15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrE1069)

Davis CS, Metzger DS, Burris S
University of Pennsylvania Center for Studies of Addiction, Philadelphia, PA, United States

BACKGROUND: There is increasing interest in understanding the relationship between policing strategies and drug-related risk behaviors. In May 2002, Philadelphia launched an intensive long-term policing initiative that targeted corners where drugs have historically been sold. Many of these corners were near syringe exchange program (SEP) sites, providing an opportunity to observe effects of this police activity on SEP utilization.

METHODS: Data were drawn from Philadelphia's SEP, which collects usage and demographic information from all participants. Aggregate changes in SEP utilization were examined for periods of 3 weeks, 3 months, 6 months and 9 months before and after the initiation of the police intervention. A mixed-effects model was then used for each response using the six-week mean response around each of the time points. These models were summarized by considering contrasts between corresponding time points from the pre and post periods.

RESULTS: SEP utilization as measured by aggregate totals declined across all measurement categories and time periods studied following the policing intervention. By contrast, utilization trends in the year-before periods were nearly stable. The mixed-effects model found significant (p<.001) declines in total visits, Black visits and male visits at three, six, and nine months post implementation. Three-week comparisons were significant for number of visits by Blacks (p<.01), and males (p<.05). Over all periods studied, Black utilization decreased at over twice the rate white utilization decreased, and male utilization decreased at nearly twice the rate female utilization decreased.

CONCLUSIONS: These findings suggest that the policing intervention adversely affected the number of IDUs, especially Black and male IDUs, utilizing the needle exchange program. The disproportionate decline in the number of Blacks presenting heightens concern that law enforcement practices may contribute to disproportionate rates of HIV infection among Blacks.

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MoOrE1069

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