Experts Warn That Police Abuse Is Fueling HIV Epidemic Among Injecting Drug Users

BANGKOK—Police abuse of drug users is undermining HIV prevention and treatment efforts in Asia and Eastern Europe, experts warned today after the opening of a conference to discuss the role of law enforcement in HIV prevention. Health care providers and advocates from 20 countries are meeting in Bangkok this week to develop strategies for HIV prevention services to work effectively with law enforcement.

HIV epidemics in at least 20 countries in Asia and Eastern Europe are now propelled by the use of contaminated needles and injection equipment. Outside Africa, nearly one in three HIV infections are due to injecting drug use, and injection-driven HIV epidemics in countries such as Russia are among the fastest-growing in the world.

The conference, sponsored by the Open Society Institute (OSI), comes as the Thai government begins an investigation into former Prime Minister Thaksin Shinawatra’s “war on drugs,” which resulted in more than 2,000 extrajudicial killings. Thailand is noted for its success in preventing the sexual transmission of HIV, but it has not stopped the growing HIV epidemic among drug users.

“We saw thousands of people murdered by the police during the drug war,” said Preecha Knoknan, who works at a Bangkok drop-in center providing HIV prevention services to drug users. “Police planted drugs in people’s pockets and forced them to sign false confessions. Now the drug war is supposed to be over, but drug users are so far underground that it is still hard for us to find them and give them information about how to protect themselves from HIV, or get HIV and drug treatment.”

The Open Society Institute funds programs to make sterile injection equipment and treatment for drug dependence accessible in Eastern Europe and Asia, but the group says that police abuse is hindering the effectiveness of new HIV prevention measures.

“From Ukraine to Malaysia, many countries are committed to increasing access to clean syringes and effective drug treatment, but fail to enlist the cooperation of police,” said Daniel Wolfe, Deputy Director of OSI’s International Harm Reduction Program. “Ministries of health emphasize access to services, while law enforcement talks about social evils and the need for harsh punishments. The result is increased HIV infections, missed treatment opportunities, and lost lives.”

Methadone and buprenorphine are prescription medications used to prevent withdrawal and reduce cravings in people dependent on heroin and other opiates. They are proven to help prevent HIV, and are the world’s best studied and most effective form of drug treatment. However, the medications are available to less than three percent of those in need worldwide, and the therapy is made even more inaccessible by police harassment.

Police violence against drug users is widespread in Indonesia, said Aditya Anugrah Putra, a former drug user and human rights researcher with the Indonesian Drug User’s Network. A recent survey in Bali found that more than 75 percent of drug users surveyed had experienced violence at the hands of the police, including beatings with weapons and inside police stations. Police harassment and extortion of drug users at methadone clinics and syringe exchanges is widespread throughout the country.

“Indonesia’s government has started methadone programs that are helping to save lives, but the police wait outside methadone clinics to search patients for drugs, and they arrest syringe exchange clients at will,” Putra said. “They treat us like criminals, when we are only trying to protect our health. We’ve even had reports of police standing outside HIV testing clinics, searching patients who come out, and demanding bribes. Why would anyone come to a clinic when they know the police are waiting for them outside?”

Alexander Tsekhanovich, founder of the oldest HIV prevention service for drug users in St. Petersburg, Russia, sounded a hopeful note at today’s conference, describing how his organization had gained the acceptance of the police.

“When we first started providing clean syringes, condoms, and health information to drug users, the police made it very difficult. They even forced our outreach workers to eat the identity cards we gave out. So we began a series of workshops to educate the police about drug use, teaching them how to protect themselves from needle sticks and other risks while giving them information about the importance of HIV prevention. Now they feel so comfortable with us that they even visit for latex gloves, condoms, and anonymous HIV tests.”

“Methadone, buprenrophine, and sterile injection equipment are essential tools in preventing HIV and reducing drug-related crime,” said OSI’s Wolfe. “We need to make law enforcement part of the solution to HIV, instead of part of the problem.”

# # #