RESUMO
To determine occupational risk factors for coccidioidomycosis among adult Hispanic outdoor agricultural workers in California, USA, we conducted a case-control study of workers seen at the Kern County medical facility and referred to the public health laboratory for coccidioidomycosis serologic testing. Participants completed an interviewer-administered health and work questionnaire. Among 203 participants (110 case-patients with positive and 93 controls with negative serologic results), approximately half were women, and more than three quarters were born in Mexico. Associated with coccidioidomycosis were self-reported dust exposure and work with root and bulb vegetable crops. A protective factor was leaf removal, an activity associated with grape cultivation. We conclude that subjective dust exposure and work with root and bulb vegetable crops are associated with increased risk for coccidioidomycosis among Hispanic farm workers. The agricultural industry should evaluate and promote dust-reduction measures, including wetting soil and freshly harvested products.
Assuntos
Coccidioidomicose , Exposição Ocupacional , Adulto , California/epidemiologia , Estudos de Casos e Controles , Coccidioides , Coccidioidomicose/epidemiologia , Fazendeiros , Feminino , Hispânico ou Latino , Humanos , Masculino , MéxicoRESUMO
The Mexico-US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico-US border region (Border, n = 553) with migrants arriving at the border from Mexican sending communities (Northbound, n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively, p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA.
Assuntos
Infecções por HIV/transmissão , Acessibilidade aos Serviços de Saúde/economia , Comportamento Sexual/estatística & dados numéricos , Normas Sociais/etnologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Migrantes/estatística & dados numéricos , Sorodiagnóstico da AIDS/estatística & dados numéricos , Adulto , Estudos Transversais , Escolaridade , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Humanos , Incidência , Seguro Saúde/economia , Seguro Saúde/estatística & dados numéricos , Masculino , México/etnologia , Prevalência , Assunção de Riscos , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Parceiros Sexuais , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Migrantes/psicologia , Estados Unidos/epidemiologiaRESUMO
HIV risk among Mexican migrants varies across migration phases (pre-departure, transit, destination, interception, and return), but there is limited knowledge about specific sexual behaviors, characteristics of sexual partners, and sexual contexts at different migration stages. To fill the gap, we used data from a cross-sectional population-based survey conducted in Tijuana, Mexico. Information on migration phase and last sexual encounter was collected from 1219 male migrants. Our findings suggest that compared to pre-departure migrants, repeat migrants returning from communities of origin were more likely to have sex with male partners, use substances before sex, and not use condoms; migrants in the transit phase in the Mexican border were more likely to have sex with casual partners and sex workers; and migrants in the interception phase were more likely to engage in anal sex and use substances before sex. Sexual behaviors, partners, and contexts vary significantly among migrants at different migration phases. Tailored HIV prevention programs targeting Mexican migrants need to be developed and implemented at all migration phases.
Assuntos
Infecções por HIV/prevenção & controle , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/etnologia , Migrantes/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Estudos Transversais , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Profissionais do Sexo , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
We conducted a probability-based survey of migrant flows traveling across the Mexico-US border, and we estimated HIV infection rates, risk behaviors, and contextual factors for migrants representing 5 distinct migration phases. Our results suggest that the influence of migration is not uniform across genders or risk factors. By considering the predeparture, transit, and interception phases of the migration process, our findings complement previous studies on HIV among Mexican migrants conducted at the destination and return phases. Monitoring HIV risk among this vulnerable transnational population is critical for better understanding patterns of risk at different points of the migration process and for informing the development of protection policies and programs.
Assuntos
Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Comportamento Sexual/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/complicações , Migrantes/estatística & dados numéricos , Adulto , Feminino , Infecções por HIV/etnologia , Infecções por HIV/transmissão , Humanos , Masculino , México/epidemiologia , México/etnologia , Prevalência , Assunção de Riscos , Distribuição por Sexo , Profissionais do Sexo , Abuso de Substâncias por Via Intravenosa/etnologia , Inquéritos e Questionários , Migrantes/psicologia , Estados Unidos/epidemiologiaRESUMO
A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N = 693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23 and 0.80 %, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3 %) and last 12-months rates of unprotected sex (63.0 %), sex with multiple sexual partners (18.1 %), casual partners (25.7 %), and sex workers (8.6 %), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico.
