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Impact of Acts of Discrimination on Quality of Life Among Injecting Drug Users in Delhi, India

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Abstract

The study examines the association between quality of life (QOL) and discrimination perpetrated against a vulnerable population like injecting drug users (IDU). Given that QOL affects self efficacy which in turn affects behavior, it is relevant to examine QOL among IDUs in the context of HIV prevention, and to study whether discriminations and human rights abuses impact QOL in this population. A cross sectional study was conducted in two research sites in Delhi, India among 343 IDUs recruited through a respondent driven sampling. A Hindi version of the WHOQOL Bref survey along with a survey questionnaire of discrimination were used to interview participants. After controlling for demographic characteristics, experiencing physical and verbal abuse (OR: 0.46, CI 0.27–0.79),arrests and imprisonment for carrying needles and/or using drugs (OR: 0.53, CI 0.31–0.90) and lacking health information (OR: 0.49, CI 0.29–0.85)was associated with lower social QOL, while being denied health care services was associated with lower psychological QOL. The more discrimination experienced, the lower was the quality of life in the social and psychological domains. Participants’ perceived well being in the four domains was related to their living conditions, discriminatory acts and to perceptions of social support. Discriminatory acts and abuses appeared to have a greater toll on their psychological well being and social relationships, thus indicating the need for human rights advocacy in order to influence law enforcement practices and to reduce stigma, while expanding social support through an extended comprehensive IDU programme.

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References

  • Aggarwal, A., Chandran, S., & Misra, R. (2006). Physical, psychosocial and economic impact of Rheumataoid arthritis: A pilot study of patients seen at a tertiary care referral centre. National Medical Journal of India, 19, 187–191.

    Google Scholar 

  • Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2–3), 188–196.

    Article  Google Scholar 

  • Aitken, C., Moore, D., Higgs, P., Kersall, J., & Kerger, M. (2002). The impact of a police crackdown on a street drug scene: Evidence from the street. International Journal of Drug Policy, 13, 189–198.

    Article  Google Scholar 

  • Asian Human Rights Commission. (2005). India: Fifty four years in jail without trial: The plight of prison inmates in India. http://www.ahrchk.net/ahrc-in-news/mainfile.php/2004ahrcinnews/451. Retrieved 7th Jan 2009.

  • Bedi, G. S., Gupta, N., Handa, R., & Pal, H. (2005). Quality of life in Indian patients with rheumatoid arthritis. Quality of Life Research, 14, 1953–1958.

    Article  Google Scholar 

  • Bizzarri, J., Rucci, P., et al. (2005). Dual diagnosis and quality of life in patients in treatment for opioid dependence. Substance Use and Misuse, 40(12), 1765–1776.

    Article  Google Scholar 

  • Blankenship, K., & Koester, S. (2002). Criminal law, policing policy, and HIV risk in female street sex workers and injection drug users. The Journal of Law, Medicine & Ethics, 30, 548–559.

    Article  Google Scholar 

  • Brody, G. H., Chen, Y., Murry, V. M., Ge, X., Simons, R. L., Gibbons, F. X., et al. (2006). Perceived discrimination and the adjustment of African American youths: A five-year longitudinal analysis with contextual moderation effects. Child Development, 77, 1170–1189.

    Article  Google Scholar 

  • Carlsson, J. M., Olsen, D. R., & Kastrup, M. (2006). Mental health and health-related quality of life: A 10-year follow-up of tortured refugees. Journal of Nervous and Mental Diseases, 194(10), 725–731.

    Article  Google Scholar 

  • Chandra, P., Gandhi, C., et al. (2006). Quality of life in HIV subtype C infection among asymptomatic subjects and its association with CD4 counts and viral loads—a study from South India. Quality of Life Research, 15(10), 1597–1605.

    Article  Google Scholar 

  • Charles, M., Bewley-Tailor, D., & Neidpath, A. (2005). Drug policy in India: Compounding harm? The Beckley Foundation Drug Policy Programme www.internationaldrugpolicy.net/reports/BeckleyFoundation_BreifingPaper_10.

  • Donoghoe, M. C., Ballerup, A. R., Lazarus, J. V., Nielson, S., & Matic, C. (2007). Access to highly active antiretroviral therapy (HAART) for injecting drug users in the WHO European Region 2002–2004. International Journal of Drug Policy, 18, 271–280.

