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Nyakio O, Kibukila F, Mukwege D, Bwani J, Tambwe A, Bhattacharjee P, Bandyopadhyay S, Akilimali A, Kakudji P, Kakoma JB. A cross-sectional study exploring the characteristics of female survivors of sexual violence living with HIV/AIDS in the eastern region of Democratic Republic of Congo. Aust N Z J Obstet Gynaecol 2024. [PMID: 38272828 DOI: 10.1111/ajo.13789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Sexual violence remains a persistent and devastating issue in eastern Democratic Republic of Congo (DRC). AIM To elucidate the sociodemographic, sexual, and obstetrical characteristics associated with the experiences of victims of sexual violence (VSV) among women in the region. MATERIALS AND METHODS A cross-sectional study was conducted involving 625 women from eastern DRC. Participants provided self-reported data, collected through interviews conducted by trained female interviewers in secure environments. Associations between VSV and various sociodemographic and reproductive health factors were examined. RESULTS Of the respondents, 26.1% reported experiences of sexual violence. VSV were predominantly younger, with 56.44% aged between 15 and 24 years. Single women comprised 57.67% of VSV, and 37.42% identified as farmers. There were 33.13% of VSV who were illiterate, and 81.60% belonged to the low socio-economic stratum. Early physiological and reproductive milestones characterised VSV: 52.15% experienced menarche at or before 13 years, 34.97% initiated sexual intercourse before age 15, and 18.70% reported their first pregnancy before age 15. Higher nulliparity was observed in VSV (29.45%) compared to non-VSV (9.31%). A lower prevalence of HIV infection was found among VSV (11.04%) relative to non-VSV (25.76%). CONCLUSION Sexual violence in the eastern DRC exhibits multifactorial associations. Younger women, those in certain occupations, and those with specific reproductive histories appear more vulnerable. The findings underscore the urgency for targeted interventions, enhanced access to education, and improved reproductive health services. Addressing these pressing issues should remain a primary focus in both societal and public health spheres.
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Affiliation(s)
- Olivier Nyakio
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Fabrice Kibukila
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - Denis Mukwege
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
| | - Joyeux Bwani
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
| | - Albert Tambwe
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Priyadarshini Bhattacharjee
- Department of Clinical Medicine, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - Soham Bandyopadhyay
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Aymar Akilimali
- Department of Research, Medical Research Circle (MedReC), Goma, Democratic Republic of Congo
- Society for Maternal-Fetal Medicine (SMFM), Washington, District of Columbia, USA
- Standing committee of research and exchange, Medical Students Association of DR Congo
| | - Prosper Kakudji
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Jean Baptiste Kakoma
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
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Gunjyal N, Rani S, Asgari Lajayer B, Senapathi V, Astatkie T. A review of the effects of environmental hazards on humans, their remediation for sustainable development, and risk assessment. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:795. [PMID: 37264257 DOI: 10.1007/s10661-023-11353-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023]
Abstract
In the race for economic development and prosperity, our earth is becoming more polluted with each passing day. Technological advances in agriculture and rapid industrialization have drastically polluted the two pillars of natural resources, land and water. Toxic chemicals and microbial contaminants/agents created by natural and anthropogenic activities are rapidly becoming environmental hazards (EH) with increased potential to affect the natural environment and human health. This review has attempted to describe the various agents (chemical, biological, and physical) responsible for environmental contamination, remediation methods, and risk assessment techniques (RA). The main focus is on finding ways to mitigate the harmful effects of EHs through the simultaneous application of remediation methods and RA for sustainable development. It is recommended to apply the combination of different remediation methods using RA techniques to promote recycling and reuse of different resources for sustainable development. The report advocates for the development of site-specific, farmer-driven, sequential, and plant-based remediation strategies along with policy support for effective decontamination. This review also focuses on the fact that the lack of knowledge about environmental health is directly related to public health risks and, therefore, focuses on promoting awareness of effective ways to reduce anthropological burden and pollution and on providing valuable data that can be used in environmental monitoring assessments and lead to sustainable development.
