A Small Randomized Controlled Trial of Three Remote Methods to Collect Mental Health Data from Migrant Farmworker Adults

There has been limited longitudinal study of the health of migrant farmworkers due to their migratory lifestyles and there are opportunities to test new remote data collection methods in this subpopulation. A small randomized controlled trial was conducted with 75 migrant farmworker families who were randomly assigned to one of three groups that participated by (1) telephone interview, (2) online survey, or (3) mobile app between June 2021-April 2022. Of 50 farmworker adults who completed the baseline survey, there was differential attrition with 21% of the telephone interview group, 18% of the online survey group, and 3.2% of the online app group completing the 2-month follow-up. Over this period, migrant farmworkers reported relatively few mental health problems but notable alcohol use problems. Online apps were less effective than traditional methods for remote data collection. Alcohol use problems among migrant farmworkers in the U.S. may be an issue that deserves further study.

Discrimination, acculturative stress, alcohol use and their associations with alcohol-related consequences among Latino immigrant men

Latino immigrant men are at increased risk for unhealthy alcohol use and related consequences due to social stressors associated with immigration. We assessed the associations of, and examined whether social stressors moderated associations between, alcohol use and alcohol-related consequences in a community-based sample of Latino immigrant men in Washington (N = 187). The mean Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score was 6.3 (scores ≥ 4 indicate unhealthy alcohol use). More than half of the men (61.5%) reported experiencing discrimination in at least one setting and mean acculturative stress score was 18.3 indicating moderate levels of acculturative stress. Linear regression models were fit to assess main effects (associations between both alcohol use and social stressors and alcohol-related consequences) and moderation (whether the association between alcohol use and consequences varied based on experience of social stressors using multiplicative interaction) after adjustment for potential confounders. Alcohol use (β = 0.47, 95% CI = 0.20-0.73; p = .001), discrimination (β = 0.85, 95% CI = 0.27-1.43; p = .004), and acculturative stress (β = 0.13, 95% CI = 0.02-0.24; p = .025) were all associated with increased experience of alcohol-related consequences. The association between alcohol use and alcohol-related consequences was stronger for those with high levels of acculturative stress (p = .025) but not experience of discrimination (p = .587). Findings underscore the importance of social and cultural context in alcohol use and related consequences. Efforts to reduce negative consequences of drinking may include focus on reducing exposure to discrimination and acculturative stress.

Relationships Between Job Stress, Psychological Adaptation and Internet Gaming Disorder Among Migrant Factory Workers in China: The Mediation Role of Negative Affective States

Factory workers make up a large proportion of China's internal migrants and may be highly susceptible to job and adaptation stress, negative affective states (e.g., depression and anxiety), and Internet gaming disorder (IGD). This cross-sectional study investigated the relationships between job stress, psychological adaptation, negative affective states and IGD among 1,805 factory workers recruited by stratified multi-stage sampling between October and December 2019. Structural equation modeling (SEM) was conducted to test the proposed mediation model. Among the participants, 67.3% were male and 71.7% were aged 35 years old or below. The prevalence of probable depression, probable anxiety, and IGD was 39.3, 28.7, and 7.5%. Being male, younger age, and shorter duration of living in Shenzhen were associated with higher IGD scores. Job stress was significantly associated with IGD (β = 0.11, p = 0.01) but not with negative affective states (β = 0.01, p = 0.77). Psychological adaptation was significantly associated with negative affective states (β = -0.37, p < 0.001) but not with IGD (β = 0.09, p > 0.05). Negative affective states were positively associated with IGD (β = 0.27, p < 0.001). The indirect effect of psychological adaptation (β = -0.10, p = 0.004) but not job stress (β = 0.003, p = 0.77) on IGD through negative affective states was statistically significant. The observed psychological correlates and mechanisms are modifiable, and can inform the design of evidence-based prevention programs for depression, anxiety, and IGD in this population.

