Safe havens and rough waters: networks, place, and the navigation of risk among injection drug-using Malaysian fishermen

The International Journal on Drug Policy
Brooke S WestAdeeba Kamarulzaman

Abstract

HIV prevalence among Malaysian fishermen is ten times that of the general population. Fishing boats are a key place where drug use occurs, but we know little about how these environments shape HIV risk behaviour. Utilizing Rhodes' 'risk environment' framework, we assessed drug use contexts and how characteristics of place associated with fishing and fishermen's social networks served as key axes along which drug use and HIV risk behaviour occurred. Data were collected during 2009-2011 in Kuantan, a fishing port on the eastern coast of Malaysia, and include 28 in-depth interviews and 398 surveys collected using RDS. Logistic regression was used to determine the effect of occupational, network and risk environment characteristics on unsafe injection behaviour and access to clean needles/syringes; qualitative data were coded and analyzed thematically. Drug injecting was common and occurred on boats, often with other crewmembers. Captains and crewmembers were aware of drug use. Unsafe injection practices were significantly associated with having a larger proportion of drug injectors in network (OR=3.510, 95% CI=1.053-11.700) and having a captain provide drugs for work (OR=2.777, 95% CI=1.018-7.576). Size of fishermen network (OR=0....Continue Reading

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Citations

Apr 22, 2014·The International Journal on Drug Policy·Hannah L F Cooper, Barbara Tempalski
May 26, 2016·Journal of Psychoactive Drugs·Alethea DesrosiersMarek C Chawarski
Jul 13, 2016·Journal of Ethnicity in Substance Abuse·Shan-Estelle BrownFrederick L Altice
Apr 16, 2019·Asia-Pacific Journal of Public Health·Priya LallAdeeba Kamarulzaman

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