RESUMO
This paper evaluates correlates of trichomoniasis among female sex workers who inject drugs (FSWIDs) in two Mexico-US border cities. HIV-negative FSWIDs aged 18 years or older were enrolled in a study between 2008 and 2010 in Tijuana and Ciudad Juarez (Cd.), Mexico. All participants underwent a baseline interviewer-administered survey and did a rapid test for trichomoniasis. Using regression to estimate prevalence ratios, we examined sociodemographics, sex work characteristics, sexual health and behavior, substance use, and police and violence exposures as potential correlates of trichomoniasis. Of 584 women (284 in Tijuana, 300 in Cd. Juarez), prevalence of trichomoniasis was 33.6%. Factors associated with trichomoniasis in multivariable analysis were having money stolen by police in the past six months (adjusted prevalence ratio [aPR] =1.448, 95% confidence interval [CI] = 1.152-1.821), recent methamphetamine use (aPR = 1.432, CI = 1.055-1.944), lifetime syphilis infection (aPR = 1.360, CI = 1.061-1.743), ever use of a home remedy to treat vaginal symptoms (aPR = 1.301, CI = 1.027-1.649), and number of regular clients in the past month (aPR = 1.006 per client, CI = 1.004-1.009), while controlling for age and city of interview. Alongside the need for trichomoniasis surveillance and treatment programs, findings indicate that both structural and behavioral factors serve as primary correlates of trichomoniasis among FSWIDs in these cities.
Assuntos
Metanfetamina/efeitos adversos , Trabalho Sexual , Profissionais do Sexo/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Tricomoníase/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , México/epidemiologia , Fatores de Risco , Tricomoníase/diagnóstico , Estados Unidos/epidemiologia , Sexo sem Proteção/estatística & dados numéricosRESUMO
OBJECTIVE: Migration is a structural factor that increases HIV vulnerability. Acculturative stress represents a possible mechanism through which migration may negatively impact HIV risk. This study investigated socio-ecological factors associated with acculturative stress levels and examined the association between acculturative stress and HIV-related behavior among Mexican im/migrants. METHODOLOGY: We used data from a probability survey of Mexican im/migrants (N = 1383) conducted in Tijuana, Mexico, in 2009-2010. The sample included migrants returning to Mexico via deportation or voluntarily after a recent stay in the USA. Linear regression models were estimated to identify individual, migration, and contextual factors independently associated with overall acculturative stress levels. Logistic regression models were used to test for associations between acculturative stress, sexual HIV risk, and HIV testing history behavior. RESULTS: We found that levels of acculturative stress were significantly and independently related to socio-economic markers, acculturation level, legal residence status, and sexual minority status. The analyses also showed that acculturative stress was positively related to sexual HIV risk behavior and negatively related to recent HIV testing. CONCLUSIONS: The results underscore that both individual and environmental factors contribute to levels of acculturative stress among Mexican im/migrants. In turn, acculturative stress may exacerbate sexual HIV risk and impede testing among this im/migrant population. Targeted interventions to prevent and decrease acculturative stress represent a potential strategy to reduce sexual HIV risk behavior and promote HIV testing among this vulnerable population of im/migrants in the USA.
Assuntos
Aculturação , Emigrantes e Imigrantes/psicologia , Infecções por HIV/psicologia , Americanos Mexicanos/psicologia , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Migrantes/psicologia , Adaptação Psicológica , Adulto , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Estresse Psicológico , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Estados Unidos/etnologiaRESUMO
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.