The Etiologic, Theory-Based, Ontogenetic Hierarchical Framework of Alcohol Use Disorder: A Translational Systematic Review of Reviews

Modern nosologies (e.g., ICD-11, DSM-5) for alcohol use disorder (AUD) and dependence prioritize reliability and clinical presentation over etiology, resulting in a diagnosis that is not always strongly grounded in basic theory and research. Within these nosologies, DSM-5 AUD is treated as a discrete, largely categorical, but graded, phenomenon, which results in additional challenges (e.g., significant phenotypic heterogeneity). Efforts to increase the compatibility between AUD diagnosis and modern conceptualizations of alcohol dependence, which describe it as dimensional and partially overlapping with other psychopathology (e.g., other substance use disorders) will inspire a stronger scientific framework and strengthen AUD's validity. We conducted a systematic review of 144 reviews to integrate addiction constructs and theories into a comprehensive framework with the aim of identifying fundamental mechanisms implicated in AUD. The product of this effort was the Etiologic, Theory-Based, Ontogenetic Hierarchical Framework (ETOH Framework) of AUD mechanisms, which outlines superdomains of cognitive control, reward, as well as negative valence and emotionality, each of which subsume narrower, hierarchically-organized components. We also outline opponent processes and self-awareness as key moderators of AUD mechanisms. In contrast with other frameworks, we recommend an increased conceptual role for negative valence and compulsion in AUD. The ETOH framework serves as a critical step towards conceptualizations of AUD as dimensional and heterogeneous. It has the potential to improve AUD assessment and aid in the development of evidence-based diagnostic measures that focus on key mechanisms in AUD, consequently facilitating treatment matching.

A Structural-Environmental Model of Alcohol and Substance-Related Sexual HIV Risk in Latino Migrant Day Laborers

A structural-environmental model of alcohol and substance-related sexual HIV risk in 344 Latino migrant day laborers, participants in a cross-sectional survey, is tested using structural equation modeling. Hypothesized pathways include: (1) direct paths between environmental conditions and both distress related risk factors, and cultural and community protective factors; (2) indirect paths between environmental conditions and distress through cultural and community protective factors; and (3) indirect paths between environmental conditions and sexual risk through both distress risk factors and cultural and community protective factors. As hypothesized, the environmental factors, discrimination and working conditions, were indirectly related to sexual risk through the distress related factor, problem drinking, and through the protective factor, contact with family in country of origin. More specifically, as discrimination and working conditions worsen, contact with family decreases, problem drinking increases, and sexual risk increases. Implications for multi-level interventions are discussed.

Exposures at day labor corners: using existing georeferenced data to describe features of urban environments

PURPOSE

Latino day laborers are male immigrants from mainly Mexico and Central America who congregate at corners, that is, informal hiring sites, to solicit short-term employment. Studies describing the occupational environment of Latino day laborers traditionally measure jobsite exposures, not corner exposures. We sought to elucidate exposures at corners by describing their demographic, socioeconomic, occupational, business, built, and physical environmental characteristics and by comparing corner characteristics with other locations in a large urban county in Texas.

METHODS

We used multiple publicly available data sets from the U.S. Census, local tax authority, Google's Nearby Places Application Programming Interface, and Environmental Protection Agency at fine spatial scale to measure 34 characteristics of corners with matched comparison locations.

RESULTS

Corners were located close to highways, high-traffic intersections, hardware and moving stores, and gas stations. Corners were in neighborhoods with large foreign-born and Latino populations, high rates of limited English proficiency, and high construction-sector employment.

CONCLUSIONS

Publicly available data sources describe demographic, socioeconomic, occupational, business, built, and physical environment characteristics of urban environments at fine spatial scale. Using these data, we identified unique corner-based exposures experienced by day laborers. Future research is needed to understand how corner environments may influence health for this uniquely vulnerable population.

Working and Living Conditions and Psychological Distress in Latino Migrant Day Laborers

Background. Little research has been conducted on relations between challenging working and living conditions and psychological distress in Latino migrant day laborers (LMDLs), a particularly marginalized Latino population in the United States. Aims. Consistent with a structural-environmental framework of LMDL vulnerability to health and mental health problems, this study tests a model of hypothesized pathways between working and living conditions and multiple forms of psychological distress. Method. Structural equation modeling was used to test the conceptual model with 344 LMDLs who participated in a cross-sectional survey in the San Francisco Bay Area. Results. As hypothesized, results reveal pathways between (1) working and living conditions; (2) working and living conditions and depression, as well as desesperación (desperation), the latter a Latino cultural idiom of distress frequently expressed by LMDLs; and (3) between living conditions and alcohol use. Discussion. Findings increase understanding regarding how challenging working and living conditions contribute to the same, as well as different, forms of psychological distress in LMDLs. Conclusions. Implications for mitigating structural vulnerability to psychological distress can be addressed at multiple social-ecological levels ranging from community-based support for enhancing LMDL employment (e.g., via day labor centers) to expanding the availability of work authorization for undocumented workers.

