RESUMO
Hispanic men who have sex with men (HMSM) experience HIV risk-related and mental health disparities. The relationship of mental health (i.e., depressive symptoms and anxiety) on sexual risk behaviors of HMSM has been reported. However, little is known about the influence of impulsivity and compulsivity on sexual risk behaviors. A cross-sectional study explored these factors among 150 HMSM in the El Paso, Texas area utilizing standardized measures, in a cross-sectional study. Regression analysis determined the influence of sexual impulsivity and compulsivity, and demographic variables on sexual risk behaviors, indicating interventions should target these behaviors to mitigate sexual risk among HMSM.
Assuntos
Hispânico ou Latino , Homossexualidade Masculina , Assunção de Riscos , Comportamento Sexual , Minorias Sexuais e de Gênero , Humanos , Masculino , Estudos Transversais , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Infecções por HIV/etnologia , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/psicologia , Comportamento Impulsivo , México , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Transtornos Mentais/etnologia , Texas , Disparidades nos Níveis de Saúde , Análise de RegressãoRESUMO
INTRODUCTION: Methamphetamine (meth) is a stimulant increasing in use and its prevalence has not yet been determined on the Mexico-U.S. border. Few studies highlight gender differences in meth use, trajectory, and initiation by gender. Ciudad Juárez, Mexico, across the border from El Paso, Texas, has an established stimulant using population and lies on drug trafficking route. This study assessed gender differences in drug and meth use patterns among people meth people use meth. MATERIAL AND METHODS: This cross-sectional study included 150 people with recent meth use, age 21 years or older, and living in Ciudad Juárez. Measures collected included sociodemographic characteristics, cross-border mobility, drug and meth use characteristics. Statistically (p-value<0.05) and marginally (p-value<0.10) significant gender differences were determined using appropriate bivariate tests. RESULTS: The sample included 45 cisgender women, five transgender women, and 100 cisgender men with a mean age of 30.9 years. Men had significantly higher rates of snorting meth by nose in powder or rock forms while trans/women more frequently using meth in pill form. Men had higher rates of crossing the border for work, with meth and to obtain meth. Trans/women reported higher rates of acquiring meth from main sexual partner and initiating meth use in Mexico. DISCUSSION: There are gender differences in patterns of meth use and initiation. CONCLUSIONS: Sample of people who use meth in general population can be achieved. These findings point to a need for evidence-based meth use reduction treatment programs that are culturally appropriate and tailored for gender.
RESUMO
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
BACKGROUND AND OBJECTIVES: Methamphetamine (meth) use and its related risk behaviors for HIV among men who have sex with men (MSM) are a public health concern across the Mexico-US border. This study aims to contribute to the limited literature of meth use and sexual risk behaviors among Latino MSM on the Mexico-US border. METHODS: Data were drawn from the Meth Pilot Study (2014-2015) among men who use meth (n = 100). Descriptive statistics and bivariate analysis comparing MSM to non-MSM were conducted using Pearson's χ2 test, Fisher's exact tests, and Mann-Whitney U test; all tests were conducted using SPSS v.25. RESULTS: Most participants obtained meth in El Paso, Texas (87.2%), used meth orally (65.2%) or smoked (78.3%), and the most common reason for initiation was curiosity. Significant differences (P < .05) in meth use behaviors and sexual risk behaviors between MSM and non-MSM who used meth included: median number of sex partners (7 vs 3), being penetrated anally by last sexual partner (31.6% vs 1.4%), and engaging in transactional sex ever (63.2% vs 9.6%) and past 12 months (52.6% vs 6.8%). Finally, rates of HIV positivity were higher among MSM than non-MSM (10.5% vs 1.4%). DISCUSSION AND CONCLUSIONS: Among men who use meth, MSM are engaging in higher HIV risk behaviors compared with non-MSM. Understanding these risks could help identify candidates for pre-exposure prophylaxis (PrEP) and evidence-based substance use disorder treatment options. SCIENTIFIC SIGNIFICANCE: This study reveals that Latino MSM who use meth is a high-risk group for HIV and a need for tailored interventions. (Am J Addict 2020;29:111-119).
Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Hispânico ou Latino/psicologia , Homossexualidade Masculina/psicologia , Drogas Ilícitas , Metanfetamina , Assunção de Riscos , Sexo sem Proteção/psicologia , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/complicações , Estudos Transversais , Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Projetos Piloto , TexasRESUMO
Sexual and gender minorities, including lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, experience barriers to healthcare as a result of stigma, discrimination, and poor cultural competence by healthcare and social services providers (HCSSP). The purpose of the study is to increase access to care and services for the LGBTQ community in a U.S.-Mexico border city by identifying LGBTQ-friendly HCSSP. A survey, developed based on concerns voiced in a predominantly Hispanic LGBTQ community, was administered to HCSSP and used to create a referral list, "The Purple Pages of El Paso" (PPoEP). Overall, 77 HCSSP have responded and 43 are included in the most recent version of the PPoEP. This model for developing a referral list of providers can be adapted in areas where LGBTQ communities face similar barriers to care and services. To be effective in reducing barriers to care, PPoEP must be updatable and sustainable.
Assuntos
Pessoal de Saúde/psicologia , Acessibilidade aos Serviços de Saúde/organização & administração , Hispânico ou Latino , Encaminhamento e Consulta/organização & administração , Minorias Sexuais e de Gênero , Assistentes Sociais/psicologia , Pesquisa Participativa Baseada na Comunidade , Competência Cultural , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Estigma Social , TexasRESUMO
BACKGROUND: Lead exposure from lead-glazed ceramics (LGCs) and traditional folk remedies have been identified as significant sources of elevated blood lead levels in Mexico and the United States. This study took place from 2005 to 2012 in a rural community in Baja California, Mexico. OBJECTIVES: 1) Investigate the knowledge, attitudes, and practices related to lead and lead exposures from LGCs and two lead-based folk remedies ( azarcon and greta); and 2) evaluate a pilot intervention to provide alternative lead-safe cookware. METHODS: A baseline household survey was conducted in 2005, followed by the pilot intervention in 2006, and follow-up surveys in 2007 and 2012. For the pilot intervention, families who reported using LGCs were given lead-safe alternative cookware to try and its acceptance was evaluated in the following year. RESULTS: The community was mostly of indigenous background from Oaxaca and a high proportion of households had young children. In 2006, all participants using traditional ceramic ware at the time ( n = 48) accepted lead-safe alternative cookware to try, and 97% reported that they were willing to exchange traditional ceramic ware for lead-safe alternatives. The use of ceramic cookware decreased from over 90% during respondents' childhood household use in Oaxaca to 47% in 2006 among households in Baja California, and further reduced to 16.8% in 2012. While empacho, a folk illness, was widely recognized as an intestinal disorder, there was almost universal unfamiliarity with the use and knowledge of azarcon and greta for its treatment. CONCLUSION: This pilot evaluation provides evidence 1) for an effective and innovative strategy to reduce lead exposure from LGCs and 2) of the feasibility of substituting lead-free alternative cookware for traditional ceramic ware in a rural indigenous community, when delivered in a culturally appropriate manner with health education. This strategy could complement other approaches to reduce exposure to lead from LGCs.
Assuntos
Intoxicação por Chumbo/prevenção & controle , Chumbo/sangue , Adolescente , Adulto , Cerâmica/química , Utensílios de Alimentação e Culinária , Exposição Ambiental , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Chumbo/toxicidade , Intoxicação por Chumbo/epidemiologia , Masculino , Medicina Tradicional , México/epidemiologia , Projetos Piloto , População Rural , Inquéritos e Questionários , Adulto JovemRESUMO
Immigrant generation status has an impact on substance use, with lower use rates for recent immigrants. Substance use surveillance data are reported at the national and state levels; however, no systematic collection of data exists at the city level for the general population. In particular, rates of substance use have not been published for El Paso, Texas. The aims of this study are to estimate the prevalence of substance use among Hispanics in El Paso and to determine the association between substance use and immigrant generation. Hispanic residents of El Paso (N = 837) were interviewed. Demographic, immigration, and substance use data were collected. Bivariate analysis indicated that substance use increased as immigrant generation increased, while perceived problems with substance use decreased. In comparison to Texas and national data, our data showed that the rates of tobacco, marijuana, and illicit drug use were lower among young adults in El Paso.
Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Texas/epidemiologia , Imigrantes Indocumentados/estatística & dados numéricos , Adulto JovemRESUMO
The purpose of this study is to extend the research on contextual factors that influence the initiation and continued use of methamphetamine (meth) by women on the U.S.-Mexico border. At present, a minimal body of literature exists that explores meth use on the Mexico-U.S. border. A purposeful sample of 20 women who were active meth users aged ≥18 years was recruited by trained outreach workers from a variety of meth-user networks in Ciudad Juárez, Mexico, the city bordering El Paso, Texas. Respondents participated in in-depth, semi-structured interviews including questions on users' perceived familial, social, and environmental influences of meth use. Gender-based themes emerged from the analysis: (1) patterns of meth use; (2) places where drugs were used; (3) effects of relationship networks on meth use; (4) differential access to drugs; (5) trading sex for drugs; (6) perceived class differences; and (7) long-term drug use and its consequences. Respondents reported a preference for using meth as powder or pills as opposed to smoking or injecting the drug. They reported being introduced to meth by men they trust and relying on men for drug acquisition in spaces less accessible and more dangerous to women. They described how the drug changed their lifestyle and their behavior towards family members and friends, including instances of physical and psychological violence. Interventions for women on the Mexico-U.S. border should be developed based on users' social networks to target social processes to prevent initiation and to bring active meth users into treatment.
Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/etnologia , Estimulantes do Sistema Nervoso Central , Metanfetamina , Mulheres , Adulto , Feminino , Humanos , México/etnologia , Pesquisa QualitativaRESUMO
For nearly 30 years, Programa Compañeros Inc (Compañeros) has worked in Ciudad Juarez, Chihuahua, Mexico, to ensure that vulnerable populations can exercise their rights to receive HIV and substance abuse prevention and treatment services. Compañeros staff has worked to ameliorate the negative results that limit access to care to the most vulnerable individuals: those who are poor, homeless, sex workers, addicted, and others whose life context put them at greater risk for being infected with HIV. With support from the MAC AIDS Foundation, Compañeros has expanded its capacity to deliver services to persons living with HIV/AIDS (PLWHA) and to HIV-vulnerable populations. This short communication describes findings from an internal evaluation conducted to investigate the effectiveness of the MAC AIDS-funded navigator-based program implemented at Compañeros.
Assuntos
Infecções por HIV/terapia , Qualidade da Assistência à Saúde/normas , Populações Vulneráveis , Adulto , Feminino , Inquéritos Epidemiológicos , Direitos Humanos , Humanos , Masculino , México , Pessoa de Meia-Idade , Apoio Social , Populações Vulneráveis/legislação & jurisprudência , Populações Vulneráveis/estatística & dados numéricos , Adulto JovemRESUMO
AIMS: To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. DESIGN: Cross-sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers >1 : 8) were identified by logistic regression. Setting Tijuana and Ciudad Juarez, two Mexican cities on the US border that are situated on major drug trafficking routes and where prostitution is quasi-legal. PARTICIPANTS: A total of 914 FSWs aged > or =18 years without known human immunodeficiency virus (HIV) infection who had had recent unprotected sex with clients. MEASUREMENTS: Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. FINDINGS: Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 31.4% had clients in the last 6 months who injected drugs, and 68.6% reported having clients from the United States. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.08), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65) and having any US clients (AOR: 2.85; 95% CI: 1.43, 5.70). CONCLUSIONS: Among female sex workers in Tijuana and Ciudad Juarez, drug-using behaviors were associated more closely with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer-sex negotiation in the context of drug use.