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Affiliation(s)
- Neelam Gunjyal
- Department of Civil Engineering, IIT Roorkee, Roorkee, 247667, India
| | - Swati Rani
- Department of Biotechnology, Ambala College of Engineering and Applied Research, 133001, Ambala Cantt, Jagadhari Rd, P.O, Sambhalkha, Haryana, India.
| | | | | | - Tess Astatkie
- Faculty of Agriculture, Dalhousie University, Truro, NS, B2N 5E3, Canada
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Lodi S, Rossi SL, Bendiks S, Gnatienko N, Lloyd-Travaglini C, Vetrova M, Toussova O, Bushara N, Blokhina E, Krupitsky E, Ekstrand ML, Lioznov D, Samet JH, Lunze K. Correlates of Intersectional HIV and Substance Use Stigma Affecting People with HIV and Substance Use in St. Petersburg, Russia. AIDS Behav 2023; 27:462-472. [PMID: 35916947 PMCID: PMC9892353 DOI: 10.1007/s10461-022-03781-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 02/04/2023]
Abstract
People with HIV (PWH) who inject drugs often experience coexisting HIV- and substance use-related stigma manifestations. We assessed correlates of HIV stigma (Berger HIV stigma scale), substance use stigma (Substance Abuse Self-stigma scale) and intersectional HIV and substance use stigma in a cohort of PWH with a lifetime history of drug use in St. Petersburg, Russia. Intersectional stigma was defined as having a score greater than the median for both forms of stigma. Of the 208 participants, 56 (27%) had intersectional stigma. Depressive symptoms and alcohol dependence were significantly associated with a higher HIV and substance stigma score, but not with intersectional stigma. Individual and community interventions to reduce the impact of HIV stigma and substance use stigma affecting PWH who inject drugs should consider assessing and addressing mental health and unhealthy substance use. Further work with longitudinal data is needed to understand mechanisms leading to intersectional stigma.
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Affiliation(s)
- Sara Lodi
- Boston University School of Public Health, Boston, MA, USA.
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
| | - Sarah L Rossi
- Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Sally Bendiks
- Department of Medicine, Boston Medical Center, Boston, MA, USA
| | | | | | - Marina Vetrova
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Olga Toussova
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Natalia Bushara
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Elena Blokhina
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Evgeny Krupitsky
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
- Department of Addiction, Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Maria L Ekstrand
- Center for AIDS Prevention Studies, School of Medicine, University of California San Francisco, San Francisco, CA, USA
- St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Dmitry Lioznov
- Laboratory of Clinical Psychopharmacology of Addictions, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Jeffrey H Samet
- Boston University School of Public Health, Boston, MA, USA
- Department of Medicine, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Karsten Lunze
- Department of Medicine, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
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Bovell-Ammon BJ, Kimmel SD, Cheng DM, Truong V, Michals A, Vetrova M, Hook K, Idrisov B, Blokhina E, Krupitsky E, Samet JH, Lunze K. Incarceration history, antiretroviral therapy, and stigma: A cross-sectional study of people with HIV who inject drugs in St. Petersburg, Russia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 111:103907. [PMID: 36402082 PMCID: PMC9868071 DOI: 10.1016/j.drugpo.2022.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/07/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The HIV epidemic is intertwined with substance use and incarceration in Russia. The relationships between incarceration history, HIV treatment history, and stigma experiences among people with HIV (PWH) who inject drugs in Russia have not been well described. METHODS We conducted a cross-sectional study of a cohort of PWH with opioid use disorder who inject drugs (n=201) recruited at a narcology (substance use treatment) hospital in St. Petersburg, Russia from September 2018 to December 2020. The primary analysis evaluated the association between self-reported prior incarceration and prior antiretroviral therapy (ART) initiation using multivariable logistic regression to adjust for demographic, social, and clinical covariates. We used multivariable linear regression models to analyze associations between prior incarceration and two secondary outcomes: HIV stigma score (11-item abbreviated Berger scale) and substance use stigma score (21-item combination of Substance Abuse Self-Stigma Scale and Stigma-related Rejection Scale). RESULTS Mean age was 37 (SD 5) years; 58.7% were male. Participants had been living with HIV for a mean of 13 (SD 6) years. Over two thirds (69.2%) of participants reported prior incarceration. One third (35.3%) of participants reported prior ART initiation. Prior incarceration was not significantly associated with prior ART initiation (AOR 1.76; 95% CI: 0.81, 3.83). Prior incarceration was associated with a lower HIV stigma score (adjusted mean difference in z-score: -0.50; 95%CI: -0.81, -0.19) but was not significantly associated with substance use stigma score (adjusted mean difference in z-score: -0.10; 95%CI: -0.42, 0.21). CONCLUSION Prior incarceration was common, and rates of prior ART initiation were low even though most participants had been living with HIV for at least a decade. We did not find an association between prior incarceration and prior ART initiation, which suggests a need to explore whether opportunities to initiate ART during or after incarceration are missed. CLINICAL TRIAL NUMBER NCT03290391.