Alcohol-related problem behaviors among Latin American immigrants in the US

BACKGROUND

Prior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care.

METHODS

The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes.

RESULTS

Foreign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33-0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32-0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior.

CONCLUSIONS

Latino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.

Cumulative Trauma Among Mayas Living in Southeast Florida

Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

Alcohol Use and Sexual Risk Behaviors in a Migrant Worker Community

There are not many studies exploring the association between alcohol use and risky sexual behaviors among migrant workers. This study analyzed how changes in alcohol use was associated with changes in risky sexual behavior and psychosocial variables. Data for this study was drawn from an HIV risk reduction project. Repeated measures ANOVA and Linear mixed model statistical method was conducted to find changes and association between alcohol use, sexual risk and psychosocial variables over time. The sample (n = 203) was composed of African Americans (33.0 %) and Hispanics (77.0 %) men. Both groups, over time, showed reduction in sexual risk in accordance with reduction in alcohol use. Changes in alcohol use and psychosocial variables showed significant association with sexual risk changes over time. Psychological strategies like building social support should be considered for HIV risk reduction intervention directed towards high alcohol consuming migrant workers.

Alcohol and Sexual Risk Behaviors Among Male Central Asian Labor Migrants and Non-migrants in Kazakhstan: Implications for HIV Prevention

This paper examines the association between alcohol consumption and sexual risk behaviors (unprotected sex, multiple sex partners, sex under influence of drugs or alcohol and commercial sex) in a sample of Central Asian migrant and non-migrant laborers in the largest marketplace in Kazakhstan. We used data from The Silk Road Health Project, conducted from 2010 to 2013 with 1342 male migrant and non-migrant market workers. Participants were selected through respondent driven sampling at the Baraholka Market in Almaty, Kazakhstan. We used regression analyses adjusting for potential confounders to examine the relationship between alcohol consumption and sexual risk behavior. We found that hazardous drinking was associated with an increase in the odds of sex under the influence of drugs (aOR = 6.09, 95% CI 3.48, 10.65; p < .001) and purchasing commercial sex (aOR = 2.02, 95% CI 1.02, 4.02; p < .05). We identified potential targets for HIV interventions to reduce sexual risk behaviors among this key population.

Depression and Risk for Problem Drinking in Latino Migrant Day Laborers

BACKGROUND

Given the structural vulnerability of Latino migrant day laborers (LMDLs) to unstable and poorly paying work, harsh living conditions and frequent inability to support or even visit families in country of origin, psychological distress is a common response and one frequently implicated in risky outcomes such as problem drinking.

OBJECTIVES

The purpose of this study was to examine the relation of three different forms of psychological distress to problem drinking in LMDLs: depression, anxiety, and desesperación, the latter a popular Latino culture-based idiom of psychological distress.

METHODS

A cross sectional survey of 344 LMDLs was conducted in the San Francisco Bay Area from January to June of 2014. Independent contributions of depression, anxiety, and desesperación in explaining problem drinking as measured by a modified version of the AUDIT, were assessed using multiple linear regression analysis.

RESULTS

Depression was significantly associated with risk for problem drinking while other forms of psychological distress were not. Conclusion/Importance: Findings provide stronger empirical support for the association between depression and problem drinking, a long suspected but under-demonstrated relationship in the literature on LMDLs. Implications for preventing problem drinking as well as mitigating psychological distress more generally for LMDLs are discussed.

