Migration, acculturation, displacement: migratory workers and "substance abuse"

Social Support Networks and HIV/STI Risk Behaviors Among Latino Immigrants in a New Receiving Environment

The objectives of this study were to: (1) describe the quantity and quality of social support networks of Latino immigrants living in a new receiving environment, and (2) determine the role such networks play in their HIV/STI risk behaviors, including substance use. Double incentivized convenience sampling was used to collect egocentric social support network data on 144 Latino immigrants. Latent class analysis was used for data reduction and to identify items best suited to measure quality and quantity of social support. Moderate and high quantity and quality of social support were protective of HIV/STI sexual risk behavior compared to low quantity and quality of support, after adjustment for gender, years in New Orleans and residing with family. Neither measure of social support was associated with binge drinking. The findings suggest that increased quantity and quality of social support decrease HIV/STI sexual risk behaviors but do not influence binge drinking. Interventions that improve the quantity and quality of social support are needed for Latino immigrants.

Syndemic factors associated with drinking patterns among Latino men and Latina transgender women who have sex with men in New York City

Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors - clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination - reported by each participant. We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population.

Common mental disorders in public transportation drivers in Lima, Peru

BACKGROUND

Traffic related injuries are leading contributors to burden of disease worldwide. In developing countries a high proportion of them can be attributed to public transportation vehicles. Several mental disorders including alcohol and drug abuse, psychotic disorders, mental stress, productivity pressure, and low monetary income were found predictors of high rates of traffic related injuries in public transportation drivers. The goal of this study was to estimate the prevalence of common mental disorders in the population of public transportation drivers of buses and rickshaws in Lima, Peru.

METHODOLOGY/PRINCIPAL FINDINGS

Cross sectional study. A sample of bus and rickshaw drivers was systematically selected from formal public transportation companies using a snowball approach. Participants completed self-administered questionnaires for assessing major depressive episode, anxiety symptoms, alcohol abuse, and burnout syndrome. Socio demographic information was also collected. The analyses consisted of descriptive measurement of outcomes taking into account both between and within cluster standard deviation (BCSD and WCSD). A total of 278 bus and 227 rickshaw drivers out of 25 companies agreed to participate in the study. BCSD for major depressive episode, anxiety symptoms and burnout syndrome was not found significant (p>0.05). The estimated prevalence of each variable was 13.7% (IC95%: 10.7-16.6%), 24.1% (IC95%: 19.4-28.8%) and 14.1% (IC95%: 10.8-17.4%) respectively. The estimated prevalence of alcohol abuse was 75.4% (IC95%: 69-81.7%, BCSD = 12.2%, WCSD = 41.9%, intra class correlation (ICC): 7.8%).

CONCLUSION

Common mental disorders such as alcohol abuse, major depressive episode, anxiety symptoms and burnout syndrome presented higher rates in public transportation drivers than general population.

New drug use among agricultural workers

Research on drug use onset rarely examines the spatial dimensions of onset, owing to a literature that is overwhelming from urban areas of an industrialized country (United States). Narrative interviews from drug-using agricultural workers in contrast reveal another side of drug use onset, where influence of familiarity with place becomes evident, despite the expectation that the novelty and/or adventure within a lifestyle of seasonal employment and migratory labor that requires overnight accommodations on-the-season is likely to push/pull one into the first use of a new drug or the first drug that an individual has ever used.

Agency and addiction in a harm reduction paradigm: French nurses' perspectives

French psychiatric nurses' perspectives on individuals addicted to drugs and their treatments are influenced by French socio-cultural norms. In this study, steps of the ethnographic method were used to elicit the intertwining of French professional and cultural perspectives on drug addiction. Emergent themes from nurses' interviews and cultural participant-observations suggest that drug addiction management in France's harm reduction paradigm challenges nurses' beliefs about addicted individuals' agency and conformity to treatment goals, and is influenced by European Union membership, changes in health care, drugs and demographics. Novel nursing strategies emergent from these themes might be applicable in other cultural contexts.

