Flath Natalie, Tobin Karin, King Kelly, Lee Alexandra, Latkin Carl
a Department of Health , Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA.
Subst Use Misuse. 2017 Jul 3;52(8):1003-1010. doi: 10.1080/10826084.2016.1268630. Epub 2017 Mar 20.
Neighborhood-level characteristics, including police activity, are associated with HIV and Hepatitis C injection risk-behaviors among people who inject drugs (PWID). However, the pathways through which these neighborhood perceptions shape individual-level HIV risk behaviors are unclear. This study helps to explain perceived behaviors between perceived neighborhood police activity and HIV injection risk behavior (i.e., injection syringe/tool sharing in the previous 6 months).
A sample of (n = 366) PWIDs who self-reported recent use were recruited using community-based outreach methods in Baltimore, Maryland. Neighborhood police perceptions were assessed by asking participants whether they would (1) be more likely to ask others to share injection tools in the context of heightened police activity and (2) be less likely to carry syringes with them due to fear of arrest. Poisson regression with robust variance was used to identify statistical relationships. Recent police encounters, frequency of heroin injection, and sociodemographic characteristics were controlled for in the model.
Neighborhood police perceptions shaped injection-risk behavior. Half of the sample (49%) reported an aversion of carrying personal syringes, due to fear of arrest. Those who agreed they would be more likely to ask others to share injection equipment in the context of heightened police activity were more likely to share syringes (21% vs. 3%, p <.01). Adjusted models showed that syringe sharing was independently associated with asking to borrow equipment in neighborhoods with perceived heightened police activity (aPR: 2.22, 95% confidence interval (CI): 1.7, 3.0).
This study sheds light on how police perceptions may influence injection risk behavior. While these relationships require further elucidation, this study suggests that public health interventions aiming to reduce HIV risk would benefit from improving community-police relationships.
社区层面的特征，包括警察活动，与注射吸毒者（PWID）中的艾滋病毒和丙型肝炎注射风险行为相关。然而，这些社区认知影响个人层面艾滋病毒风险行为的途径尚不清楚。本研究有助于解释社区警察活动认知与艾滋病毒注射风险行为（即过去6个月内注射注射器/工具共享）之间的感知行为。
在马里兰州巴尔的摩市，采用基于社区的外展方法招募了（n = 366）自我报告近期使用毒品的PWID样本。通过询问参与者是否会（1）在警察活动增加的情况下更有可能要求他人共享注射工具，以及（2）由于害怕被捕而不太可能随身携带注射器，来评估对社区警察的认知。使用具有稳健方差的泊松回归来确定统计关系。模型中控制了近期与警察的接触、海洛因注射频率和社会人口学特征。
对社区警察的认知塑造了注射风险行为。一半的样本（49%）报告因害怕被捕而不愿随身携带个人注射器。那些同意在警察活动增加的情况下更有可能要求他人共享注射设备的人更有可能共享注射器（21%对3%，p <.01）。调整后的模型显示，在认为警察活动增加的社区中，注射器共享与要求借用设备独立相关（调整后的风险比：2.22，95%置信区间（CI）：1.7，3.0）。
本研究揭示了警察认知如何可能影响注射风险行为。虽然这些关系需要进一步阐明，但本研究表明，旨在降低艾滋病毒风险的公共卫生干预措施将受益于改善社区与警察的关系。