Cultural Correlates of DUI Risk Perceptions Among Documented and Undocumented Recent Latino Immigrants in South Florida

Latinos do not drink and drive more often than non-Latino Whites, yet are disproportionately involved in alcohol-related arrests and fatal crashes. These disparities have been linked to a failure in recognizing the impairing effects of alcohol on driving psychomotor abilities and low risk perceptions of being caught or prosecuted by law enforcement for DUI (driving under the influence). However, little is known about the role that cultural factors play in shaping drinking and driving risk perceptions among Latino immigrants. This study examines associations between cultural factors and DUI risk perceptions in a sample of 467 documented and undocumented recent Latino immigrants. Results revealed cultural risk factors were associated with higher alcohol use and decreased DUI risk perceptions. Cultural protective factors were linked with less drinking behaviors. Undocumented immigrants reported higher rates of alcohol use, lower levels of cultural protective factors, and higher levels of cultural risk factors. Findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest a need for greater attention to cultural factors in developing DUI prevention programs tailored toward Latino immigrants.

Neighborhood Ethnic Composition and Problem Drinking Among Older Mexican American Men: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly

Ethnic enclaves may be protective for health. This study investigates the effects of neighborhood co-ethnic density on problem drinking among older Mexican American men. Probability sample of 2,086 community-dwelling Mexican Americans aged 75 or older drawn in 2004-2005 residing in communities in Arizona, California, Colorado, New Mexico and Texas. Problem drinking was found among 15.3 % of men (n = 350). For each percent increase in neighborhood percent Mexican American, men had 2 % lower odds of problem drinking [odds ratio (OR) 0.98; P < 0.05]. U.S. born men had lower odds of problem drinking (OR 0.40; P < 0.05) compared with foreign born men, while English language use was associated with greater odds of problem drinking (OR 2.14; P < 0.05). Older Mexican American men in neighborhoods with low levels of co-ethnic density, the foreign born, and those with English language facility had an increased likelihood of problem drinking.

La desesperación in Latino migrant day laborers and its role in alcohol and substance-related sexual risk

The purpose of this study was to better understand the relation between psychological distress and alcohol and substance related sexual risk in Latino migrant day laborers (LMDLs). In addition to examining the roles of depression and anxiety, it was also necessary to examine the role of desesperación, a popular Latino idiom of distress frequently expressed by LMDLs in response to the thwarting of major migration related life goals such as traveling to the U.S. in search of work to support families, projects and purchases in country of origin. Given the structural vulnerability of LMDLs to under-employment and frequent unemployment, LMDLs also refer to desesperación as a prelude to problem drinking, substance use, and sexual risk taking. Hence we developed and validated a scale of desesperación for LMDLs to explore this culturally relevant construct of psychological distress in this unique population of Latinos. Based on a cross sectional survey of 344 LMDLs, this study found that the dissatisfaction subscale of desesperación predicted alcohol-related sexual risk taking, while depression predicted substance-related sexual risk taking. These findings are discussed including implications of preventing alcohol and substance related sexual risk taking in LMDLs.

Evaluating a Culturally Tailored HIV Risk Reduction Intervention Among Latina Immigrants in the Farmworker Community

Latina immigrants in the farmworker community are a vulnerable and understudied population at risk of acquiring HIV. Employing a CBPR framework, this pilot study was the first to evaluate the efficacy of SEPA, a CDC evidenced-based and culturally tailored HIV risk reduction intervention on a cohort of N = 110 predominantly undocumented Latina immigrants in a farmworker community. Findings revealed SEPA was effective in increasing HIV knowledge and decreasing HIV risk behaviors. However, no changes in self-efficacy were found in the present sample. We posit specific socio-cultural and structural barriers specific to the farmworker community not targeted in the original intervention may have hindered the program's capacity to influence changes in self-efficacy among this less acculturated population. Possible socio-cultural adaptations of the intervention to the target population and policy implications are discussed.