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Affiliation(s)
- Benjamin J Bovell-Ammon
- Department of Medicine, Boston Medical Center; and Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Center 2nd Floor, Boston, MA 02118, USA.
| | - Simeon D Kimmel
- Department of Medicine, Boston Medical Center; and Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Center 2nd Floor, Boston, MA 02118, USA
| | - Debbie M Cheng
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown Center 3rd Floor, Boston, MA 02118, USA
| | - Ve Truong
- Department of Medicine, Boston Medical Center; and Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Center 2nd Floor, Boston, MA 02118, USA
| | - Amy Michals
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, 85 East Newton Street, M921, Boston, MA 02118, USA
| | - Marina Vetrova
- Pavlov First St. Petersburg State Medical University, Lev Tolstoy Street, 6-8, St. Petersburg 197022, Russian Federation
| | - Kimberly Hook
- Department of Psychiatry, Boston Medical Center and Boston University School of Medicine, 720 Harrison Avenue 9th Floor, Boston, MA 02118, USA
| | - Bulat Idrisov
- Department of Health Systems and Population Health, University of Washington, 3980 15th Ave NE, Seattle, WA 98195-1621, USA; Bashkir State Medical University, 3 Lenin Street, Ufa, Republic of Bashkortostan 450008, Russian Federation
| | - Elena Blokhina
- Pavlov First St. Petersburg State Medical University, Lev Tolstoy Street, 6-8, St. Petersburg 197022, Russian Federation
| | - Evgeny Krupitsky
- Pavlov First St. Petersburg State Medical University, Lev Tolstoy Street, 6-8, St. Petersburg 197022, Russian Federation; V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Bekhtereva Street, 3, St. Petersburg 192019, Russian Federation
| | - Jeffrey H Samet
- Department of Medicine, Boston Medical Center; and Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Center 2nd Floor, Boston, MA 02118, USA; Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown Center 4th Floor, Boston, MA 02118, USA
| | - Karsten Lunze
- Department of Medicine, Boston Medical Center; and Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Center 2nd Floor, Boston, MA 02118, USA
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Gilbert L, Marotta PL, Goddard-Eckrich D, Richer A, Akuffo J, Hunt T, Wu E, El-Bassel N. Association Between Multiple Experiences of Violence and Drug Overdose Among Black Women in Community Supervision Programs in New York City. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21502-NP21524. [PMID: 34882025 DOI: 10.1177/08862605211057269] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research has documented associations between all types of violence and substance misuse among Black women. However, research has yet to examine how different experiences of violence may be contributing to the surging epidemic of drug overdose among Black women. This study was conducted between 2015 and 2018 among 296 Black women who were mandated to community supervision programs (CSPs) in New York City (NYC). We used generalized linear modeling (GLM) to estimate associations of the adjusted relative risk (aRR) of experiencing a non-fatal overdose based on exposure to each type of violence after controlling for potentially confounding variables. Lifetime prevalence of a non-fatal drug overdose was 13.9% (n = 41). Lifetime severe physical/sexual violence by a male intimate partner (prevalence rate = 61.8%, n = 181) was associated with an overdose (aRR = 3.41, 95%CI = 1.19, 9.73). Severe violence by a female partner (prevalence rate = 7.4%, n = 22) was also associated with an overdose (aRR = 2.61, 95%CI = 1.46, 4.65). Lifetime sexual violence by a non-intimate partner (prevalence rate: 29.1%, n = 86) was associated with an overdose (aRR = 2.23, 95%CI = 1.32, 3.77). Sexual abuse by police/CSP staff (prevalence rate: 14.9%, n = 44) was associated with an overdose (aRR = 2.29, 95%CI = 1.27, 4.12). For each increase in the number of types of violence experienced, there was a 27% increase in the risk for an overdose (aRR = 1.27, 95%CI = 1.14, 1.42). This study found high rates of multiple types of violence that are associated with drug overdose among this sample of Black women in CSPs. These findings highlight the urgent public health need to address violence associated with overdose in this population.
