Aligning Criminal Justice and HIV Prevention: From Conflict to Synergy
26 Pages Posted: 24 Sep 2009
Date Written: February 27, 2009
Abstract
As the dual epidemics of drug abuse and HIV continue to plague communities at home and abroad, public health and law enforcement professionals working in the same neighborhoods remain separated by divergent professional philosophies, operational approaches, and institutional incentives. Especially when it comes to efforts targeting injection drug users (IDU) and other criminalized at-risk groups, these professionals view each other’s work with suspicion and sometimes with outright hostility. Data demonstrate, however, that the population-level impact of disease and drug control efforts in hardest-hit populations remains equally bleak. In this context, police and public health practitioners can no longer afford to work in conflict. Collaboration between these sectors is essential to create safer communities, improve health outcomes, and free up capacity to fight dangerous criminals, all of which can lead to other public benefits including cost-savings to the taxpayer.
The 2009 summit Aligning Criminal Justice and HIV Prevention: From Conflict to Synergy was designed to convene practitioners from the policing and public health sectors to share experiences and ideas with academic researchers and funders. The primary goals of this event were to explore a common understanding of the dual epidemic of drug abuse and HIV in hardest-hit communities, to learn about the ongoing efforts to harmonize policing with HIV prevention, and to identify and operationalize steps for further research, evaluation, and programmatic action.
The proceedings highlighted the complex institutional, cultural, economic, and other factors that lead to the considerable misalignment between policing with public health efforts targeting drug users. Different professional tools, outcome measures, incentive structures, and occupational philosophies fuel this dysfunctional conflict. In many ways, however, police and public health professionals share some key core values and detailed understanding of the complex problems facing at-risk populations. Focusing on these similarities and mutual strengths can help facilitate discussion and frame collaborative efforts that, in the end, benefit both sectors.
In the specific context of HIV prevention among IDUs, panel discussions, case study presentations, and round-table sessions helped distil a number of key themes that emerge from efforts to harmonize policing and public health, including: • legal reforms designed to alter policing practices are sometimes necessary, but are never sufficient to substantially shift street-level law enforcement practices to align them with public health efforts because these practices are fueled by powerful cultural, political, and economic factors; • establishing both formal and informal relationships with personnel on different levels of law enforcement command has proved an effective way for public health professionals to institutionalize cooperation with policing and criminal justice actors, • highlighting aspects of public health efforts that parallel law enforcement’s self-interest and world-view, such as lowering visible drug activity, promoting officers’ occupational safety, and reducing paperwork, • understanding and system integration of both carrots and sticks to engage criminal justice actors in collaboration is necessary for progress in this realm.
A key outcome sought in this meeting was to produce a set of ideas and recommendations about scientific needs and programmatic priorities. These included: 1. research to quantify and characterize the influence of criminal justice actors on HIV and other health outcomes, 2. research to help understand motivators and modifiers of police behavior, 3. research to identify the key ingredients of effective police-public health collaboration, and 4. programmatic activities that facilitate interdisciplinary scientific inquiry in this domain, including conferences, publications, and funding streams specially designated to promote police-public health collaboration in the HIV prevention realm as well as in other domains of community health and safety.
The report concludes with a summary of next steps and instructions on how to become involved in the research and other activities directed at aligning policing and HIV prevention.
Keywords: law enforcement, HIV prevention, drug abuse, collaborative synergy
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