Wood Emily F, Werb Dan, Beletsky Leo, Rangel Gudelia, Cuevas Mota Jazmine, Garfein Richard S, Strathdee Steffanie A, Wagner Karla D
Interdisciplinary Social Psychology Ph.D. Program, University of Nevada, Reno, United States.
Division of Global Public Health, University of California, San Diego, United States.
Int J Drug Policy. 2017 Mar;41:132-139. doi: 10.1016/j.drugpo.2016.12.010. Epub 2017 Jan 19.
Research among people who inject drugs (PWIDs) in the USA and Mexico has identified a range of adverse health impacts associated with policing of PWIDs. We employed a mixed methods design to investigate how PWIDs from San Diego and Mexico experienced policing in Tijuana, and how these interactions affect PWIDs behavior, stratifying by country of origin.
In 2012-2014, 575 PWIDs in San Diego, 102 of whom had used drugs in Mexico in the past six months, were enrolled in the STAHR-II study, with qualitative interviews conducted with a subsample of 20 who had recently injected drugs in Mexico. During this period, 735 PWIDs in Tijuana were also enrolled in the El Cuete-IV study, with qualitative interviews conducted with a subsample of 20 recently stopped by police. We calculated descriptive statistics for quantitative variables and conducted thematic analysis of qualitative transcripts. Integration of these data involved comparing frequencies across cohorts and using qualitative themes to explain and explore findings.
Sixty-one percent of San Diego-based participants had been recently stopped by law enforcement officers (LEOs) in Mexico; 53% reported it was somewhat or very likely that they would be arrested while in Mexico because they look like a drug user. Ninety percent of Tijuana-based participants had been recently stopped by LEOs; 84% reported it was somewhat or very likely they could get arrested because they look like a drug user. Participants in both cohorts described bribery and targeting by LEOs in Mexico. However, most San Diego-based participants described compliance with bribery as a safeguard against arrest and detention, with mistreatment being rare. Tijuana-based participants described being routinely targeted by LEOs, were frequently detained, and reported instances of sexual and physical violence. Tijuana-based participants described modifying how, where, and with whom they injected drugs in response; and experienced feelings of stress, anxiety, and powerlessness. This was less common among San Diego-based participants, who mostly attempted to avoid contact with LEOs in Mexico while engaging in risky injection behavior.
Experiences of discrimination and stigma were reported by a larger proportion of PWIDs living in Mexico, suggesting that they may be subject to greater health harms related to policing practices compared with those residing in the USA. Our findings reinforce the importance of efforts to curb abuse and align policing practices with public health goals in both the US and Mexico.
在美国和墨西哥针对注射吸毒者（PWIDs）开展的研究已确定了一系列与对注射吸毒者的治安管控相关的不良健康影响。我们采用了混合方法设计，以调查来自圣地亚哥和墨西哥的注射吸毒者在蒂华纳如何经历治安管控，以及这些互动如何影响注射吸毒者的行为，并按原籍国进行分层。
在2012年至2014年期间，圣地亚哥的575名注射吸毒者被纳入STAHR-II研究，其中102人在过去六个月内在墨西哥使用过毒品，并对20名最近在墨西哥注射过毒品的子样本进行了定性访谈。在此期间，蒂华纳的735名注射吸毒者也被纳入El Cuete-IV研究，并对20名最近被警察拦下的子样本进行了定性访谈。我们计算了定量变量的描述性统计数据，并对定性访谈记录进行了主题分析。这些数据的整合包括比较不同队列的频率，并使用定性主题来解释和探索研究结果。
61%的圣地亚哥参与者最近在墨西哥被执法人员（LEOs）拦下；53%的人报告说，他们在墨西哥时因为看起来像吸毒者而有点或非常有可能被逮捕。90%的蒂华纳参与者最近被执法人员拦下；84%的人报告说，他们因为看起来像吸毒者而有点或非常有可能被逮捕。两个队列的参与者都描述了在墨西哥被执法人员贿赂和针对的情况。然而，大多数圣地亚哥参与者将行贿视为防止被捕和拘留的一种保障，很少有虐待情况发生。蒂华纳的参与者描述说经常被执法人员针对，经常被拘留，并报告有性暴力和身体暴力事件。蒂华纳的参与者描述说，他们相应地改变了注射毒品的方式、地点和对象；并经历了压力、焦虑和无力感。这在圣地亚哥的参与者中不太常见，他们大多在进行危险注射行为时试图避免与墨西哥的执法人员接触。
居住在墨西哥的注射吸毒者中，报告遭受歧视和污名化经历的比例更高，这表明与居住在美国的注射吸毒者相比，他们可能因治安管控措施而受到更大的健康伤害。我们的研究结果强化了在美国和墨西哥努力遏制滥用行为并使治安管控措施与公共卫生目标保持一致的重要性。