Sex and drug risk behavior pre- and post-emigration among Latino migrant men in post-Hurricane Katrina New Orleans

High rates of sex and drug risk behaviors have been documented among Latino migrant men in the US. Whether these behaviors were established in the migrants' home countries or were adopted in the US has not been described and has implications for prevention strategies. Quarterly surveys were conducted to gather information on selected sex and drug risk practices of Latino migrant men who arrived in New Orleans after Hurricane Katrina seeking work. Both kappa scores and McNemar's tests were performed to determine if practice of these behaviors in home country was similar to practice post-emigration to the US. Female sex worker (FSW) patronage, same sex encounters (MSM), and crack cocaine use was more likely to occur post- rather than pre-emigration. Of those who ever engaged in these selected behaviors, most adopted the behavior in the US (i.e., 75.8% of FSW patrons, 72.7% of MSM participants, and 85.7% of crack cocaine users), with the exception of binge drinking (26.8%). Men who were living with a family member were less likely to adopt FSW patronage OR = 0.27, CI = 0.10-0.76, whereas men who earned >$465 per week were more likely to adopt crack cocaine use OR = 6.29 CI = 1.29, 30.57. Interventions that facilitate the maintenance of family cohesion and provide strategies for financial management may be useful for reducing sex and drug risk among newly arrived migrants.

Prevalence, patterns and predictors of substance use among Latino migrant men in a new receiving community

BACKGROUND

The purpose of this study was to evaluate the prevalence, patterns and predictors (individual, social, cultural, and environmental) of illicit drug use and binge drinking in a cohort of Latino migrant men (LMM) in a new receiving community.

METHODS

A cohort of LMM in New Orleans (n=125) was assembled in 2007 using respondent driven sampling and interviewed quarterly for 18 months regarding past month substance use and other potential covariates. Baseline frequencies were weighted using RDSAT and longitudinal analyses included generalized estimating equations (GEE) and the Cochran-Armitage test for trends.

RESULTS

At baseline, substance use behaviors were: drug use 15.0% (range 7.3-25.0%) and binge drinking 58.3% (range 43.6-74.6%). All three of these behaviors decreased over follow-up (P<0.01). Baseline alcohol dependence and drug problem were 11.8% (range 5.6-24.3%) and 0.08% (range 0.00-2.7%) and both remained the same over time. Baseline rate of chlamydia was 9% (range 0.00-22.4%); all men tested negative for gonorrhea, HIV, and syphilis. For both binge drinking and drug use, having sex with a female sex worker was associated with increased risk, whereas belonging to a club or organization was associated with less risk. Additional factors associated with increased drug use were: having a friend in New Orleans upon arrival, symptoms of depression, and working in construction. An additional factor associated with less binge drinking was having family in New Orleans upon arrival.

CONCLUSION

Among LMM, substance use is influenced by social and environmental factors. Interventions increase community connectedness may help decrease usage.

Patterns and predictors of multiple sexual partnerships among newly arrived Latino migrant men

Multiple sexual partnerships (MSP), both concurrent and serial short gap, are thought to increase the risk of HIV and sexually transmitted infection (STI) acquisition and transmission. In this study we evaluate potential individual and environmental risk factors for engaging in MSP in a cohort of newly arrived Latino migrant men (LMM) in New Orleans, LA, USA. Participants were surveyed at three time points over a nine-month period to examine factors associated with MSP. Of the 113 men, 32.5 % reported ever MSP. In 290 observations, 19.5 % of men had concurrent, and 15.0 % had serial short gap partnerships in at least one interviews. Substance was associated with MSP, OR (95 % CI) 2.00 (1.16, 3.45) whereas belonging to a community organization was found to be protective, OR 0.32 (0.17, 0.59). Interventions to reduce substance use and promote social connection are needed to prevent a potential HIV/STI epidemic in this population.

Prevalence of alcohol, tobacco and street drugs consumption in adult Latin American immigrants

To estimate the prevalence of alcohol, tobacco and illicit drug consumption (through the self-report) in adult Latin-American immigrants of Seville, a cross-sectional descriptive study was carried out in a representative sample of 190 immigrants. The results showed that 61.4% of the participants had consumed alcohol in previous month before data collection, although 13.2% of them were at risk of alcoholism. Moreover, 30.0% were smokers. In addition, 5.3% of the interviewed people had consumed illicit psychoactive substances in the previous six months (Marihuana: 3.7%, hashish: 1.1% and cocaine: 0.5%). For all substances under analysis, the consumption prevalence was much higher in men from 25 to 39 years of age. In conclusion, prevalence levels of this consumption were high among the studied immigrants. Nurses could train the population in the prevention of these risk behaviors through preventive practices.

