Health and Human Rights Concerns of Drug Users in Detention in Guangxi Province, China
Background:
Although confinement in drug detoxification (“detox”) and re-education through labor (RTL) centers is the most common form of treatment for drug dependence in China, little has been published about the experience of drug users in such settings. We conducted an assessment of the impact of detention on drug users' access to HIV prevention and treatment services and consequent threats to fundamental human rights protections.
Methods and Findings:
Chinese government HIV and anti-narcotics legislation and policy documents were reviewed, and in-depth and key informant interviews were conducted with 19 injection drug users (IDUs) and 20 government and nongovernmental organization officials in Nanning and Baise, Guangxi Province. Significant contradictions were found in HIV and antinarcotics policies, exemplified by the simultaneous expansion of community-based methadone maintenance therapy and the increasing number of drug users detained in detox and RTL center facilities. IDU study participants reported, on average, having used drugs for 14 y (range 8–23 y) and had been confined to detox four times (range one to eight times) and to RTL centers once (range zero to three times). IDUs expressed an intense fear of being recognized by the police and being detained, regardless of current drug use. Key informants and IDUs reported that routine HIV testing, without consent and without disclosure of the result, was the standard policy of detox and RTL center facilities, and that HIV-infected detainees were not routinely provided medical or drug dependency treatment, including antiretroviral therapy. IDUs received little or no information or means of HIV prevention, but reported numerous risk behaviors for HIV transmission while detained.
Conclusions:
Legal and policy review, and interviews with recently detained IDUs and key informants in Guangxi Province, China, found evidence of anti-narcotics policies and practices that appear to violate human rights and imperil drug users' health.
Vyšlo v časopise:
Health and Human Rights Concerns of Drug Users in Detention in Guangxi Province, China. PLoS Med 5(12): e234. doi:10.1371/journal.pmed.0050234
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.0050234
Souhrn
Background:
Although confinement in drug detoxification (“detox”) and re-education through labor (RTL) centers is the most common form of treatment for drug dependence in China, little has been published about the experience of drug users in such settings. We conducted an assessment of the impact of detention on drug users' access to HIV prevention and treatment services and consequent threats to fundamental human rights protections.
Methods and Findings:
Chinese government HIV and anti-narcotics legislation and policy documents were reviewed, and in-depth and key informant interviews were conducted with 19 injection drug users (IDUs) and 20 government and nongovernmental organization officials in Nanning and Baise, Guangxi Province. Significant contradictions were found in HIV and antinarcotics policies, exemplified by the simultaneous expansion of community-based methadone maintenance therapy and the increasing number of drug users detained in detox and RTL center facilities. IDU study participants reported, on average, having used drugs for 14 y (range 8–23 y) and had been confined to detox four times (range one to eight times) and to RTL centers once (range zero to three times). IDUs expressed an intense fear of being recognized by the police and being detained, regardless of current drug use. Key informants and IDUs reported that routine HIV testing, without consent and without disclosure of the result, was the standard policy of detox and RTL center facilities, and that HIV-infected detainees were not routinely provided medical or drug dependency treatment, including antiretroviral therapy. IDUs received little or no information or means of HIV prevention, but reported numerous risk behaviors for HIV transmission while detained.
Conclusions:
Legal and policy review, and interviews with recently detained IDUs and key informants in Guangxi Province, China, found evidence of anti-narcotics policies and practices that appear to violate human rights and imperil drug users' health.
Zdroje
1. Country Coordinating Mechanism of China
2004
Reducing HIV transmission among and from vulnerable groups and alleviating its impact in seven provinces in China.
Round four proposal to The Global Fund against HIV, TB and malaria
Beijing
Country Coordinating Mechanism of China
2. People's Republic of China
2008
UNGASS Country Progress Report, January 2006–December 2007
Beijing
People's Republic of China.
Available: http://data.unaids.org/pub/Report/2008/china_2008_country_progress_report_en.pdf. Accessed 23 May 2008.
3. WuZSullivanSGWangYRotheram-BorusMJDetelsR
2007
Evolution of China's response to HIV/AIDS.
Lancet
369
679
690
4. SullivanSGWuZ
2007
Rapid scale up of harm reduction in China.
Int J Drug Policy
18
118
128
5. State Council of the People's Republic of China
1998
Chinese National medium-and long-term strategic plan for HIV/AIDS prevention and control (1998–2010).
