RESUMO
The economic, social, cultural and political milieus that influence injection drug-related HIV risk behaviors along the US-Mexico border in the previous decade have been studied comparing cities on an East-West axis. In an effort to inform interventions targeting factors beyond the individual level, we used a cross-sectional study design comparing people who inject drugs during 2016-2018, living on a North-South axis, in two cities-Ciudad Juárez, Chihuahua, Mexico and El Paso, Texas, USA-situated at the midpoint of the 2000 US-Mexico borderland stretch. We conceptualize injection drug use and its antecedents and consequences as influenced by factors operating at various levels of influence. Results of analysis comparing samples recruited from each border city indicated significant differences in demographic, socioeconomic, micro- and macro-level factors that affect risk. Similarities emerged in individual-level risk behaviors and some dynamics of risk at the drug use site most frequented to use drugs. In addition, analyses testing associations across samples indicated that different contextual factors such as characteristics of the drug use sites influenced syringe sharing. In this article, we reflect on the potential tailored interventions needed to target the context of HIV transmission risk among people who use drugs and reside in binational environment.
Assuntos
Infecções por HIV , Abuso de Substâncias por Via Intravenosa , Transtornos Relacionados ao Uso de Substâncias , Humanos , Infecções por HIV/epidemiologia , Estudos Transversais , Cidades , Abuso de Substâncias por Via Intravenosa/epidemiologia , México/epidemiologiaRESUMO
Ethnic and sexual minority young adults in El Paso, Texas, are at high risk for substance use, human immunodeficiency virus (HIV), and hepatitis C virus (HCV). In 2014, a Hispanic-serving higher education institution partnered with two community-based organizations to implement integrated substance use interventions and HIV and HCV prevention among young adults on campus and in surrounding communities. Among the 95 young adults, aged 18-24 years, who responded to a needs assessment survey, 91.5% were Hispanic, 53.7% were female, and 27.4% were sexual or gender minorities (SGMs) as defined by behavior and identity. SGMs had significantly higher rates of current smoking, drinking when bored, and of being told they had a drinking problem. Compared with the other young adult survey respondents, SGMs had lower health risk perceptions for tobacco, alcohol, and marijuana use and reported similar or higher rates of lifetime drug use during sex and higher rates of HIV risk behaviors. Study findings have implications for including measures for sexual orientation and gender identity in substance use studies, examining regional and cultural norms that may intersect to shape substance use among SGMs, and incorporating unique risk contexts for SGMs in interventions for substance use.
Assuntos
Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Feminino , Identidade de Gênero , Humanos , Masculino , México , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Universidades , Adulto JovemRESUMO
Pasa la Voz (spread the word) is a human immunodeficiency virus (HIV) prevention methodology inspired by respondent-driven sampling (RDS) that uses social networks to access hard-to-reach populations. As field testing showed the approach to be efficacious among at-risk women in West Texas and Southern New Mexico, we set out to evaluate the methodology in a Mexican context. A local community organization, Programa Compañeros, first implemented a traditional one-on-one outreach strategy using promotoras (outreach workers) in Ciudad Juarez, Mexico, from September 2005 to January 2006. This was followed by implementation of Pasa la Voz from February 2006 to January 2007. The percentage of women agreeing to be tested increased from 11.9% to 49.9%, and staff time declined from 22.70 hours to 3.68 hours per HIV test, comparing the one-on-one with the Pasa la Voz methodology, respectively. Pasa la Voz was successful at imparting a cost-savings prevention education program with significant increases in the number of at-risk women being tested for HIV.
Assuntos
Relações Comunidade-Instituição , Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Apoio Social , Sorodiagnóstico da AIDS , Agentes Comunitários de Saúde , Feminino , Infecções por HIV/diagnóstico , Humanos , México , New Mexico , Aceitação pelo Paciente de Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Texas , MigrantesRESUMO
The economic, social, cultural, and political milieus that influence HIV risk behaviors along the US-Mexico border are understudied. In an effort to appropriately inform interventions targeting structural influences, we compared injecting drug using populations living in two cities--Ciudad Juárez, Chihuahua and Tijuana, Baja California--situated on the Mexico-US border. These populations presented with similar demographic profiles, but differed significantly in terms of social and environmental influences that can influence both risk and protective factors (e.g., family drug use, migration, drug use patterns). We observed distinct behavioral and structural influences in these two border cities that will require tailored intervention strategies to reduce HIV transmission.