RESUMO
Low HPV vaccination rates among Latina young adults perpetuate HPV-associated cancer disparities. Using qualitative methods, this study explored individual, interpersonal, and community factors that influence HPV vaccine delay and refusal among Mexican- and U.S.-born Mexican American young adult women. Participants (N = 30) between 18 and 26 years old were purposively sampled from two federally qualified health centers in Orange County, California. The National Institute on Minority Health and Health Disparities research framework and narrative engagement theory guided semi-structured phone interviews coded inductively and deductively. Participants primarily attributed vaccine status to individual and interpersonal reasons. Emerging themes included low HPV vaccine knowledge, insufficient provider communication, negative perceptions about HPV and the vaccine, motherhood responsibilities, mother's communication about HPV, cultural family norms, health care access, and misinformation. Compared to U.S.-born Latinas, Mexican-born participants more frequently expressed avoiding health care discussions with family. HPV vaccine recommendations for young Mexican American women should include socioculturally tailored messages that may improve HPV vaccination acceptance and uptake.
Assuntos
Americanos Mexicanos , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Hesitação Vacinal , Vacinação , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/etnologia , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/psicologia , Vacinas contra Papillomavirus/uso terapêutico , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Vacinação/psicologia , Hesitação Vacinal/etnologia , Hesitação Vacinal/psicologia , Competência CulturalRESUMO
Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care. We used thematic analysis to explore the processes of retention in care. Six ubiquitous themes were perceived to influence HIV clinic attendance: (1) stigma as a barrier to HIV serostatus disclosure; (2) social support as a safety net during negative life circumstances; (3) unaddressed trauma and substance use leading to interruption in care; (4) a trusting relationship between patient and provider motivating HIV clinic attendance; (5) basic unmet needs competing with the perceived value of HIV care; and (6) religion providing a source of hope and optimism. Cultural subthemes were the centrality of family (familismo), masculinity (machismo), and trusting relationships (confianza). The timing of barriers was acute (e.g., eviction) and chronic (e.g., family conflict). These co-occurring and dynamic constellation of factors affected HIV primary care attendance over time. HIV-infected Latino immigrants and migrants experienced significant challenges that led to interruptions in HIV care. Anticipatory guidance to prepare for these setbacks may improve retention in HIV care in this population.
Assuntos
Emigrantes e Imigrantes , Infecções por HIV/tratamento farmacológico , Hispânico ou Latino/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Pacientes Desistentes do Tratamento/etnologia , Estigma Social , Migrantes/psicologia , Aculturação , Adulto , Barreiras de Comunicação , Aconselhamento , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pacientes Desistentes do Tratamento/psicologia , Relações Médico-Paciente , Porto Rico , Pesquisa Qualitativa , Apoio Social , Migrantes/estatística & dados numéricos , Estados Unidos/etnologiaRESUMO
BACKGROUND: Available drug treatment modalities may inadequately address social and structural contexts surrounding recovery efforts. METHODS: This mixed methods analysis drew on (1) surveys with female sex workers and their intimate male partners and (2) semi-structured interviews with a subsample of 41 couples (n=82 individuals, 123 total interviews) in Northern Mexico. Descriptive and content analyses examined drug cessation and treatment experiences. RESULTS: Perceived need for drug treatment was high, yet only 35% had ever accessed services. Financial and institutional barriers (childcare needs, sex-segregated facilities) prevented partners from enrolling in residential programs together or simultaneously, leading to self-treatment attempts. Outpatient methadone was experienced more positively, yet financial constraints limited access and treatment duration. Relapse was common, particularly when one partner enrolled alone while the other continued using drugs. CONCLUSIONS: Affordable, accessible, evidence-based drug treatment and recovery services that acknowledge social and structural contexts surrounding recovery are urgently needed for drug-involved couples.
Assuntos
Área Carente de Assistência Médica , Profissionais do Sexo , Parceiros Sexuais/psicologia , Abuso de Substâncias por Via Intravenosa/reabilitação , Adulto , Relações Familiares , Feminino , Humanos , Entrevistas como Assunto , Masculino , México , Aceitação pelo Paciente de Cuidados de Saúde , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/economia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico-US border. METHODS: From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. RESULTS: Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. CONCLUSIONS: Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners' HIV risk. HIV interventions should consider the emotional quality of sex workers' intimate relationships.
Assuntos
Infecções por HIV/psicologia , Amor , Profissionais do Sexo/psicologia , Parceiros Sexuais/psicologia , Confiança , Sexo sem Proteção/psicologia , Adulto , Estudos Transversais , Feminino , Infecções por HIV/etiologia , Humanos , Relações Interpessoais , Masculino , México , Profissionais do Sexo/estatística & dados numéricos , Confiança/psicologia , Sexo sem Proteção/estatística & dados numéricosRESUMO
A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs' relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners' depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship.
