Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA.
Drug Alcohol Depend. 2013 Nov 1;133(1):154-60. doi: 10.1016/j.drugalcdep.2013.05.018. Epub 2013 Jun 12.
Ukraine's HIV epidemic, primarily affecting people who inject drugs (PWID), is expanding and transitioning despite free opioid substitution therapy (OST) and antiretroviral therapy (ART), two effective ways to reduce HIV transmission. Police detention of PWID not resulting in a formal charge or imprisonment is common, but its prevalence and impact on health are not known.
HIV-infected individuals (N=97) released from prison within one year were recruited and surveyed in two HIV-endemic Ukrainian cities about post-release police detention experiences. Data on the frequency of police detention, related adverse events, and impact on OST and ART continuity were collected, and correlates of detention were examined using logistic regression.
Detention responses were available for 94 (96.9%) participants, of which 55 (58.5%) reported police detentions (mean=9.4 per person-year). For those detained while prescribed OST (N=28) and ART (N=27), medication interruption was common (67.9% and 70.4%, respectively); 23 of 27 participants prescribed OST (85.2%) were detained en route to/from OST treatment. Significant independent correlates of detention without charges included post-release ART prescription (AOR 4.98, p=0.021), current high-risk injection practices (AOR 5.03, p=0.011), male gender (AOR 10.88, p=0.010), and lower lifetime months of imprisonment (AOR 0.99, p=0.031).
HIV-infected individuals recently released from prison in Ukraine experience frequent police detentions, resulting in withdrawal symptoms, confiscation of syringes, and interruptions of essential medications, including ART and OST. Structural changes are urgently needed to reduce police detentions in order to control HIV transmission and improve both individual and public health.
乌克兰的艾滋病毒疫情主要影响注射毒品者（PWID），尽管有免费的阿片类药物替代疗法（OST）和抗逆转录病毒疗法（ART），这两种有效减少艾滋病毒传播的方法，疫情仍在扩大和转变。警察拘留未被正式指控或监禁的 PWID 很常见，但这种做法的流行程度及其对健康的影响尚不清楚。
在两个艾滋病毒流行的乌克兰城市，从监狱获释后一年内的艾滋病毒感染者（N=97）被招募并接受调查，了解其出狱后的警察拘留经历。收集了关于拘留频率、相关不良事件以及对 OST 和 ART 连续性的影响的数据，并使用逻辑回归检查了拘留的相关因素。
94 名（96.9%）参与者提供了拘留情况，其中 55 名（58.5%）报告了警察拘留（人均每年 9.4 次）。对于接受 OST 治疗（N=28）和 ART 治疗（N=27）的被拘留者，药物中断很常见（分别为 67.9%和 70.4%）；27 名接受 OST 治疗的参与者中有 23 名（85.2%）在前往/离开 OST 治疗的途中被拘留。无指控拘留的独立显著相关因素包括出狱后 ART 处方（AOR 4.98，p=0.021）、当前高危注射行为（AOR 5.03，p=0.011）、男性（AOR 10.88，p=0.010）和较低的终生监禁月数（AOR 0.99，p=0.031）。
乌克兰最近从监狱获释的艾滋病毒感染者经常受到警察拘留，导致出现戒断症状、没收注射器，并中断包括 ART 和 OST 在内的基本药物。迫切需要进行结构性改革，减少警察拘留，以控制艾滋病毒传播，改善个人和公共健康。
