Reports of police beating and associated harms among people who inject drugs in Bangkok, Thailand: a serial cross-sectional study
1 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
2 Interdisciplinary Studies Graduate Program, University of British Columbia, Green Commons, 6201 Cecil Green Park Road, Vancouver, BC V6T 1Z1, Canada
3 School of Population & Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
4 Global Drug Policy Program, Open Society Foundations, 7th Floor Millbank Tower, 21-24 Millbank, London SW1P 4QP, United Kingdom
5 Mitsampan Harm Reduction Center / Thai AIDS Treatment Action Group, 18/89 Vipawadee Rd., soi 40 Chatuchak, Bangkok 10900, Thailand
6 Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
BMC Public Health 2013, 13:733 doi:10.1186/1471-2458-13-733Published: 7 August 2013
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.
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.
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.
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.