Assuntos
Infecções por HIV/prevenção & controle , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Adulto , Preservativos/estatística & dados numéricos , Vítimas de Crime , Estudos Transversais , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , México/epidemiologia , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Inquéritos e QuestionáriosRESUMO
History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence (IPV), psychological distress, and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs.
Assuntos
Trabalho Sexual , Profissionais do Sexo , Violência , Adulto , Cidades , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , México/epidemiologia , Maus-Tratos Conjugais , Estresse Psicológico , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos , Violência/estatística & dados numéricos , Adulto JovemRESUMO
Female sex workers (FSWs) experience elevated risk for HIV and sexually transmitted infections (STIs) through unprotected sex with male clients, yet the complexity of these commercial relationships remains understudied. From 2010 to 2011, we explored FSWs' conceptualizations of various client types and related risk behavior patterns using semistructured interviews with 46 FSWs in Tijuana and Ciudad Juarez, Mexico, where FSWs' HIV/STI prevalence is increasing. Our grounded theory analysis identified four types of commercial relationships: nonregular clients, regular clients and friends, clients who "fell in love" with FSWs, and long-term financial providers who often originated from the United States. As commercial relationships developed, clients' social and emotional connections to FSWs increased, rendering condom negotiation and maintaining professional boundaries more difficult. Drug abuse and poverty also influenced behaviors, particularly in Ciudad Juárez, where lucrative U.S. clients were increasingly scarce. While struggling to cultivate dependable relationships in a setting marked by historical sex tourism from a wealthier country, some FSWs ceased negotiating condom use. We discuss the need for HIV/STI research and prevention interventions to recognize the complexity within FSWs' commercial relationships and how behaviors (e.g., condom use) evolve as relationships develop through processes that are influenced by local sociopolitical contexts and binational income inequality.
Assuntos
Relações Interpessoais , Profissionais do Sexo/psicologia , Sexo sem Proteção/etnologia , Adulto , Preservativos/estatística & dados numéricos , Feminino , Humanos , México/etnologia , Pessoa de Meia-Idade , Negociação/psicologia , Estados Unidos , Adulto JovemRESUMO
We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that FSWs' injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence of client-perpetrated emotional, physical, and sexual abuse in the past 6 months was 26, 18, and 10% respectively; prevalence of current injection drug use and HIV was 12 and 6%, respectively. Logistic regression analyses revealed that client-perpetrated sexual abuse was significantly associated with HIV-seropositivity and injection drug use, and that injection drug use was positively associated with HIV-seropositivity. Injection drug use partially mediated the relationship between client-perpetrated sexual abuse and HIV-seropositivity. Results suggest the need to address client-perpetrated violence and injection drug use when assessing HIV risk among FSWs.
Assuntos
Infecções por HIV/diagnóstico , Trabalho Sexual/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Violência/psicologia , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Soropositividade para HIV/epidemiologia , Humanos , Relações Interpessoais , Entrevistas como Assunto , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Assunção de Riscos , Trabalho Sexual/estatística & dados numéricos , Parceiros Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologia , População Urbana , Violência/estatística & dados numéricos , Adulto JovemRESUMO
PURPOSE: To examine correlates of early initiation into sex work in two Mexico-U.S. border cities. METHODS: Female sex workers (FSWs) >/=18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews. Correlates of initiation into sex work before age 18 were identified with logistic regression. RESULTS: Of 920 FSWs interviewed in Tijuana (N=474) and Ciudad Juarez (N=446), 9.8% (N=90) were early initiators (<18 years) into sex work. Median age of entry into sex work was 26 years (range: 6-58). After adjusting for age, compared to older initiators, early initiators were more likely to use inhalants (21.1% vs. 9.6%, p=.002), initiate sex work to pay for alcohol (36.7% vs. 18.4%, p < .001), report abuse as a child (42.2% vs. 18.7%, p<.0001), and they were less likely to be migrants (47.8% vs. 62.3%, p=.02). Factors independently associated with early initiation included inhalant use (adjOR=2.39), initiating sex work to pay for alcohol (adjOR=1.88) and history of child abuse (adjOR=2.92). Factors associated with later initiation included less education (adjOR=0.43 per 5-year increase), migration (adjOR=0.47), and initiating sex work for better pay (adjOR=0.44) or to support children (adjOR=0.03). CONCLUSIONS: Different pathways for entering sex work are apparent among younger versus older females in the Mexico-U.S. border region. Among girls, interventions are needed to prevent inhalant use and child abuse and to offer coping skills; among older initiators, income-generating strategies, childcare, and services for migrants may help to delay or prevent entry into sex work.
