Healthcare Avoidance by People Who Inject Drugs in Bangkok, Thailand

Although people who inject drugs (IDU) often contend with various health-related harms, timely access to health care among this population remains low. We sought to identify specific individual, social and structural factors constraining healthcare access among IDU in Bangkok, Thailand.

Data were derived from a community-recruited sample of IDU participating in the Mitsampan Community Research Project between July and October 2011. We assessed the prevalence and correlates of healthcare avoidance due to one's drug use using multivariate logistic regression.

Among 437 participants, 112 (25.6%) reported avoiding health care because they were IDU. In multivariate analyses, factors independently associated with avoiding health care included having ever been drug tested by police, experienced verbal abuse, been discouraged from engaging in usual family activities, been refused medical care, experienced any barriers to health care and received healthcare information and support at a drop-in centre.

These findings highlight the need to address the broader policy environment, which perpetuates the criminalization and stigmatization of IDU, and to expand peer-based interventions to facilitate access to health care for IDU in this setting.

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By: Heath AJ1, Kerr T2, Ti L2, Kaplan K3, Suwannawong P4, Wood E2, Hayashi K2.

• 1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada V6T 1Z3.
• 2British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada V6Z 1Y6 Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada V6Z 1Y6.
• 3Treatment Action Group, New York, NH 10016-7701, USA.
• 4Thai AIDS Treatment Action Group, Bangkok 10900, Thailand.  

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