1. Police Brutality is Independently Associated with Sharing Injection Equipment among Injection Drug Users in Odessa, Ukraine Supported by the National Institute on Drug Abuse (RO1DA17620 & R01 DA027772-S1) Robert Booth (1) Sergei Dvoryak (2) Christy Anderson (3) J.T. Brewster (1) Steffanie A. Strathdee (3) (1) School of Medicine, University of Colorado Denver (2) Ukrainian Institute on Public Policy (3) Division of Global Public Health, University of California San Diego

2. Perspective from People Using Drugs in Odessa Interviewer: “Aren't you concerned about getting AIDS?" Reply : "No". Interviewer: "What is your biggest fear?" Reply: "Withdrawal." Interviewer: "What is your 2 nd biggest fear?" Reply: "The police. Withdrawal and the police are today. If I get HIV, I will still live another day."

3. Rushed Injections

4. Factors Independently Associated with Sharing Injection Equipment in Odessa (n = 480) Sharing Injection Equipment (n = 93; 19%) Characteristic or BehaviorAdjOR95% CI Ever beaten by police and then released 3.61*(2.08 – 6.27) Injected drugs more than 30 times † 2.71*(1.54 – 4.76) Injected sedatives † 3.56*(1.35 – 9.36) Injected stimulants † 4.40*(2.60 – 7.43) Homeless3.30*(1.37 – 7.99) Participant had vaginal, anal, or oral sex with IDU † 1.71(1.01 - 2.89) † Past 30 days

5. Conclusions One quarter of IDUs in Odessa report being beaten by police and then released. Police brutality was independently associated with sharing injection equipment in Odessa, adding to the considerable body of literature showing that policing practices can adversely affect the HIV epidemic. Eliminating these human rights violations could favorably impact the HIV epidemic by preventing up to one fifth of HIV infections over the next 5 years (Strathdee et al, Lancet 2010).