Directors' Choice

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Feb. 2018 Cepeda JA, Strathdee SA, Arredondo J, Mittal ML, Rocha T, Morales M, Clairgue E, Bustamante E, Abramovitz D, Artamonova I, Banuelos A, Kerr T, Magis-Rodriguez CL, Beletsky L. Assessing police officers' attitudes and legal knowledge on behaviors that impact HIV transmission among people who inject drugsInt J Drug Policy. 2017;50:56-63. PMID: 29028564. PMCID: 5705567

About This Paper

Syringe possession is legal in many jurisdictions, however certain policing practices, such as confiscating syringes from people who inject drugs (PWID) can act as structural drivers of HIV infection. The elevated risk of sharing syringes among PWID who have had negative interactions with police has been observed in many settings, including Tijuana, Mexico. Further, police face occupational risks such as experiencing accidental needlestick injuries when conducting searches as part of their policing duties. Indeed, approximately 15% of police in Tijuana reported ever experiencing a needlestick injury. In order to better align policing with public health, researchers from the UCSD division of infectious diseases and global public health partnered with the Tijuana municipal police department to train over 1,800 police officers on : 1) occupational safety related to needlestick injuries and HIV 2) drug law reform and legality of syringe possession 3) drug pharmacology and harm reduction services. 

Our paper reports on the baseline findings from this structural HIV prevention intervention. We examined correlates of three outcomes that could have a direct impact on the health of PWID: frequency of 1) syringe confiscation 2) arrest for heroin possession 3) referral to health/social programs (e.g. drug treatment). We found that officers who had ever experienced a needlestick injury were 1.38 times as likely to confiscate syringes, while officers who expressed positive attitudes towards laws that treat addiction as a public health issue were approximately 20% less likely to arrest someone for heroin possession. Officers who believed that it was their duty to refer PWID to health/social programs were over 3 times as likely to report doing so. Interestingly, officers who had correct knowledge that syringe possession was legal in Mexico were not significantly less likely to confiscate syringes. 

Our findings suggest that modifying officers attitudes towards PWID may be important in mitigating behaviors that are inconsistent with good public health practices. Conversely, simply changing drug policy may not be sufficient in aligning policing with public health. We intend to explore how changes in attitudes and knowledge after receipt of the training will impact officers behaviors as we will be following police prospectively for 24 months. 

View other Directors' Choice selections from 2017 and  2016.

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