Drug and Alcohol Review
Volume 37, 2018, Pages S277-S284

Cross-border migration and initiation of others into drug injecting in Tijuana, Mexico (Article)

Rafful C. , Melo J. , Medina-Mora M.E. , Rangel G. , Sun X. , Jain S. , Werb D.*
  • a Division of Global Public Health, University of California San Diego, San Diego, United States, Department of Public Health, San Diego State University, San Diego, United States
  • b Division of Global Public Health, University of California San Diego, San Diego, United States
  • c National Institute of Psychiatry, Mexico City, Mexico
  • d Secretariat of Health, Mexico City, Mexico, Mexico–United States Border Health Commission, Tijuana, Mexico
  • e Department of Family Medicine and Public Health, Biostatistics Research Center, University of California San Diego, San Diego, United States
  • f Department of Family Medicine and Public Health, Biostatistics Research Center, University of California San Diego, San Diego, United States
  • g Division of Global Public Health, University of California San Diego, San Diego, United States, Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Canada

Abstract

Introduction and Aims: Efforts to prevent injection drug use (IDU) are increasingly focusing on the role that people who inject drugs (PWID) play in facilitating the entry of others into this behaviour. This is particularly relevant in settings experiencing high levels of IDU, such as Mexico’s northern border region, where cross-border migration, particularly through forced deportation, has been found to increase a range of health and social harms related to injecting. Design and Methods: PWID enrolled in a prospective cohort study in Tijuana, Mexico, since 2011 were interviewed semi-annually, which solicited responses on their experiences initiating others into injecting. Univariate and multivariable logistic regression analyses were conducted at the Preventing Injection by Modifying Existing Responses (PRIMER) baseline, with the dependent variable defined as reporting ever initiating others into injection. The primary independent variable was lifetime deportation from the USA to Mexico. Results: Among 532 participants, 14% (n = 76) reported initiating others into injecting, the majority of participants reporting initiating acquaintances (74%, n = 56). In multivariable analyses, initiating others into injecting was independently associated with reporting living in the USA for 1–5 years [adjusted odds ratio (AOR) = 2.42; 95% confidence interval (CI) 1.22–4.79, P = 0.01], and methamphetamine and heroin injection combined (AOR = 3.67; 95% CI 1.11–12.17, P = 0.03). Deportation was not independently associated with initiating others into injecting. Discussion and Conclusions: The impact of migration needs to be considered within binational programming seeking to prevent the expansion of epidemics of injecting and HIV transmission among mobile populations residing in the Mexico–USA border region. © 2017 Australasian Professional Society on Alcohol and other Drugs

Author Keywords

Migration injection initiation people who inject drugs Border health Mexico, USA

Index Keywords

HIV Infections Human immunodeficiency virus infection human substance abuse Needle Sharing Mexico United States Humans psychology male female risk factor Risk Factors high risk behavior Risk-Taking Substance Abuse, Intravenous adult migration Emigration and Immigration
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85034754389&doi=10.1111%2fdar.12630&partnerID=40&md5=be935422e04b52c3a69a17f29f6a0aa3
DOI: 10.1111/dar.12630
ISSN: 09595236
Cited by: 3
Original Language: English