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Affiliation(s)
- Louisa Gilbert
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | | | - Dawn Goddard-Eckrich
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | - Ariel Richer
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | - Jasmine Akuffo
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | - Timothy Hunt
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | - Elwin Wu
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
| | - Nabila El-Bassel
- Social Intervention Group, 5798Columbia University School of Social Work, New York, NY, USA
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Carroll JJ, Rossi SL, Vetrova MV, Kiriazova T, Lunze K. Supporting the Health of HIV-Positive People Who Inject Drugs During COVID-19 and Beyond: Lessons for the United States from St. Petersburg, Russia. Am J Public Health 2022; 112:S123-S127. [PMID: 35349320 PMCID: PMC8965173 DOI: 10.2105/ajph.2022.306727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Jennifer J Carroll
- Jennifer J. Carroll is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, and the Department of Medicine, Brown University, Providence, RI. Sarah L. Rossi is with Boston Medical Center, Boston, MA. Marina V. Vetrova is with First Pavlov State Medical University, St. Petersburg, Russia. Tetiana Kiriazova is with Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. Karsten Lunze is with Boston Medical Center and the Boston University School of Medicine
| | - Sarah L Rossi
- Jennifer J. Carroll is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, and the Department of Medicine, Brown University, Providence, RI. Sarah L. Rossi is with Boston Medical Center, Boston, MA. Marina V. Vetrova is with First Pavlov State Medical University, St. Petersburg, Russia. Tetiana Kiriazova is with Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. Karsten Lunze is with Boston Medical Center and the Boston University School of Medicine
| | - Marina V Vetrova
- Jennifer J. Carroll is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, and the Department of Medicine, Brown University, Providence, RI. Sarah L. Rossi is with Boston Medical Center, Boston, MA. Marina V. Vetrova is with First Pavlov State Medical University, St. Petersburg, Russia. Tetiana Kiriazova is with Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. Karsten Lunze is with Boston Medical Center and the Boston University School of Medicine
| | - Tetiana Kiriazova
- Jennifer J. Carroll is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, and the Department of Medicine, Brown University, Providence, RI. Sarah L. Rossi is with Boston Medical Center, Boston, MA. Marina V. Vetrova is with First Pavlov State Medical University, St. Petersburg, Russia. Tetiana Kiriazova is with Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. Karsten Lunze is with Boston Medical Center and the Boston University School of Medicine
| | - Karsten Lunze
- Jennifer J. Carroll is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, and the Department of Medicine, Brown University, Providence, RI. Sarah L. Rossi is with Boston Medical Center, Boston, MA. Marina V. Vetrova is with First Pavlov State Medical University, St. Petersburg, Russia. Tetiana Kiriazova is with Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. Karsten Lunze is with Boston Medical Center and the Boston University School of Medicine
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Ataiants J, Mazzella S, Roth AM, Robinson LF, Sell RL, Lankenau SE. Multiple Victimizations and Overdose Among Women With a History of Illicit Drug Use. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1588-NP1613. [PMID: 32536256 PMCID: PMC7808297 DOI: 10.1177/0886260520927501] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The experiences of violence and overdose are highly prevalent among women who use illicit drugs. This study sought to ascertain whether multiple victimizations during adulthood increase the frequency of women's overdose. The sample comprised 218 women recruited at Philadelphia harm reduction sites during 2016-2017. Victimization was assessed as exposure to 16 types of adulthood violence. Three measures were constructed for multiple victimizations: continuous and categorical polyvictimization, and predominant violence domain. Negative binomial regression estimated the incidence rate ratio (IRR) of lifetime overdoses from multiple victimizations. Lifetime history of opioid use (88.6%) and drug injection (79.5%) were common. Among overdose survivors (68.5%), the median of lifetime overdoses was 3. The majority of participants (58.7%) were victims of predominantly sexual violence, 26.1% experienced predominantly physical abuse/assault, and 3.7% were victims of predominantly verbal aggression/coercive control. Participants reported a mean of seven violence types; the higher-score category of polyvictimization (9-16 violence types) comprised 41.7% of the total sample. In multivariable models, one-unit increase in continuous polyvictimization was associated with 4% higher overdose rates (IRR: 1.04, 95% confidence interval [CI]: [1.00, 1.08]). Compared to women who were not victimized (11.5%), those in the higher-score category of polyvictimization (IRR: 2.01; 95% CI: [1.06, 3.80]) and exposed to predominantly sexual violence (IRR: 2.10, 95% CI: [1.13, 3.91]) were expected to have higher overdose rates. Polyvictimization and sexual violence amplified the risk of repeated overdose among drug-involved women. Female overdose survivors need to be screened for exposure to multiple forms of violence, especially sexual violence. Findings underscore the need to scale-up victimization support and overdose prevention services for disenfranchised women.