Patterns and predictors of HIV/STI risk among Latino migrant men in a new receiving community

The purpose of this study was to examine patterns and predictors of HIV/STI risk over time among Latino migrant men in a new receiving community. Latino men (N = 125) were interviewed quarterly for 18 months and HIV/STI tested annually. Selected individual, environmental and cultural factors by partner type and condom use were explored longitudinally and in a cross-section. Sex with female sex workers (FSWs) and multiple partners decreased, sex with main partners and abstinence increased, while the number of casual partners remained stable. Consistent condom use was highest with FSWs, lowest with main partners and midrange with casual partners with no trends over time. STI morbidity was low; no HIV was detected. Drug use and high mobility were associated with inconsistent condom use with FSW, whereas having family in the household was protective. HIV/STI prevention efforts should focus on drug using Latino migrants who are highly mobile and should foster healthy social connections.

Substance Abuse, Acculturation, and HIV Risk among Caribbean-Born Immigrants in the United States

US immigrants of Caribbean origin are overrepresented in the HIV/AIDS prevalence statistics. Bidirectional travel between the United States and the Caribbean region by providing opportunities for sexual mixing may contribute to these high HIV rates. Caribbean immigrants face further risk because of limited health care access, social isolation, and stigma. Additionally, although substance abuse may not represent a major health issue in their countries of origin, Caribbean immigrants are composed disproportionately of adolescents who are at greatest risk of substance abuse. There is little information on the health care characteristics of these migrants, especially regarding HIV care. This article describes how the social and economic circumstances that surround the lives of people from the Caribbean and the challenges of the acculturation process have placed these individuals at risk of substance abuse and HIV infection. The article draws on findings from the literature and analysis of data from several sources.

Lessons from the fields: a migrant HIV prevention project

Migrant and seasonal workers are vulnerable to human immunodeficiency virus (HIV) due to poverty, inadequate knowledge of preventive strategies, and lack of access to health care. This study addresses the disparate impact of HIV among Hispanic and African American migrant workers in Immokalee, Florida, who use alcohol and other drugs. Through pilot testing to adapt the experimental and comparison interventions to these two distinct populations, research staff have learned the importance of (1) establishing and maintaining trust between outreach staff and the migrant community; (2) being aware of cultural nuances and practices that might create challenges to the research process, and the interaction of these factors with poverty; and (3) having flexibility in recruitment and intervention. As one of the first intervention studies in this population to use an experimental design and to focus on the social and contextual factors that contribute to risky behaviors, these lessons may provide guidance for future researchers.

Acculturation and substance use: social influence as a mediator among Hispanic alternative high school youth

Research suggests that acculturation increases the risk of substance use among Hispanic youth. However, this process is not well understood. This study examined associations between acculturation and several substance use indicators among a sample of 714 Hispanic youth attending alternative high schools in southern California. Peer social influence was assessed as a potential mediator. Acculturation, measured by language use, was associated with increased risk of lifetime alcohol, marijuana, and current alcohol, cigarettes, marijuana, and hard drug use, controlling for age, socioeconomic status, and gender. Results of mediation analyses indicate that peer social influence mediated the relationship between acculturation and lifetime alcohol and current alcohol, cigarettes, and hard drug use. Evidence for partial mediation was observed with lifetime and current marijuana use. These results provide evidence that peer social influence is an important mediating variable that should be considered when examining the relationship between acculturation and substance use.

Research challenges to the study of HIV/AIDS among migrant and immigrant Hispanic populations in the United States

Migrant populations have been found to be at risk of HIV/AIDS. The growth in immigrant and migrant Hispanic populations in the United States increases the need to enhance understanding of influences on their HIV-risk behaviors. Four challenges to conducting research among these populations were identified: (1) the need to use multilevel theoretical frameworks; (2) the need to differentiate between Hispanic subgroups; (3) challenges to recruitment and data collection; and (4) ethical issues. This article describes how two studies of Hispanic immigrants and migrants in the New York area addressed these challenges. One study focused on new immigrants from Mexico, the Dominican Republic, El Salvador, Honduras and Guatemala, and a second study focused on Puerto Rican drug users. Both studies incorporated qualitative and quantitative methods to study these hard-to-reach populations. Continued study of the sociocultural and contextual factors affecting HIV risk for mobile populations, and addressing the research challenges, is crucial to developing effective intervention programs.