State Council Document GF
(1998)
38
Beijing
State Council
6. State Council of the People's Republic of China
2001
China's action plan for reducing and preventing the spread of HIV/AIDS (2001–2005).
State Council Document
2001
40
Beijing
State Council
7. State Council of the People's Republic of China
2004
State council notice on strengthening HIV/AIDS prevention and control.
State Council Document 2004(7)
Beijing
State Council
8. The Bill & Melinda Gates Foundation
2007 November 14
Major commitment to expand HIV prevention in China
Seattle
Gates Foundation.
Available: http://gateskeepers.civiblog.org/blog/_archives/2007/11/15/3353847.html. Accessed 31 October 2007.
9. ReidGCostiganG
2002
Revisiting ‘the hidden epidemic': a situation assessment of drug use in Asia in the context of HIV/AIDS
Fairfield (Australia)
The Centre for Harm Reduction, The Burnet Institute.
Available: http://www.lcgbangladesh.org/HIV_AIDS/reports/2002-Reid%20and%20Costigan-Revisiting%20'The%20Hidden%20Epidemic'.pdf. Accessed 31 October 2008.
10. National Narcotics Control Commission
2006
Annual Report on Drug Control in China [in Chinese]
Beijing
National Narcotics Control Commission
11. Xinhua News Agency
2007 September 18
Beijing introduces compulsory urine tests to keep drug addicts clean
Beijing
Xinhua News Agency.
Available: http://news.xinhuanet.com/english/2007–09/18/content_6747818.htm. Accessed 10 January 2008.
12. HeYSwanstromN
2006
China's war on narcotics: Two perspectives
Washington (D. C.)
Central Asia-Caucasus Institute and Silk Road Studies Program
13. Xinhua
News Agency (2004 June 21) China registers 740,000 drug addicts
Beijing
Xinhua News Agency.
Available: http://www.china.org.cn/english/China/98945.htm. Accessed: 10 January 2008
14. State Council of the People's Republic of China
1995
Methods for forced detoxification [in Chinese]
Beijing
State Council
15. Standing Committee of the 10th National People's Congress
2007
Prohibited drugs law of the People's Republic of China [in Chinese]
Beijing
National People's Congress
16. YuW
2007
New anti-drug law uses quarantine to replace controversial re-education through labor.
Available: http://www.law-star.com/cac/125018581.htm. Accessed 8 October 2007.
17. China National Knowledge Infrastructure
2008
Database [in Chinese].
Available: http://number.cnki.net/cyfd/index.aspx. Accessed 10 June 2008.
18. YuXFChenJShaoYBeyrerCLaiK
1998
Two subtypes of HIV-1 among injection-drug users in southern China.
Lancet
351
1250
19. AuerbachCFSilversteinLB
2003
Qualitative data: An introduction to coding and analysis
New York
New York University Press
20. BaileyK
1994
Methods of social research
New York
Free Press
21. Human Rights Watch
2008
An unbreakable cycle: Drug dependency, mandatory confinement and HIV/AIDS in Guangxi Province, China.
New York: Human Rights Watch
In press.
22. State Council of the People's Republic of China
2000
White paper on narcotics control
Beijing
State Council.
Available: http://english.gov.cn/official/2005–08/17/content_24165.htm#2000. Accessed 20 November 2007.
23. TangYZhaoDZhaoCCubellsJ
2006
Opiate addiction in China: Current situation and treatments.
Addiction
101
657
665
24. HammettTBartlettNChenYNguDCuongN
2005
Law enforcement influences on HIV prevention for injection drug users: Observations from a cross-border project in China and Vietnam.
Int J Drug Policy
216
235
245
25. ZhaoCLiuZ
2004
Drug abuse in China.
Ann N Y Acad Sci
1025
439
445
26. McDonaldH
2005 June 25
Chinese addicts get cold turkey and herbs.
The Age.
Available: http://www.theage.com.au/news/world/chinese-addicts-get-cold-turkey-and-herbs/2005/06/24/1119321904276.html. Accessed 13 November 2007.
27. Human Rights Watch
2003
Locked doors: The human rights of people living with HIV/AIDS in China
New York
Human Rights Watch
28. LiuHGruskyOZhuYLiX
2006
Do drug users who frequently receive detoxification treatment change their risky drug use practices and sexual behavior.
