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Health and safety risks associated with public injecting among people who inject drugs in Bangkok, Thailand

Authors

  • Leslie Tze Fung Leung,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
    2. Faculty of Medicine, University of British Columbia, Vancouver, Canada
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  • Lianping Ti,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
    2. School of Population & Public Health, University of British Columbia, Vancouver, Canada
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  • Kanna Hayashi,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
    2. Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, Canada
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  • Paisan Suwannawong,

    1. Mitsampan Harm Reduction Center/Thai AIDS Treatment Action Group, Bangkok, Thailand
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  • Karyn Kaplan,

    1. Mitsampan Harm Reduction Center/Thai AIDS Treatment Action Group, Bangkok, Thailand
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  • Evan Wood,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
    2. Faculty of Medicine, University of British Columbia, Vancouver, Canada
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  • Thomas Kerr

    Corresponding author
    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
    2. Faculty of Medicine, University of British Columbia, Vancouver, Canada
    • Correspondence to Dr Thomas Kerr, Urban Health Research Initiative, B.C. Centre for Excellence in HIV/AIDS, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6. Tel: +1 604 806 9116; Fax: +1 604 806 9044; E-mail: uhri-tk@cfenet.ubc.ca

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  • Leslie Tze Fung Leung BSc (Pharm), Medical Student, Lianping Ti MPH: BC-CfE, Assistant Project Coordinator and Graduate Student, Kanna Hayashi MIA, MPH: BC-CfE, Project Coordinator and Graduate Student, Paisan Suwannawong TTAG, Executive Director, Karyn Kaplan BA: TTAG, Policy and Development Director, Evan Wood MD, PhD, ABIM, FRCPC: BC-CfE, Director and Professor, Thomas Kerr PhD: BC-CfE, Director and Associate Professor.

Abstract

Introduction and Aims

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.

Design and 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).

Discussion and Conclusion

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. [Leung LTF, Ti L, Hayashi K, Suwannawong P, Kaplan K, Wood E, Kerr T. Health and safety risks associated with public injecting among people who inject drugs in Bangkok, Thailand. Drug Alcohol Rev 2013;32:582–587]

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