Factors associated with early initiation into sex work and sexually transmitted infections among female sex workers in two Mexico-U.S. border cities

Purpose: To examine correlates of early initiation into sex work and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, two Mexican cities on the U.S. border where prostitution is quasi-legal. Methods: FSWs aged >̲18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews and testing for syphilis, Chlamydia and gonorrhea. Correlates of early initiation into sex work (age<18) and each infection were identified with logistic regression. Results: Of 920 FSWs interviewed in Tijuana and Ciudad Juarez, 10% were early initiators into sex work. Median age, age initiation into sex work, and duration in sex work were 32, 26, and 4 years, respectively. Overall, 18% had ever injected drugs, 14% often/always used illegal drugs before/during sex in the past month, 38% had clients who injected drugs in the last 6 months, and 69% reported having clients from the U.S. Prevalence of HIV, active syphilis, Chlamydia, and gonorrhea were 6%, 10%, 13%, and 6%, respectively. Conclusions: Different pathways for early versus later initiators into sex work are apparent in the Mexico-U.S. border region; which has implications for intervention strategies. Drug-using behaviors were more closely associated with active syphilis, Chlamydia, and gonorrhea than were sexual behaviors. STI eradication programs should focus on subgroups of FSWs and their partners who use and inject drugs, expanding access to sterile syringes, and assisting FSWs with safer-sex negotiation in the context of drug use. Factors independently associated with early initiation were inhalant use, initiating sex work to pay for alcohol, and history of child abuse. Factors associated with later initiation were less education, migration, and initiating sex work for better pay or to support children. Factors independently associated with active syphilis were having injecting drugs, using illegal drugs before/during sex, and having any U.S. clients. Factors independently associated with Chlamydia were being younger, working in Tijuana versus Ciudad Juarez, and recent methamphetamine injection. Factors independently associated with gonorrhea were working in Tijuana versus Ciudad Juarez, using illegal drugs before or during sex, and having a male sex partner who injected drug

Exploring the two trigger fingers thesis: racial and ethnic differences in officer involved shootings

© 2016 Informa UK Limited, trading as Taylor & Francis Group. This article provides a comparative, qualitative and quantitative, analysis of officer-involved shootings of residents who were white, black, or Latino in the City and County of Denver, Colorado from 1983 to 2012. This research project combined district attorney summaries, police shooting files, and police shooting video interviews to understand the patterns involving 213 officer-involved shootings resulting in 103 deaths. Thematically, the differences by race and ethnicity are outlined by three themes including (1) suspect characteristics, (2) officer characteristics, and (3) contextual factors. The findings highlight similarities and differences between incident narratives and compare these observations with aggregated statistics to explore whether law enforcement officers possess one trigger finger for whites and another for blacks and Latinos. This comprehensive analysis of racial and ethnic differences in officer-involved shootings indicates the intersectionality of suspect and officer characteristics along with contextual factors

A qualitative exploratory study on gender identity and the health risks and barriers to care for transgender women living in a U.S.–Mexico border city

© 2017 Taylor & Francis Group, LLC. This exploratory, qualitative study examined the health risks and barriers to care for transgender women who live in a U.S.–Mexico border city. Individual in-depth interviews were conducted with 13 self-identified transgender women in El Paso, Texas, seven of whom identified as Latina. The interviews were recorded, transcribed, and coded for analysis of emerging themes, using the qualitative analysis software Atlas.ti (v.7.0). The themes that emerged are (1) self-acceptance of transgender identity; (2) acceptance of transgender identity within social networks; and (3) health risks, including body modifications and barriers to health care. The findings reveal phases of self-acceptance of transgender identity, a high level of health risks, scarce health services resources, and low levels of acceptance from family, friends, and partners. This study provides an important contribution to the health disparities literature on gender identity and health risks and the needs of transgender women, particularly in a U.S.–Mexico border context

Substance Use by Immigrant Generation in a U.S.-Mexico Border City

© 2016, Springer Science+Business Media New York. 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

Navigator approach to improve quality of care for vulnerable populations in Mexico

© SAGE Publications. 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

Border health: Inequities, social determinants, and the cases of tuberculosis and HIV

© 2012 Springer Science+Business Media B.V. All rights reserved. The US-Mexico border region attracts migrants from Mexico and Latin America who seek economic opportunities through relocation to the United States. These goals are not always achieved once they arrive in the region, thus creating populations that are displaced and vulnerable. Further, when poor people migrate into developed countries, there is an increased risk for adverse health outcomes. An example is the association between the distributions of TB and HIV with social disparities and access to medical care and treatment. The trend in public health research along the border has increased focus on an individual\u27s behavior while deemphasizing the social determinants of disease. This chapter includes a description of the social determinants of health and health outcomes prevalent along the border, the case of TB and HIV with appropriate or lack of structural interventions, and recommendations for policy

Healthcare and Social Services Providers Who Serve Sexual and Gender Minorities in a U.S.-Mexico Border City

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. 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

Methamphetamine Use and Sexual Risk Behaviors among Men Who Have Sex With Men in a Mexico-US Border City

© 2020 American Academy of Addiction Psychiatry 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 \u3c.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)

Health disparities in access to health care for HIV infection, substance abuse, and mental health among Latino men who have sex with men in a U.S.–Mexico Border City

© 2021 Taylor & Francis Group, LLC. A cross-sectional study among 150 community-dwelling Latino men who have sex with men (MSM) in a U.S.–Mexico border city was conducted to describe health disparities in access to care for HIV infection, substance use/abuse, and mental health. Data were collected in 2013 and 2014. Median age of participants was 26 years, and the majority of participants identified as a sexual minority and born in the United States. Half did not have health insurance and reported suicidal ideation. One-eighth reported living with HIV. Most common substances reported were alcohol, tobacco, and marijuana. Clinicians who provide care for Latino MSM should be aware of intersecting comorbidities

Use of lead-glazed ceramic ware and lead-based folk remedies in a rural community of Baja California, Mexico

© 2016, © The Author(s) 2016. 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