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Abstract
The study was conducted from August to December Citation, 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.
RÉSUMÉ
Impact des violations des droits de l'homme et perceptions de discrimination sur l'utilisation des services de santé parmi ceux qui utilisent des drogues injectables à Delhi en Inde
Cette étude a été menée d'août à Décembre Citation, dans deux quartiers urbains pauvres de Delhi. Nous avons utilisé un échantillon à base de répondants pour recruter 343 utilisateurs de drogues injectables, que nous avons interrogés avec un questionnaire qui contenait des questions sur les violations des droits de l'homme, l'utilisation des services de santé, et les caractéristiques sociodémographiques. Nous avons utilisé une analyse par régression logistique multi-variée avec sélection de variables a posteriori (multivariate logistic regression with backward selection of variables); les trois variables-résultat consistaient en l'utilisation des services dans le secteur des soins généraux, la réduction des effets nocifs, et le traitement des usagers de drogues. Les résultats suggèrent le besoin d'une activité de défense des droits de l'homme, de la garantie des normes de soins afin d'améliorer l'utilisation des soins de santé, ainsi que d'une recherche future afin de documenter les violations des droits de l'homme dans les établissements des soins de santé. Les auteurs notent les limites de cette étude.
RESUMEN
El impacto de las violaciónes de los derechos humanos, y la percepción de la discriminación en la utilización de los servicios de salud entre los usuarios que se inyectan drogas en Delhi, India
El estudio se realizó entre agosto y diciembre de Citation, en dos barrios pobres de las ciudades de Nueva Delhi. Muestreo Dirigido por Entrevistados (RDS) se utilizó para alcanzar a 343 usuarios de drogas inyectables y se entrevistó con un cuestionario que incluía elementos de abusos contra los derechos humanos, utilización de servicios de salud y características socio-demográficas. Regresión logística multivariado se llevó a cabo con tres variables de resultado: utilización de servicios de salud en general, reducción de daños asociada con el uso de drogas, y tratamiento para consumidores de drogas. Los resultados sugieren la importancia de la defense de los derechos humanos y la necesidad de asegurar mejores estándares de atención de la salud. El estudo tambien indica la necesidad de investigaciónes futuras para documentacar violaciones de los derechos en los centros de atención de salud. Las limitaciones del estudio se observan.
THE AUTHORS
Enisha Sarin, Ph.D., has been working in the field of HIV prevention research and program development for the last 15 years with a focus on behavioral and social interventions among urban poor and marginalized populations in India. She completed her masters, doctoral, and postdoctoral programs from the Johns Hopkins University Bloomberg School of Public Health. She has been actively engaged in grassroots community research and believes that HIV prevention can be addressed effectively only through addressing the social and cultural context in which HIV vulnerabilities are situated. After completing her studies, Enisha returned to India, where she always desired to pursue public health research that impacted on the lives of the poor and marginalized. Currently, she is heading the HIV and gender portfolio in the Asia regional office of the International Center for Research on Women.
Deanna Kerrigan, Ph.D., M.P.H., has been working in the field of international health for the last 18 years. A significant portion of her work has focused on conducting and disseminating HIV prevention intervention research to ensure that the social and structural contexts surrounding HIV-related vulnerability in diverse geographic and cultural settings are understood and addressed in prevention policies and programs. Her work regarding the development and effectiveness of environmental–structural interventions to reduce HIV/AIDS in lower- and middle-income settings has been published in many of the top journals of the field of public health including the American Journal of Public Health and Social Science and Medicine and translated into novel program and policy approaches. In addition to her experience leading her own HIV-related intervention research as a faculty member at the Johns Hopkins School of Public Health, Dr. Kerrigan has also been responsible for managing a diverse portfolio of research and programmatic funding regarding HIV/AIDS and sexual and reproductive health as conducted by other institutions. In the latter capacity, she has held various professional positions that have involved project management and financial oversight. She has, for example, served as a Project Director for a multisite community health program in rural Guatemala, as a Contract Officer supervising over 35 community-based organizations for the AIDS Bureau of the Massachusetts Department of Public Health and most recently as a Program Officer for the Sexuality and Reproductive Health and Rights Unit of the Ford Foundation. She is currently an adjunct assistant professor of International Health in the Bloomberg School of Public Health at the Johns Hopkins University.