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Tariq S, Kasadha B. HIV and women’s health: Where are we now? WOMEN'S HEALTH 2022; 18:17455065221076341. [PMID: 35107041 PMCID: PMC8814966 DOI: 10.1177/17455065221076341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Shema Tariq
- UCL Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK
- Mortimer Market Centre, CNWL NHS Foundation Trust, London, UK
| | - Bakita Kasadha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Lee JO, Yoon Y, Idrisov B, Kiriazova T, Makarenko O, Sereda Y, Bendiks S, Cody K, Schoenberger SF, Nurius PS, Halim N, Flanigan T, Samet JH, Liebschutz J, Lunze K. Violence, HIV Risks, and Polysubstance Use Among HIV-Positive People Who Inject Drugs in Ukraine. AIDS Behav 2021; 25:2120-2130. [PMID: 33385280 DOI: 10.1007/s10461-020-03142-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/28/2022]
Abstract
Violence experience has been consistently associated with HIV risks and substance use behaviors. Although many studies have focused on intimate partner violence (IPV), the role of violence at a structural level (i.e., police abuse) remains relevant for people who inject drugs. This study evaluated the association of IPV and police-perpetrated violence experiences with HIV risk behaviors and substance use in a cohort of HIV-positive people who inject drugs in Ukraine. We also evaluated possible moderation effects of gender and socioeconomic status in the links between violence exposure and HIV risk and polysubstance use behaviors. Data came from the Providence/Boston-CFAR-Ukraine Study involving 191 HIV-positive people who inject drugs conducted at seven addiction treatment facilities in Ukraine. Results from logistic regressions suggest that people who inject drugs and experienced IPV had higher odds of polysubstance use than those who did not experience IPV. Verbal violence and sexual violence perpetrated by police were associated with increased odds of inconsistent condom use. The odds of engaging in polysubstance use were lower for women in relation to police physical abuse. We found no evidence supporting socioeconomic status moderations. Violence experiences were associated with substance use and sexual HIV risk behaviors in this cohort of HIV-positive people who inject drugs in Ukraine. Trauma-informed prevention approaches that consider both individual and structural violence could improve this population's HIV risks.
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Affiliation(s)
- Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th St., Los Angeles, CA, 90089, USA.
| | - Yoewon Yoon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th St., Los Angeles, CA, 90089, USA
| | - Bulat Idrisov
- Bashkir State Medical University, Ufa, Russia
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia
- Moscow Institute of Physics and Technology, Moscow, Russia
| | | | | | | | - Sally Bendiks
- Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MA, USA
| | - Kate Cody
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th St., Los Angeles, CA, 90089, USA
| | | | - Paula S Nurius
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Nafisa Halim
- School of Public Health, Boston University, Boston, MA, USA
| | - Timothy Flanigan
- Division of Infectious Disease, Alpert Medical School of Brown University, The Miriam and Rhode Island Hospitals, Brown University, Providence, RI, USA
| | - Jeffrey H Samet
- Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Jane Liebschutz
- Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Karsten Lunze
- Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
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Stringer KL, Marotta P, Goddard-Eckrich D, Akuffo J, Richer AM, El-Bassel N, Gilbert L. Mental Health Consequences of Sexual Misconduct by Law Enforcement and Criminal Justice Personnel among Black Drug-Involved Women in Community Corrections. J Urban Health 2020; 97:148-157. [PMID: 31773558 PMCID: PMC7010876 DOI: 10.1007/s11524-019-00394-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study examines the prevalence, correlates, and mental health consequences of sexual misconduct by law enforcement and criminal justice (LECJ) personnel. Baseline data for Project E-WORTH (Empowering African-American Women on the Road to Health) were collected between November 2015 and May 2018 from 351 drug-involved Black women from community corrections in New York City. LECJ sexual misconduct was self-reported and we measured mental health outcomes with the CESD-4 and the PTSD Checklist. Univariate and multivariable logistic regression analyses were performed. Approximately 14% of our sample had experienced LECJ sexual misconduct. Participants who reported multiple arrests, recent drug use, and having experienced childhood sexual victimization were more likely to have experienced LECJ sexual misconduct. Further, LECJ sexual misconduct was positively associated with depression and PTSD. These findings suggest that LECJ sexual misconduct is a previously unreported risk factor for adverse mental health outcomes among criminal-legal system-involved women. There is a need for recognition of LECJ sexual victimization among criminal-legal system-involved women. As such, prevention, treatment, and community corrections service delivery for this population should be trauma informed.