    Article  Google Scholar 

  • Dorabjee, J. D., Sarin, E., Singh, S., Singh, V., Mishra, M., & Sharma, M. (2000). Rapid situation assessment of drug use in Delhi. New Delhi, Sharan-Society for Service to Urban Poverty. Report submitted to UNESCO and EU.

  • Gee, G., & Pnce, N. (2010). American Journal of Public Health, 100(5), 888–895.

    Google Scholar 

  • Giacomuzzi, S., Kemmler, G., et al. (2006). Opioid addicts at admission versus slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants. Substance Use and Misuse, 41(2), 223–244.

    Article  Google Scholar 

  • Greene, M. L., Way, N., & Pahl, K. (2006). Trajectories of perceived adult and peer discrimination among Black, Latino and Asian American adolescents: Patterns and psychological correlates. Developmental Psychology, 42, 218–238.

    Article  Google Scholar 

  • Haroon, N., Aggarwal, A., et al. (2007). Impact of rheumatoid arthritis on quality of life. Modern Rheumatology, 17(4), 290–295.

    Article  Google Scholar 

  • Johansen, V., Wahl, A., et al. (2007). The predictive value of post-traumatic stress disorder symptoms for quality of life: A longitudinal study of physically injured victims of non-domestic violence. Health and Quality of Life Outcomes, 5(1), 26.

    Article  Google Scholar 

  • Kalichaman, S. C., Rompa, D., & Muhammad, A. (1997). Psychological predictors of risk for HIV infection among low income inner city men: A community based survey. Psychology and Health, 12(2), 493–503.

    Article  Google Scholar 

  • Kessler, R., Mickelson, K., & Williams, D. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40, 208–230.

    Article  Google Scholar 

  • Krieger, N. (1999). Embodying inequality: A review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services, 29(2), 295–352.

    Article  Google Scholar 

  • Li, X., Stanton, B., Fang, X., & Lin, D. (2006). Social stigma and mental health among rural-to-urban migrants in China: A conceptual framework and future research needs. World Health & Population, 8(3), 14–31.

    Google Scholar 

  • Mann, J. M. (1998). Dignity and health: The UDHR’s revolutionary first article. Health and Human Rights, 3(2), 30–38.

    Article  Google Scholar 

  • Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869–1876. doi:10.2105/AJPH.91.11.1869.

    Article  Google Scholar 

  • Mohan, D., & Dhawan, A. (2002). Rapid assessment survey on alcohol, tobacco and other substances in districts of Thrissur. Draft report submitted to the Ministry of Health and family welfare, Govt of India and WHO.

  • Narcotics Control Bureau, Govt. of India. (2008). NDPS Act. Basic features of the Narcotic Drugs and Psychotropic substances Act, 1985. http://narcoticsindia.nic.in/NDPSACT.htm. Retrieved August 1, 2008.

  • National AIDS Control Organisation. (2007). National AIDS control policy III. Retrieved September 4, 2008. www.nacoonline.org.

  • North East India Harm Reduction Network (NEIHRN). (2006). Documenting testimonies within a rights-based framework. Draft report.

  • Padaiga, Z., Subata, E., & Vanagas, G. (2007). Outpatient methadone maintenance treatment program. Quality of life and health of opioid-dependent persons in Lithuania. Medicina (Kaunas), 43(3), 235–241.

    Google Scholar 

  • Physician for Human Rights (PHR). (2003). PLWA form to study access to health care for people living with HIV and AIDS in Nigeria. Retrieved from http://physiciansforhumanrights.org.

  • Ponizovsky, A. M., & Grinshpoon, A. (2007). Quality of life among heroin users on buprenorphine versus methadone maintenance. The American Journal of Drug and Alcohol Abuse, 33(5), 631–642.

    Article  Google Scholar 

  • Reno, R. R., & Aiken, L. S. (1993). Life activities and life quality of heroin addicts in and out of methadone treatment. International Journal of Addiction, 28(3), 211–232.

    Google Scholar 

  • Rhodes, T., Mikhailova, L., Sarang, A., Lowndes, C., et al. (2003). Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliati City. Social Science and Medicine, 57(1), 39–54.

    Article  Google Scholar 

  • Rhodes, T., Singer, M., et al. (2005). The social structural production of HIV risk among injecting drug users. Social Science and Medicine, 61(5), 1026–1044.