Assuntos
Infecções por HIV/epidemiologia , Comportamento Sexual , Parceiros Sexuais , Migrantes/estatística & dados numéricos , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Humanos , Masculino , México/epidemiologia , Vigilância da População , Prevalência , Fatores de Risco , Assunção de Riscos , Estados Unidos , Adulto JovemRESUMO
Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.
Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Infecções por HIV/mortalidade , Infecções por HIV/transmissão , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Comportamento Sexual , Estereotipagem , Fatores de Tempo , Adulto JovemRESUMO
Condom availability programs (CAPs) may increase access to condoms and contribute to increased condom use among youth. This study describes the characteristics, degree of satisfaction, and gender differences among users of a CAP implemented in two high schools in Tijuana (Baja California, Mexico). A kiosk distributing free male condoms was set up in two high schools in Tijuana. Kiosk users (N=570) were more likely to be male, young, and/or enrolled in a lower SES school. Most kiosk users were either sexually active or planning to have sex. Females were less likely to request condoms and to continue using the kiosk, but more likely to request information on other contraceptive methods. Results demonstrate the feasibility of implementing CAPs in Mexican schools and suggest that these programs can improve adolescents' condom access.
Assuntos
Preservativos/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Estudantes/psicologia , Adolescente , Comportamento do Adolescente , Feminino , Humanos , Masculino , México , Psicologia do Adolescente , Instituições AcadêmicasRESUMO
OBJECTIVE: To estimate the prevalence of risk factors for HIV infection among Mexican migrants and immigrants (MMIs) in different geographic contexts, including the sending communities in Mexico, the receiving communities in the United States (US), and the Mexican North border region. MATERIAL AND METHODS: We conducted a probability survey among MMIs traveling through key border crossing sites in the Tijuana (Baja California, Mexico)-San Diego (California, US) border region (N= 1,429). RESULTS: The survey revealed substantial rates of reported sexually transmitted infections, needle-sharing and sexual risk practices in all migration contexts. CONCLUSIONS: The estimated levels of HIV risk call for further binational research and preventive interventions in all key geographic contexts of the migration experience to identify and tackle the different personal, environmental, and structural determinants of HIV risk in each of these contexts.
Assuntos
Emigração e Imigração , Infecções por HIV/epidemiologia , Adulto , Feminino , Humanos , Masculino , México/etnologia , Prevalência , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
OBJETIVO: Estimar la prevalencia de prácticas de riesgo para la infección por VIH en migrantes mexicanos durante su estancia en distintos contextos geográficos, incluyendo sus comunidades de origen en México, las comunidades de destino en Estados Unidos de América (EUA), y la frontera Norte de México. MATERIAL Y MÉTODOS: Encuesta probabilística de migrantes mexicanos que transitan por la región fronteriza Tijuana (Baja California, México)-San Diego (California, EUA) (N=1 429). RESULTADOS: La encuesta reveló una alta prevalencia de infecciones de transmisión sexual, uso compartido de agujas, y prácticas sexuales de riesgo en todos los contextos geográficos estudiados. CONCLUSIONES: Los niveles de riesgo de infección por VIH estimados para migrantes mexicanos en diferentes contextos geográficos exigen estudios e intervenciones preventivas binacionales que identifiquen y aborden los distintos factores de riesgo personales, ambientales, y estructurales que contribuyen al riesgo de infección por VIH en cada contexto.
Assuntos
Adulto , Feminino , Humanos , Masculino , Emigração e Imigração , Infecções por HIV/epidemiologia , México/etnologia , Prevalência , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: Previous studies have indicated varying rates of HIV infection among labor migrants to the United States of America. Most of these studies have been conducted with convenience samples of farmworkers, thus presenting limited external validity. This study sought to estimate the prevalence of HIV infection and risk factors among Mexican migrants traveling through the border region of Tijuana, Baja California, Mexico, and San Diego, California, United States. This region handles 37% of the migrant flow between Mexico and the United States and represents the natural port of entry for Mexican migrants to California. METHODS: From April to December 2002 a probability survey was conducted at key migrant crossing points in Tijuana. Mexican migrants, including ones with a history of illegal migration to the United States, completed an interview on HIV risk factors (n = 1 429) and an oral HIV antibody test (n = 1,041). RESULTS: Despite reporting risk factors for HIV infection, none of the migrants tested positive for HIV. CONCLUSIONS: Our findings contrast with previous estimates of HIV among labor migrants in the United States that were based on nonprobability samples. Our findings also underline the need for early HIV prevention interventions targeting this population of Mexican migrants.