Drug Alcohol Depend
84
114
121
29. ZhouYLiX
1999
Demographic characteristics and illegal drug use patterns among attendees of drug cessation programs in China.
Subst Use Misuse
34
907
920
30. WuZ
1999
Preventing HIV infection among injection drug users in China.
Global Research Network, HIV Prevention in Drug-Using Populations, Second Annual Meeting Report
Atlanta
Global Research Network, HIV Prevention in Drug-Using Populations, Second Annual Meeting Report
31. United Nations Drug Control Program
2000
China country profile
Bangkok
Regional Centre for East Asia and the Pacific
32. The Joint United Nations Programme on HIV/AIDS, United Nations International Drug Control Program
2000
Drug use and HIV vulnerability: Policy research study in Asia
Bangkok
Regional Centre for East Asia and the Pacific
33. United Nations Office of Drugs and Crime
2002
Contemporary drug abuse treatment: A review of the evidence base
Vienna
United Nations International Drug Control Program
34. National Institute of Drug Abuse
1999
Principles of effective drug addiction treatment: A research-based guide.
Available: http://www.drugabuse.gov/PDF/PODAT/PODAT.pdf. Accessed 30 October 2007.
35. Center for Substance Abuse Treatment
2002
Tip 45: Detoxification and substance abuse treatment
Rockville (Maryland)
Substance Abuse and Mental Health Services Administration.
Available: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.part.22441. Accessed 12 January 2008.
36. SchottenfeldRSChawarskiMCMazlanM
2008
Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: A randomised, double-blind, placebo-controlled trial.
Lancet
371
2192
2200
37. United Nations Commission on Human Rights
2006
Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment and punishment: Mission to China. E/CN.4/2006/6/Add.6, paras 64, 82.
Available: http://ap.ohchr.org/documents/dpage_e.aspx?m=103. Accessed 3 November 2008.
38. United Nations
1969
Vienna Convention on the Law of Treaties.
United Nations Treaty Series, vol. 1155
331
New York
United Nations.
Available: http://untreaty.un.org/ilc/texts/instruments/english/conventions/1_1_1969.pdf. Accessed: 12 May 2008.
39. United Nations
1966
International covenant on civil and political rights. UN Doc. A/6316 (1966)
New York
United Nations.
Available: http://www.unhchr.ch/html/menu3/b/a_ccpr.htm. Accessed 3 November 2008.
40. United Nations
1994
General Comment 8, Article 9, Sixteenth session, 1982.
In:
United Nations, Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, UN Doc. HRI/GEN/1/Rev.1(8)
New York
United Nations
41. United Nations
1988
Body of principles for the protection of all persons under any form of detention or imprisonment
UN Doc A/43/49
New York
United Nations.
Available: http://www.unhchr.ch/html/menu3/b/h_comp36.htm. Accessed 3 November 2008.
42. United Nations
1992
Humane treatment of persons deprived of liberty. Human Rights Committee General Comment 21.
In:
Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, UN Doc. HRI/GEN/1/Rev
6
3
New York
United Nations
43. United Nations
1984
Convention against torture and other cruel, inhuman or degrading treatment or punishment. UN Doc. A/39/51
New York
United Nations.
Available: http://www.unhchr.ch/html/menu3/b/h_cat39.htm. Accessed 3 November 2008.
44. United Nations
1990
Basic principles for the treatment of prisoners. UN General Assembly Resolution 45/111, Article 9
New York
United Nations.
Available: http://www.unhchr.ch/html/menu3/b/h_comp35.htm. Accessed 3 November 2008.
45. World Health Organization, The Joint United Nations Programme on HIV/AIDS
1999
Guidelines on HIV infection and AIDS in prisons. UNAIDS Doc 99.47/E
Geneva
UNAIDS.
Available: http://data.unaids.org/Publications/IRC-pub01/JC277-WHO-Guidel-Prisons_en.pdf. Accessed 3 November 2008.
46. Committee on Economic, Social, and Cultural Rights
2000
General comment No. 14: The right to the highest attainable standard of health. UN Doc E/C.12/2000/4
Geneva
Economic and Social Council.
Available: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En. Accessed 3 November 2008.
47. AmonJ
2008
High hurdles for health.
In:
WordenM
China's Great Leap
New York
Seven Stories Press
125
140
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