Health and Human Rights of Drug Users. Joseph Amon Health & Human Rights Division Human Rights Watch

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1 Health and Human Rights of Drug Users in Detention in Guangxi Province, China Joseph Amon Health & Human Rights Division Human Rights Watch

2 Outline Background Methods Results Conclusions

3 Background 5 6 million drug users Roughly half of all HIV infections associated with IDU Rapidly expanded dcommunity based methadone >350,000 drug users detained in detox, RTL 700 detox centers, 165 re education education through labor Rapid expansion from 1995 on

4 Background Before st time offenders: 3 6 month sentence in detox Repeat offenders: 1 3 years in RTL Detox sentences may not exceed 1 year Limited due process / oversight June 2008 new law Increased powers to conduct drug search Eliminates RTL sentences compulsory isolation detoxification 1 3 years followed by up to 3 years in community rehabilitation

5 Methods July 2007 Site Baise, Nanning, Guangxi Province Legal/Policy review Key informant interviews Chinese government and NGOs, HCWs Recently (5 (<5 y) detained didu interviews i Notice, referral

6 Methods Semi structured IDU interviews IDU experiences in detox, RTL Living conditions, health status, drug use, access to health care, labor IDU experiences prior/post detention IDU knowledge/access to HIV prevention in community 3 hours Informed consent, anonymous

7 Results 20 key informant interviews 20 IDUs contacted 19 eligible 15 male, 4 female 8 from Baise, 11 from Nanning years Detained, on average: 4 times in detox (range: 1 8 times) 1 RTL (range: 0 3)

8 IDU # # times in Last date # times in Last date HIV detox in detox RELC in RELC status dk dk dk dk dk dk dk

9 Results Fear of Arrest Inability to Access Community Services Lack of Due Process Oversight Conditions i in Detention Mandatory HIV testing Little access to health care Disruption of antiretroviral therapy HIV and TB infection risk Physical, sexual abuse and forced labor

10 I really can t go out in public anymore because if police are trying to fill their quota they will arrest me when they see me. IDU Fear of Arrest

11 Everyone who takes methadone is identified by police IDUs are a prime target for arrest NGO worker Fear of Arrest

12 Sometimes I m Im afraid I might be sick with AIDS but I d rather be sick and free than go get tested, get arrested, and be sick ikin detox or RTL Fear of Arrest

13 If you get arrested when they have enough people in RTL then you are safe, but if you get arrested at another time, then you can be put into RTL Due process

14 I was tested in detox twice for HIV, but never told the result. IDU Conditions in detox/rtl

15 The CDC does not want to tell people their HIV status when they areimprisoned because they think it would cause unrest. Government official Conditions in detox/rtl

16 They say that detox and RTL are for quitting drugs, but it is no different from a prison. You work like a slave and don t thave access to treatment. Conditions in detox/rtl

17 I had no access to HIV medicines while I was in detox and then when I left I had TB People are always sicker when they leave than they were coming in. Conditions in detox/rtl

18 In RTL or detox, if you are there long enough you find drugs. In RTL we would have 300 people sharing one needle. Conditions in detox/rtl

19 I started taking ARV bf before I was put into detox. Then when I was in I had to stop. Conditions in detox/rtl

20 This place is hell. We are supposed to be there for quitting drugs but instead we work like we are slaves and then get beat up. We leave detox and eventually if we don t die, we get arrested again, and have to go through it again. Conditions in detox/rtl

21 Human Rights Violations Lack of judicialoversight Right to the highest attainable standard of health the failure to provide adequate medical care and HIV/TB prevention Right to absolute protection against torture and cruel, inhuman, or degrading di treatment or punishment forced labor physical/sexual abuse The UNSpecial Rapporteur ontorture has stated that RTL centers can be considered a form of inhuman or degrading treatment or punishment, if not mental torture

22 Thepurpose of the detox center is reallyjust disciplinary, it's not to give people medical care. Physician working at detox center, Nanning

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