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Davis DA, Morales GJ, Ridgeway K, Mendizabal M, Lanham M, Dayton R, Cooke J, Santi K, Evens E. The health impacts of violence perpetrated by police, military and other public security forces on gay, bisexual and other men who have sex with men in El Salvador. CULTURE, HEALTH & SEXUALITY 2020; 22:217-232. [PMID: 30957697 DOI: 10.1080/13691058.2019.1582801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/11/2019] [Indexed: 05/24/2023]
Abstract
Gay, bisexual and other men who have sex with men face both high levels of violence and a disproportionate burden of poor health outcomes. We explored violence perpetrated against Salvadoran gay, bisexual and other men who have sex with men by public security forces; perceived motivations of violence; and impacts on health. We conducted structured qualitative interviews with 20 participants and used systematic coding and narrative analysis to identify emergent themes. Nearly all participants described the physical, emotional, sexual and/or economic violence by public security forces. Most attributed being targeted to their gender expression and/or perceived sexual orientation. The most common impact was emotional distress, including humiliation, fear and depression; lasting physical injuries were also widely reported. Study participants felt unable to report these incidents for fear of retribution or inaction. Men reported feelings of helplessness and distrust, avoidance of authorities and altering when, where or how often they appeared in public spaces. Programmes and interventions should focus on providing mental health services for LGBTI (lesbian, gay, bisexual, transgender and intersex) victims of violence, educating public security forces on the legal rights of Salvadorans and expanding current LGBTI-inclusive policies to all public security forces.
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Affiliation(s)
- Dirk A Davis
- FHI 360, Durham, North Carolina, USA
- Department of Health Behavior Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | | | - Modesto Mendizabal
- Asociación Diké de Personas Transgénero y LGBTI+, San Salvador, El Salvador
| | | | | | - Juana Cooke
- Regional HIV, Health and Development Team, United Nations Development Programme, Panama City, Panama
| | - Karin Santi
- Regional HIV, Health and Development Team, United Nations Development Programme, Panama City, Panama
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12
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Baker P, Beletsky L, Avalos L, Venegas C, Rivera C, Strathdee SA, Cepeda J. Policing Practices and Risk of HIV Infection Among People Who Inject Drugs. Epidemiol Rev 2020; 42:27-40. [PMID: 33184637 PMCID: PMC7879596 DOI: 10.1093/epirev/mxaa010] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 01/03/2023] Open
Abstract
Drug-law enforcement constitutes a structural determinant of health among people who inject drugs (PWID). Street encounters between police and PWID (e.g., syringe confiscation, physical assault) have been associated with health harms, but these relationships have not been systematically assessed. We conducted a systematic literature review to evaluate the contribution of policing to risk of human immunodeficiency virus (HIV) infection among PWID. We screened MEDLINE, sociological databases, and gray literature for studies published from 1981 to November 2018 that included estimates of HIV infection/risk behaviors and street policing encounters. We extracted and summarized quantitative findings from all eligible studies. We screened 8,201 abstracts, reviewed 175 full-text articles, and included 27 eligible analyses from 9 countries (Canada, China, India, Malaysia, Mexico, Russia, Thailand, Ukraine, and the United States). Heterogeneity in variable and endpoint selection precluded meta-analyses. In 5 (19%) studies, HIV infection among PWID was significantly associated with syringe confiscation, reluctance to buy/carry syringes for fear of police, rushed injection due to a police presence, fear of arrest, being arrested for planted drugs, and physical abuse. Twenty-one (78%) studies identified policing practices to be associated with HIV risk behaviors related to injection drug use (e.g., syringe-sharing, using a "shooting gallery"). In 9 (33%) studies, policing was associated with PWID avoidance of harm reduction services, including syringe exchange, methadone maintenance, and safe consumption facilities. Evidence suggests that policing shapes HIV risk among PWID, but lower-income settings are underrepresented. Curbing injection-related HIV risk necessitates additional structural interventions. Methodological harmonization could facilitate knowledge generation on the role of police as a determinant of population health.