Assuntos
Tomada de Decisões , Trabalho Sexual , Adolescente , Adulto , Criança , Feminino , Humanos , Entrevistas como Assunto , Modelos Logísticos , México , Pessoa de Meia-Idade , Delitos Sexuais , Trabalho Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos , Adulto JovemRESUMO
Intimate partner violence (IPV) has been associated with greater vulnerability to HIV infection among women. We examined prevalence and correlates of IPV among female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-U.S. border cities where HIV prevalence is rising. Participants were 300 FSWs with a current spouse or a steady partner. Participants' mean age was 33 years, and mean number of years as a sex worker was 6 years. The prevalence of IPV in the past 6 months among participants was 35%. Using multivariate logistic regression, factors independently associated with IPV included having experienced abuse as a child, a partner who had sex with someone else, and lower sexual relationship power. Our findings suggest the need for previous abuse screening and violence prevention services for FSWs in the Mexico-U.S. border region. Careful consideration of relationship dynamics such as infidelity and relationship power is warranted when assessing for IPV risk.
RESUMO
This study examined histories of past emotional, physical, and sexual abuse as correlates of current psychological distress using data from 916 female sex workers (FSWs) who were enrolled in a safer-sex behavioral intervention in Tijuana and Ciudad (Cd.) Juarez, Mexico. We hypothesized that histories of abuse would be associated with higher symptom levels of depression and somatization and that social support would moderate the relationship. Nonparametric correlations and a series of hierarchical regression analyses revealed that all forms of past abuse predicted higher levels of depressive symptoms, and physical and sexual abuse were significantly associated with higher levels of somatic symptoms. Social support was also significantly associated with fewer symptoms of distress; however, it was not shown to moderate the relationship between abuse history and distress.
Assuntos
Depressão/epidemiologia , Trabalho Sexual/estatística & dados numéricos , Transtornos Somatoformes/epidemiologia , Maus-Tratos Conjugais/estatística & dados numéricos , Mulheres Trabalhadoras/estatística & dados numéricos , Adulto , Comorbidade , Depressão/psicologia , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Trabalho Sexual/psicologia , Apoio Social , Fatores Socioeconômicos , Transtornos Somatoformes/psicologia , Maus-Tratos Conjugais/psicologia , Saúde da Mulher , Mulheres Trabalhadoras/psicologia , Adulto JovemRESUMO
The present study examined the applicability of the Social Ecological Model for explaining condom use in a sample of female sex workers (FSWs) (N=435) participating in a behavioral intervention to increase condom use in Tijuana, Mexico. Using a multigroup path analysis, we compared women who work in bar settings (n=233) to those who worked on the street (n=202) with regard to an individual factor (self-efficacy), an interpersonal factor (client financial incentives), and a structural factor (condom access). Competing models showed differential impacts of these factors in the two venue-based groups. Having access to condoms was associated with greater self-efficacy and less unprotected sex in women who worked in bars. Among street-based FSWs, having clients offer monetary incentives for unprotected sex was related to greater unprotected sex, while having access to condoms was not. Understanding the contextual factors associated with condom use among subgroups of FSWs has important implications for the development of HIV prevention interventions.
Assuntos
Infecções por HIV/psicologia , Trabalho Sexual , Sexo sem Proteção/psicologia , Adulto , Preservativos/estatística & dados numéricos , Feminino , Humanos , Renda , México , Assunção de Riscos , Autoeficácia , Sexo sem Proteção/estatística & dados numéricosRESUMO
OBJECTIVE: We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico-United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. METHODS: Four hundred nine HIV-negative FSWs aged >or=18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). RESULTS: Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. CONCLUSIONS: Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation.
Assuntos
Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , México , Comportamento de Redução do Risco , Trabalho Sexual , Comportamento Sexual/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVES: We examined the efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. METHODS: We randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioral intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. RESULTS: We observed a 40% decline in cumulative sexually transmitted illness incidence (P = .049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P = .034) and 0 versus 2.01 per 100 person-years for HIV (P < .001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex acts with clients (P < .05). CONCLUSIONS: This brief behavioral intervention shows promise in reducing HIV and sexually transmitted illness risk behaviors among female sex workers and may be transferable to other resource-constrained settings.
