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dc.contributor.authorPolonsky, Maximen_US
dc.contributor.authorAzbel, Lyubaen_US
dc.contributor.authorWegman, Martin Pen_US
dc.contributor.authorIzenberg, Jacob Men_US
dc.contributor.authorBachireddy, Chethanen_US
dc.contributor.authorWickersham, Jeffrey Aen_US
dc.contributor.authorDvoriak, Sergiien_US
dc.contributor.authorAltice, Frederick Len_US
dc.date.accessioned2016-08-09T14:52:49Z
dc.date.issued2016en_US
dc.identifier.citationPolonsky, Maxim, Lyuba Azbel, Martin P Wegman, Jacob M Izenberg, Chethan Bachireddy, Jeffrey A Wickersham, Sergii Dvoriak, and Frederick L Altice. 2016. “Pre-incarceration police harassment, drug addiction and HIV risk behaviours among prisoners in Kyrgyzstan and Azerbaijan: results from a nationally representative cross-sectional study.” Journal of the International AIDS Society 19 (4Suppl 3): 20880. doi:10.7448/IAS.19.4.20880. http://dx.doi.org/10.7448/IAS.19.4.20880.en
dc.identifier.issn1758-2652en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:27822193
dc.description.abstractIntroduction: The expanding HIV epidemic in Azerbaijan and Kyrgyzstan is concentrated among people who inject drugs (PWID), who comprise a third of prisoners there. Detention of PWID is common but its impact on health has not been previously studied in the region. We aimed to understand the relationship between official and unofficial (police harassment) detention of PWID and HIV risk behaviours. Methods: In a nationally representative cross-sectional study, soon-to-be released prisoners in Kyrgyzstan (N=368) and Azerbaijan (N=510) completed standardized health assessment surveys. After identifying correlated variables through bivariate testing, we built multi-group path models with pre-incarceration official and unofficial detention as exogenous variables and pre-incarceration composite HIV risk as an endogenous variable, controlling for potential confounders and estimating indirect effects. Results: Overall, 463 (51%) prisoners reported at least one detention in the year before incarceration with an average of 1.3 detentions in that period. Unofficial detentions (13%) were less common than official detentions (41%). Optimal model fit was achieved (X2=5.83, p=0.44; Goodness of Fit Index (GFI) GFI=0.99; Comparative Fit Index (CFI) CFI=1.00; Root Mean Square Error of Approximation (RMSEA) RMSEA=0.00; PCLOSE=0.98) when unofficial detention had an indirect effect on HIV risk, mediated by drug addiction severity, with more detentions associated with higher addiction severity, which in turn correlated with increased HIV risk. The final model explained 35% of the variance in the outcome. The effect was maintained for both countries, but stronger for Kyrgyzstan. The model also holds for Kyrgyzstan using unique data on within-prison drug injection as the outcome, which was frequent in prisoners there. Conclusions: Detention by police is a strong correlate of addiction severity, which mediates its effect on HIV risk behaviour. This pattern suggests that police may target drug users and that such harassment may result in an increase in HIV risk-taking behaviours, primarily because of the continued drug use within prisons. These findings highlight the important negative role that police play in the HIV epidemic response and point to the urgent need for interventions to reduce police harassment, in parallel with interventions to reduce HIV transmission within and outside of prison.en
dc.language.isoen_USen
dc.publisherInternational AIDS Societyen
dc.relation.isversionofdoi:10.7448/IAS.19.4.20880en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951538/pdf/en
dash.licenseLAAen_US
dc.subjectprisonersen
dc.subjectpolice harassmenten
dc.subjectAzerbaijanen
dc.subjectKyrgyzstanen
dc.subjectaddiction severityen
dc.subjectHIV risk behavioursen
dc.subjectdrug injectionen
dc.titlePre-incarceration police harassment, drug addiction and HIV risk behaviours among prisoners in Kyrgyzstan and Azerbaijan: results from a nationally representative cross-sectional studyen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalJournal of the International AIDS Societyen
dc.date.available2016-08-09T14:52:49Z
dc.identifier.doi10.7448/IAS.19.4.20880*


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