    Article  Google Scholar 

  • Ronzani, T. M., Higgins-Biddle, J., & Furtado, E. F. (2009). Stigmatization of alcohol and other drug users by primary care providers in Southeast Brazil. Social Science and Medicine, 69(7), 1080–1084.

    Article  Google Scholar 

  • Sarin, E., Dorabjee, J., Singh, S., & Mehra, D. (1998). Rapid situation assessment of injecting drug use in Delhi. Paper presented at NIDA International Conference on Addiction, Arizona, USA. June, 1998.

  • Schnurr, P. P., Hayes, A. F., Lunney, C. A., McFall, M., & Uddo, M. (2006). Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 707–713. doi:10.1037/0022-006X.74.4.707.

    Article  Google Scholar 

  • Scogin, F., Morthland, M., Kaufman, A., & Burgio, L. (2007). Improving quality of life in diverse rural older adults: A randomized trial of a psychological treatment. Psychology and Aging, 22(4), 657–665. doi:10.1037/0882-7974.22.4.657.

    Article  Google Scholar 

  • Sellers, R. M., Linder, N. C., Martin, P. M., & Lewis, R. L. (2006). Racial identity matters: The relationship between racial discrimination and psychological functioning in African American adolescents. Journal of Research on Adolescence, 16, 187–216.

    Article  Google Scholar 

  • Sharan and Johns Hopkins University. (2007). Dissemination workshop report: Evaluation of a three component IDU Intervention in India. Dissemination workshop, New Delhi, September 27th, 2007.

  • Shetty, H., Nimkar, S., Pinto, D., & Bramachari, P. (1997). A few emerging trends. Indian Journal of Psychiatry, (suppl.), 39–46.

  • Shrestha, N. M., Sharma, B., et al. (1998). Impact of torture on refugees displaced within the developing world: Symptomatology among Bhutanese refugees in Nepal. JAMA, 280(5), 443–448.

    Article  Google Scholar 

  • Sibitz, I., Amering, M., Unger, A., Seyringer, M. E., Bachmann, A., Schrank, B., et al. (2011). The impact of the social network, stigma and empowerment on the quality of life in patients with schizophrenia. European Psychiatry, 26(1), 28–33. Epub 2010 Oct 30.

    Article  Google Scholar 

  • Skevington, S. M., Lotfy, M., et al. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310.

    Article  Google Scholar 

  • Torrens, M., & San, L. (1997). Use of the Nottingham health profile for measuring health status of patients in methadone maintenance treatment. Addiction, 92(6), 707–716.

    Article  Google Scholar 

  • Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200–208.

    Article  Google Scholar 

  • Winklbaur, B., Jagsch, R., Ebner, N., Thau, K., & Fischer, G. (2008). Quality of life in patients receiving opioid maintenance therapy. A comparative study of slow-release morphine versus methadone treatment. European Addiction Research, 14(2), 99–105.

    Article  Google Scholar 

  • Wolitski, R. J., Pals, S. L., Kidder, D. P., Courtenay-Quirk, C., & Holtgrave, D. R. (2009). The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV. AIDS and Behavior, 13(6), 1222–1232.

    Article  Google Scholar 

  • World Health Organization. (1996). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment.

  • Zhang, J., Xiaoming, L., Xiaoyi, F., & Xiong, Q. (2009). Discrimination experience and quality of life among rural to urban migrants in China: The mediation effect of reality-expectation discrepancy. Quality of Life Research, 18, 291–300.

    Article  Google Scholar 

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Authors and Affiliations

  1. Independent Consultant, B7, 1st floor, Suncity, Sector-54, Gurgaon, Haryana, 122002, India

    Enisha Sarin

  2. Sharan, Society for Service to Urban Poverty, F-6/8A, Vasant Vihar, New Delhi, 110057, India

    Luke J. Samson

  3. Department of Psychiatry and Behavioral Sciences, Family Service Research Center, The Medical University of South Carolina, McClennan Banks 4th Floor, 326 Calhoun St. STE MC406, Charleston, SC, 29401, USA

    Michael D. Sweat

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  1. Enisha Sarin
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Correspondence to Enisha Sarin.

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Sarin, E., Samson, L.J. & Sweat, M.D. Impact of Acts of Discrimination on Quality of Life Among Injecting Drug Users in Delhi, India. Soc Indic Res 113, 319–334 (2013). https://doi.org/10.1007/s11205-012-0095-8

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