In the Tijuana neighborhood known as La Zona Norte, you don’t have to look very hard to find people using drugs.
On the sidewalk of a busy street, a man uses a needle to inject himself in the neck. Around the corner, in the middle of a pile of garbage, another man shoots up.
Used syringes are everywhere.
When Tijuana police officers find syringes on someone, they typically break them apart, or throw them in the trash. That’s what they were taught to do.
But these practices are risky. In a recent survey, 15 percent of Tijuana officers said they’ve suffered a needle-stick injury.
“Normally we don’t get courses in how to avoid becoming infected by syringes and other things," officer Jonathan Martinez said.
Until now.
UC San Diego is working with the Tijuana police to coordinate special training for officers to make it safer for them to patrol the streets in the border city.
Special training
A unique program is underway to change the way Tijuana police handle syringes and drug users.
At the police academy in Tijuana, Sub Inspector Cesar Quinones talks to a roomful of officers about where they’re likely to encounter intravenous drug users, including "shooting galleries" — places where addicts go to shoot themselves up with heroin and other drugs.
Quinones explains how some officers enter shooting galleries wearing gloves for protection. Others don’t.
Next, he shows a slide with statements about how HIV is spread. He asks officers to raise their hands if they think mosquitoes transmit the disease.
“Uno, dos, tres, quarto, cinco, seis, siete, ocho, nueve," he counted out loud as many hands went up.
As Quinones goes through his presentation, the officers ask a lot of questions.
Dr. Eliane Bustamante, a physician who’s also in the room, gives them a little HIV 101.
“If I have contact of any kind with secretions like blood and semen from someone who’s infected, I can become contaminated, too," she told the roomful of cops.
During a break in the training, Bustamante said she’s surprised about the officers’ lack of knowledge.
“They seem really interested in the topic," she said. "But there’s several questions (where) I thought, ‘Well, that’s really obvious.’ But no, they seem really interested in the basic topics, like what’s HIV?”
It's so well-known in the U.S. that most people don't even think anymore about what the acronym stands for — human immunodeficiency virus. It's a sexually transmitted infection often spread by contact with infected blood. It weakens an infected person's immune system to the point that it eventually becomes AIDS.
The lack of understanding about what HIV is can hurt officers, Bustamante said.
“By not knowing what it is and how I can prevent it, they can easily get infected," she said.
During the training, officers learn how HIV is transmitted and how to handle needles safely in the field.
They’re told that federal law in Mexico allows people to possess syringes without a prescription. The law also lets people carry up to 50 milligrams of heroin for personal use.
The class introduces officers to the concept that drug users aren’t scum. They’re human beings who need help with their addiction.
The trainings began in February. Eventually, the entire Tijuana police force will take the three-hour class. So far, about 300 officers have gone through it.
Quinones said when he goes out in the field now, he sees officers acting differently.
“We’ve emphasized in the class that the most important thing is their safety during their shift," he said. "And we’re noticing that they’re changing, and they’re respecting the law about syringes.”
Partnering with UCSD
UC San Diego's Division of Global Public Health came up with idea for the training. It’s also the first partnership between an American university and a Mexican police force.
It's a collaborative effort between UCSD and El Colegio de la Frontera Norte, a higher education research center based in Tijuana that focuses on border issues.
UCSD Global Health Division Chief Steffanie Strathdee is leading the partnership, along with Leo Beletsky, adjunct assistant professor in the Division of Global Public Health at UC San Diego and assistant professor of law and health sciences at the Northeastern University School of Law, and Gudelia Rangel, a professor at COLEF in Mexico.
Strathdee said research has shown that training can change officers’ attitudes and knowledge.
“But nobody’s ever studied to see if it would change the behaviors of police officers," she said. "We’ll be following 500 police officers in Tijuana over two years to see whether or not this intervention works.”
The status quo is clearly risky.
Statistics show the HIV rate among IV drug users in Tijuana ranges from 4 percent for men to 10 percent for women.
