostering a mutual understanding between the police and public health sectors.
  
  
  CONCLUSIONS
  Participants describe substantial human rights violations as part of policing illicit drug use in Russia. Police should include principles of effective prevention of substance use and HIV risk reduction in their trainings. Alignment of public safety and public health goals could address drug use-related risks and HIV prevention among key populations in Russia.
authors: Boston University School of Medicine, Boston, MA, United States of America.
authors: Karsten
authors: K
authors: Lunze
authors: Boston Children's Hospital, Harvard Medical School, Boston, MA, United States of America.
authors: Fatima I
authors: FI
authors: Lunze
authors: Division of Global Public Health, Department of Medicine, University of California at San Diego School of Medicine, San Diego, CA, United States of America.
authors: Anita
authors: A
authors: Raj
authors: Boston University School of Medicine, Boston, MA, United States of America.
authors: Jeffrey H
authors: JH
authors: Samet
mesh_terms: D006040:Goals; D006291:Health Policy; D006806:Human Rights; D045809:Human Rights Abuses / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D016495:Police; D011634:Public Health; D036301:Qualitative Research; D012307:Risk Factors; D012426:Russia; D057545:Social Stigma; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014754:Violence