Assuntos
Preservativos/estatística & dados numéricos , Aconselhamento , Trabalho Sexual/psicologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Resultado do Tratamento , Sexo sem Proteção/prevenção & controle , Serviços de Saúde da Mulher , Adolescente , Adulto , Pesquisa Comportamental , Feminino , Promoção da Saúde , Humanos , Entrevista Psicológica , México/epidemiologia , Avaliação de Programas e Projetos de Saúde , Assunção de Riscos , Autoeficácia , Infecções Sexualmente Transmissíveis/epidemiologia , Saúde da População UrbanaRESUMO
BACKGROUND: We examined human immunodeficiency virus (HIV) prevalence and correlates among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 large cities on the Mexico-US border. METHODS: FSWs aged > or =18 years underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with HIV infection. RESULTS: In 924 FSWs, the prevalence of HIV, gonorrhea, chlamydia, and syphilis titers > or =1:8 was 6%, 6.4%, 13%, and 14.2%, respectively. Factors independently associated with HIV were the injection of cocaine (odds ratio [OR], 2.96); the smoking, snorting, or inhalation of methamphetamine (OR, 3.32); and syphilis titers > or =1:8 (OR, 4.16). CONCLUSIONS: Culturally appropriate interventions are needed to identify and treat ulcerative sexually transmitted infections and reduce HIV risks associated with stimulants among FSWs in the Mexico-US border region.
Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Infecções por HIV/epidemiologia , Trabalho Sexual , Adulto , Feminino , Infecções por HIV/etnologia , Humanos , México/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Transtornos Relacionados ao Uso de Substâncias , Sexo sem ProteçãoRESUMO
BACKGROUND: HIV prevalence is increasing among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 Mexican cities on the US border. Quasilegal prostitution in both cities attracts large numbers of sex tourists. We compared FSWs with and without US clients in both cities. METHODS: FSWs aged > or =18 years reporting unprotected sex with > or =1 client within the last 2 months, who were not knowingly HIV-infected, were enrolled in a behavioral intervention study. At baseline, participants underwent interviews, antibody testing for HIV and syphilis, and vaginal swabs for detecting gonorrhea and Chlamydia. Logistic regression identified factors associated with reporting >1 US client. RESULTS: Of 924 FSWs, 69% had US clients. Median age and duration in sex work were 32 and 4 years. Prevalence of HIV, infectious syphilis (titer > or =1:8), gonorrhea, Chlamydia, and any STI was 6%, 14%, 6%, 13%, and 27%, respectively. Compared with other FSWs, FSWs with US clients were more likely to have syphilis titers > or =1:8 (16% vs. 10%, P = 0.01), gonorrhea (8% vs. 2%, P <0.001) or any STI, including HIV (30% vs. 20%, P = 0.002). Factors independently associated with having US clients were: living in Tijuana, being younger, speaking English, being paid more for having sex without a condom, having >250 clients in the last 6 months, having syphilis titers > or =1:8, and injecting drugs. CONCLUSIONS: In these border cities, FSWs reporting US clients were more likely to have current STIs and to engage in higher-risk behaviors. Intensified binational prevention efforts involving both FSWs and their clients are urgently needed.
Assuntos
Trabalho Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Sexo sem Proteção , Adolescente , Adulto , California/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/sangue , Infecções Sexualmente Transmissíveis/etiologia , Inquéritos e Questionários , Saúde da MulherRESUMO
Female sex workers (FSWs) have been documented to have high rates of sexually transmitted diseases and HIV in many parts of the world. However, little work has been done to characterize the prevalence of these infections along the U.S.-Mexican border, where sexual tourism and culturally sanctioned sex work among nationals is widespread. The objective of this study was to compare differences in background characteristics, HIV risk behaviors, drug use, and sexually transmitted infection/HIV prevalence between FSWs who participated in a behavioral risk intervention in two U.S.-Mexican border cities. Baseline data were collected from March 2004 through September 2005. Data from 295 FSWs were compared between Tijuana and Ciudad (Cd.) Juarez. Among 155 FSWs in Tijuana and 140 in Cd. Juarez, HIV seroprevalence was 4.8% and 4.9%, respectively. FSWs in Cd. Juarez were more likely to test positive for active syphilis (31.3%) compared with Tijuana (11.8%) but did not differ in terms of the prevalence of gonorrhea and chlamydia. FSWs in both sites reported high levels of unprotected sex and use of drugs; however, FSWs in Cd. Juarez were more likely than those in Tijuana to ever have injected drugs (75% vs. 25%, p <.001). Heroin and cocaine use and injection drug use were significantly more common in Cd. Juarez, whereas methamphetamine use was more common in Tijuana. Injection of vitamins was common in both cities. Logistic regression analyses suggested that being younger, working in Cd. Juarez, and using heroin or cocaine were independently associated with active syphilis infection. In Tijuana, methamphetamine use was strongly associated with active syphilis infection. These preliminary results suggest that risk profiles for HIV/sexually transmitted infection among FSWs in these two Mexico-U.S. border cities differ, suggesting a need to tailor interventions to the specific needs in each city.