The Impact of Human Rights Violations and Perceptions of Discrimination on Health Service Utilization Among Injection Drug Users in Delhi, India

Abstract

The study was conducted from August to December 2007, in two urban, poor neighborhoods in Delhi. A respondent-driven sampling was used to recruit 343 injection drug users who were interviewed with a survey questionnaire that included items of human rights abuses, health service utilization, and sociodemographic characteristics. Multivariate logistic regression with backward selection of variables was conducted with the three outcome variables-service utilization in general care sector, harm reduction, and drug user treatment. Findings suggest advocating for human rights and securing standards of care in improving health care use and future research on documenting human rights abuses occur in health care settings. The study's limitations are noted.

Male-to-male sex among men who inject drugs in Delhi, India: Overlapping HIV risk behaviours

“…Questions regarding demographics, drug use and sexual behaviours (predominantly condom use with various partners) were adapted from a previous study (Sarin & Kerrigan, 2012) among PWIDs in Delhi and from the Integrated Biological and Behavioural Assessment (IBBA) survey previously undertaken among PWIDs in three states of India (Indian Council of Medical Research & FHI 360, 2011). Recent sexual risk behaviour with female partners was gathered by first asking participants about the number and type of sex partners they had during the preceding six months and then asking whether or not they used a condom at last sex with these partners.…”

Healthcare avoidance by people who inject drugs in Bangkok, Thailand

“…33 The latter, however, was to our knowledge the only study to analyse social and structural factors and found that low utilization of healthcare services was associated with exposure to policing, social exclusion and negative healthcare experiences.…”

“…26 The findings presented herein add to the growing body of evidence that the Thai government's emphasis on aggressive drug law enforcement undermines public health by constraining healthcare access, 19,28 which is consistent with international literature suggesting the negative impact of aggressive policing tactics. 25,33,36,37 As urged by the World Bank and UNAIDS, 4,10,11,38 Thai policymakers should re-examine their ongoing punitive strategies and instead place emphasis on access to comprehensive harm reduction and healthcare services.…”

“…That negative experiences in healthcare settings would be discouraging to utilization is understandable and supported by the previously mentioned Indian study, which found that IDU with such experience were less likely to utilize healthcare services. 33 All Thai citizens have a constitutional right to standard care without discrimination, 34,39 and narcotics legislation specifically identifies drug users as 'patients' in need of treatment 40,41 ; therefore, policymakers and health officials should seek to address and reduce the stigmatizing attitudes towards IDU that persist in healthcare settings in Thailand 28,42 to ensure fair and universal access.…”

Getting to 90: linkage to HIV care among men who have sex with men and people who inject drugs in India

“…Across India, there are an estimated 2.4 million high-risk MSM (National AIDS Control Organization [NACO], 2006) despite criminalization of homosexuality under the Indian penal code. Poor access to and utilization of HIV services as well as stigma and discrimination are common for both MSM and PWID (Latkin et al, 2010; Mawar, Sahay, Pandit, & Mahajan, 2005; Sarin & Kerrigan, 2012; Thomas et al, 2011). …”