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Affiliation(s)
- Pieter Baker
- Correspondence to Pieter Baker, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093 (e-mail: )
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13
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Detels R, Wu J, Wu Z. Control of HIV/AIDS can be achieved with multi-strategies. GLOBAL HEALTH JOURNAL 2019. [DOI: 10.1016/j.glohj.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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14
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Marotta PL, Gilbert L, Terlikbayeva A, Wu E, El-Bassel N. Differences by sex in associations between injection drug risks and drug crime conviction among people who inject drugs in Almaty, Kazakhstan. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 60:96-106. [PMID: 30219718 PMCID: PMC6340710 DOI: 10.1016/j.drugpo.2018.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 06/15/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The criminalization of drug use leads to high rates of drug crime convictions for engaging in injection drug use behaviors, introducing barriers to HIV prevention and drug treatment for PWID. Females (FWID) face unique vulnerabilities to HIV compared to males (MWID) in Kazakhstan. This study examined sex differences in associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, and conviction for a drug crime in a sample of people who inject drugs (PWID) in Almaty, Kazakhstan. METHODS Analyses were performed on baseline data from 510 PWID and stratified by males (MWID) (329) and females (FWID) (181) from Kazakhstan in a couples-focused HIV prevention intervention. Logistic regression analyses using mixed effects (AOR) examined associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, drug use severity, drug treatment history and conviction for a drug crime. RESULTS About three quarters of PWID reported drug crime conviction (73.92%, n = 377). HCV infection was associated with increased odds of drug crime conviction for FWID (AOR = 4.35, CI95 = 1.83-10.31, p < .01) and MWID (AOR = 3.62, CI95 = 1.09-12.07, p < .01). HIV transmission knowledge was associated with increased odds of conviction for MWID (AOR = 1.19, CI95 = 1.00-1.41, p < .05). Injection drug risk knowledge was associated with lower odds of conviction (AOR = .75, CI95 = .59-.94, p < .05) for FWID. Receptive syringe sharing (AOR = 3.48, CI95 = 1.65-7.31, p < .01), splitting drug solutions (AOR = 4.12, CI95 = 1.86-7.31, p < .05), and injecting with more than two partners (AOR = 1.89, CI95 = 1.06-3.34, p < .05) was associated with increased odds of conviction for FWID. Receptive syringe or equipment sharing with intimate partners was associated with conviction for both MWID (AOR = 1.90, CI95 = 1.03-3.92, p < .05) and FWID (AOR = 1.95, CI95 = 1.02-3.70, p < .05). For FWID, injection drug use in public spaces was associated with conviction (AORME = 3.25, CI95 = 1.31-7.39, p < .01). Drug use severity was associated with increased odds of conviction for FWID (AOR = 1.29, CI95 = 1.09-1.53, p < .001) and MWID (AOR = 1.24, CI95 = 1.09-1.41, p < .001). Ever receiving drug treatment was associated with conviction for MWID (AOR = 2.31, CI95 = 1.32-4.12, p < .01). CONCLUSION High-risk behaviors, HCV infection and more severe substance use disorders are associated with drug crime conviction for PWID, particularly FWID. Structural interventions are necessary to increase the engagement of PWID with drug crime convictions in HIV prevention and substance abuse treatment.
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Affiliation(s)
| | - Louisa Gilbert
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
| | | | - Elwin Wu
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
| | - Nabila El-Bassel
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
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15
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Mateu-Gelabert P, Guarino H, Quinn K, Meylakhs P, Campos S, Meylakhs A, Berbesi D, Toro-Tobón D, Goodbody E, Ompad DC, Friedman SR. Young Drug Users: a Vulnerable Population and an Underutilized Resource in HIV/HCV Prevention. Curr HIV/AIDS Rep 2018; 15:324-335. [PMID: 29931468 PMCID: PMC6309604 DOI: 10.1007/s11904-018-0406-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW The social networks of people who inject drugs (PWID) have long been studied to understand disease transmission dynamics and social influences on risky practices. We illustrate how PWID can be active agents promoting HIV, HCV, and overdose prevention. RECENT FINDINGS We assessed drug users' connections and interactions with others at risk for HIV/HCV in three cities: New York City (NYC), USA (n = 539); Pereira, Colombia (n = 50); and St. Petersburg, Russia (n = 49). In all three cities, the majority of participants' network members were of a similar age as themselves, yet connections across age groups were also present. In NYC, knowing any opioid user(s) older than 29 was associated with testing HCV-positive. In NYC and St. Petersburg, a large proportion of PWID engaged in intravention activities to support safer injection and overdose prevention; in Pereira, PWID injected, had sex, and interacted with other key groups at risk. People who use drugs can be active players in HIV/HCV and overdose risk- reduction; their networks provide them with ample opportunities to disseminate harm reduction knowledge, strategies, and norms to others at risk. Local communities could augment prevention programming by empowering drug users to be allies in the fight against HIV and facilitating their pre-existing health-protective actions.
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Affiliation(s)
- Pedro Mateu-Gelabert
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA.