¿A quién le importa? Las familias transnacionales en los debates sobre la migración y el desarrollo

La migración internacional pone en marcha una serie de procesos transnacionales significativos que conectan países y personas. Desde el inicio del nuevo milenio, el modo en como la migración interactúa con el desarrollo, y cómo las políticas públicas pueden promover y enriquecer tales interacciones, han captado la atención de la agenda internacional. Forma parte de este debate reconocer que las prácticas transnacionales conectan a los migrantes y a sus familias a través de sociedades que envían y reciben personas. Sin embargo, siguen sin explorarse las maneras por medio de las cuales el debate político utiliza y comprende esos lazos familiares transnacionales. Este artículo pretende aproximarse a la comprensión de estas familias situándolas en dos debates, frecuentemente entremezclados, relacionados con las interacciones transnacionales. El primero remite al discurso estatal y político sobre los beneficios potenciales de la migración en el desarrollo económico. El segundo se refiere a las familias transnacionales, y se centra en los cuidados y en las micro-políticas de género y generacionales, cuestiones estas a las que se ha dedicado una gran literatura académica. Focalizando la atención en la relación entre las diversas dinámicas de desarrollo migratorio y las posiciones familiares específicas, nos preguntamos, más concretamente, si la elección de un punto de partida analítico con respecto a la maternidad, la paternidad o la niñez transnacionales puede vincularse con el énfasis en un determinado tipo de resultados. Concluimos, haciendo una descripción de distintas inclusiones o exclusiones de los asuntos familiares en el discurso político, y sugerimos formas para integrar de una manera más adecuada la perspectiva de la familia transnacional en las políticas públicas de migración y desarrollo a nivel global.

State and Local Policies as a Structural and Modifiable Determinant of HIV Vulnerability Among Latino Migrants in the United States

We explore how state and local policies in labor, health, education, language, community and neighborhood environments, deportation, and state-authorized identification can reduce or exacerbate HIV vulnerability among Latino migrants in the United States. We reviewed literature on Latino migrants and HIV risk, on the structural-environmental contexts experienced by Latino migrants, and on the many domains in which policies influence those contexts. To illustrate the pathways through which policies across multiple sectors are relevant to HIV vulnerability, we describe how policies shape 2 mediating domains (a climate of hostility toward Latino migrants and the relative ease or difficulty of access to beneficial institutions) and how those domains influence behavioral risk practices, which increase vulnerability to HIV. This argument demonstrates the utility of considering the policy context as a modifiable element of the meso-level through which structural factors shape vulnerability to HIV. This approach has specific relevance to the consideration of HIV prevention for Latino migrants, and more generally, to structural approaches to HIV prevention.

Development and Preliminary Testing of a Promotora-Delivered, Spanish Language, Counseling Intervention for Heavy Drinking among Male, Latino Day Laborers

This study developed and then tested the feasibility, acceptability and initial efficacy of a 3-session, culturally adapted, intervention combining motivational enhancement therapy (MET) and strengths-based case management (SBCM) delivered by promotoras in Spanish to reduce heavy drinking among male, Latino day laborers. A pilot two-group randomized trial (N=29) was conducted to evaluate the initial efficacy of MET/SBCM compared to brief feedback (BF). Alcohol-related measures were assessed at 6, 12 and 18weeks after baseline. Most intervention group participants (12/14) attended all counseling sessions and most participants (25/29) remained in the study at 18weeks. Alcohol related measures improved in both groups over time with no statistically significant differences observed at any of the time points. However the comparative effect size of MET/SBCM on weekly drinking was in the large range at 6-weeks and in the moderate range at 12-weeks. Post hoc analyses identified a statistically significant reduction in number of drinks over time for participants in the intervention group but not for control group participants. Despite the extreme vulnerability of the population, most participants completed all sessions of MET/SBCM and reported high satisfaction with the intervention. We feel our community partnership facilitated these successes. Additional studies of community-partnered and culturally adapted interventions are needed to reduce heavy drinking among the growing population of Latinos in the U.S.

Alcohol Consumption and Risk for Dependence Among Male Latino Migrant Farmworkers Compared to Latino Nonfarmworkers in North Carolina

BACKGROUND

Our aim was to describe alcohol consumption behavior of male Latino migrant farmworkers, compare their alcohol consumption behavior with that of other male Latino immigrants, and determine factors associated with risk for alcohol dependence among Latino immigrant workers.

METHODS

Cross-sectional data were drawn from baseline interviews conducted as part of a larger community-based participatory research project examining the cognitive and neurological outcomes of pesticide exposure. A total of 235 farmworkers and 212 nonfarmworkers completed interviews between May and August 2012.