| | - H Guarino
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA
| | - K Quinn
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA
- Department of Population Health, New York University, New York City, NY, USA
| | - P Meylakhs
- International Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, St. Petersburg, Russia
| | - S Campos
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA
| | - A Meylakhs
- International Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, St. Petersburg, Russia
| | - D Berbesi
- School of Nursing, CES University, Medellín, Colombia
| | - D Toro-Tobón
- School of Medicine, CES University, Medellín, Colombia
| | - E Goodbody
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA
| | - D C Ompad
- College of Global Public Health, New York University, New York City, NY, USA
| | - S R Friedman
- National Development Research Institutes, Inc., 71 West 23rd Street, 4th Floor, New York, NY, 10010, USA
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Hall J, Hutson SP, West F. Anticipating Needs at End of Life in Narratives Related by People Living With HIV/AIDS in Appalachia. Am J Hosp Palliat Care 2018; 35:985-992. [PMID: 29378424 DOI: 10.1177/1049909118754879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As part of a mixed methods study determining end-of-life and advanced care planning needs in southern Appalachia, a narrative analysis was done of stories told in interviews of 8 selected participants using transcript data. Narratives were fraught with contradiction and paradox. Tensions were evident about living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The primary finding was that stigma, from several sources, and shrinking circles of social support for people living with HIV/AIDS, all of whom were in treatment, combined to create a sense of solitariness. Narratives were fraught with tensions, contradictions, and paradoxes. Living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The rejection-based religiously based stigma was often predicated on stereotypes about sexual behavior and illicit drug use. Diagnosis was a key turning point after which many spiraled downward financially and socially. Implications for research and advanced care planning are included.
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Affiliation(s)
- Joanne Hall
- 1 College of Nursing, The University of Tennessee, Knoxville, TN, USA
| | - Sadie P Hutson
- 1 College of Nursing, The University of Tennessee, Knoxville, TN, USA
| | - Frankie West
- 2 Department of Anthropology, The University of Tennessee, Knoxville, TN, USA
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Idrisov B, Murphy SM, Morrill T, Saadoun M, Lunze K, Shepard D. Implementation of methadone therapy for opioid use disorder in Russia - a modeled cost-effectiveness analysis. Subst Abuse Treat Prev Policy 2017; 12:4. [PMID: 28107824 PMCID: PMC5248462 DOI: 10.1186/s13011-016-0087-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 12/23/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Opioid agonist therapy using methadone, an effective treatment of opioid use disorders (OUD) for people who inject drugs (PWID), is recommended by the World Health Organization as essential to curtail the growing HIV epidemic. Yet, despite increasing prevalence of OUD and HIV, methadone therapy has not yet been implemented in Russia. The aim of this modeling study was to estimate the cost-effectiveness of methadone therapy for Russian adults with a diagnosed OUD. METHODS/DESIGN We modeled the projected program implementation costs and estimated disability-adjusted life years (DALYs) averted over a 10-year period, associated with the provision of methadone therapy for a hypothetical, unreplenished cohort of Russian adults with an OUD (n = 249,000), in comparison to the current therapies at existing addiction treatment facilities. Our model compared four distinct scenarios of treatment coverage in the cohort ranging from 3.1 to 55%. RESULTS Providing methadone therapy to as few as 3.1% of adults with an OUD amounted to an estimated almost 50,000 DALYs averted over 10 years at a cost of just over USD 17 million. Further expanding service coverage to 55% resulted in an estimated almost 900,000 DALYs averted, at a cost of about USD 308 million. CONCLUSION Our study indicated that implementing opioid agonist therapy with methadone to treat OUD at existing facilities in Russia is highly cost-effective.
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Affiliation(s)
- Bulat Idrisov
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Sean M. Murphy
- Department of Health Policy and Administration, Washington State University, Spokane, WA 99202 USA
| | - Tyler Morrill
- Schneider Institutes for Health Policy Heller School, Brandeis University, Waltham, MA 02454 USA
| | - Mayada Saadoun
- Schneider Institutes for Health Policy Heller School, Brandeis University, Waltham, MA 02454 USA
| | - Karsten Lunze
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Donald Shepard
- Schneider Institutes for Health Policy Heller School, Brandeis University, Waltham, MA 02454 USA
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Police must join the fast track to end AIDS by 2030. J Int AIDS Soc 2016; 19:21153. [PMID: 27435719 PMCID: PMC4951534 DOI: 10.7448/ias.19.4.21153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/09/2016] [Indexed: 01/23/2023] Open
Abstract
World leaders have committed to ending AIDS by 2030, but stigma and discrimination remain significant obstacles. In particular, police are critical, front-line determinants of risk for many people living with HIV (PLHIV) and members of other key affected populations (KAPs). The negative impact of adverse police behaviours and practices on HIV risk is well documented, and these risks undermine global efforts to end AIDS. Far less well documented, and less common, are attempts to ameliorate this impact by working to change police behaviours. This Special Issue seeks to help redress this imbalance by presenting a selection of original, provocative and important interventions from academics, police officers and other stakeholders concerned with documenting the potential for constructive, progressive and evidence-based approaches to the reduction of HIV risk. We recommend urgent boosting of efforts and funding to engage police in the HIV response. Among other strategies, this needs sustainable funding of programmes and their evaluation, and increased and continuing advocacy and education at all levels to match policy and law reform.
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