RESULTS

Although 17.5% of the North Carolina Latino farmworkers report never having drunk alcohol, and a total of 34.5% report not having drunk alcohol in the previous 3 months, 48.5% engaged in heavy episodic drinking (HED) in the previous 3 months, and 23.8% frequently engaged in HED during this period. Farmworkers and nonfarmworkers did not differ significantly in alcohol consumption behavior. Farmworkers and nonfarmworkers did differ significantly in each component of the CAGE scale, with 37.9% of farmworkers and 16.0% of nonfarmworkers being at risk for alcohol dependence (p < 0.0001). Significant factors for being at risk for alcohol dependence were stress (odds ratio 1.06, 95% confidence interval 1.03, 1.09) and being a farmworker (odds ratio 3.58, 95% confidence interval 2.12, 6.06). Being married reduced the risk of alcohol dependence (odds ratio 0.45, 95% confidence interval 0.23, 0.87).

CONCLUSIONS

Latino farmworkers and nonfarmworkers consume relatively large amounts of alcohol and engage in HED at relatively high rates. Latino farmworkers have very high rates of risk for alcohol dependence. Policy changes and public health interventions are needed to address these concerns for a population that is vital to the agricultural economy.

Alcohol use among Latino migrant workers in South Florida

BACKGROUND

A significant segment of the Latino migrant worker population in the United States is at high risk for alcohol abuse and related risk behaviors. Information about the prevalence of alcohol use and abuse and its association with sociodemographic and psychological variables is needed for designing effective intervention prevention strategies.

METHODS

Cross-sectional data were drawn from a baseline assessment that was part of a randomized controlled trial of 278 Latino migrant workers (LMWs) conducted between 2008 and 2010.

RESULTS

About one-third (32%) of participants engaged in heavy drinking in the past 30 days prior to baseline interview. More females than males reported no alcohol use in the past 30 days (53.5% vs. 20.5%). On the other hand, more males reported drinking every day or nearly (25.2% vs. 7.1%). Five factors-gender, country of origin, relationship status, living arrangements, and acculturation-were significantly associated with frequency of alcohol consumption. Multivariate analyses indicated that gender, country of origin, education attainment, relationship status, living arrangement, living with children, length of stay in the US, religious beliefs, acculturation, and depression were associated with frequent heavy drinking, alcohol abuse/dependence, and unprotected sex under the influence of alcohol.

CONCLUSIONS

There is significant variation in alcohol use among Latino migrant workers. Although a substantial proportion of this population abstains from alcohol, an equally substantial proportion report levels of alcohol use that pose significant risk. More research is needed to better understand drinking patterns in this community in order to design prevention strategies specifically tailored for this population.

Newcomer Status as a Protective Factor among Hispanic Migrant Workers for HIV Risk

The HIV rate among U.S. migrant workers is 10 times that of the national rate. The highly unstable lifestyle of migrant workers places them at heightened vulnerability to sexually transmitted infections; hence, there is a need to investigate the attitudes and sexual risk factors that may play a protective role in the transmission of HIV in this population. This study examines the association between attitudes and HIV risk behaviors among Hispanic male and female migrant workers (n = 255) and their length of stay (shorter length of stay as a protective factor) in Immokalee, FL, USA. Pearson's correlation and regression analyses were utilized to analyze the relationship between HIV risk behaviors (intention to use condoms and alcohol use) with length of stay in Immokalee. Longer length of stay positively correlated with number of drinks (p < 0.05) and frequency of drinks (p < 0.01) and negatively correlated with ethnic identity search (p < 0.05). Regression analysis showed that length of stay predicted both behavioral intention to use condoms (p < 0.05) and alcohol consumption (p < 0.05). The findings suggest that migrant workers who are new to Immokalee may have a higher likelihood of practicing protective HIV risk behaviors and having more favorable attitudes toward risk reduction than long-timers. This study might provide important new evidence on the drivers of multiple concurrent and potential protective factors against risky sexual behaviors among Hispanic migrant workers.

Social stressors and alcohol use among immigrant sexual and gender minority Latinos in a nontraditional settlement state

We sought to quantify the association of social stressors with alcohol use among immigrant sexual and gender minority Latinos in North Carolina (n = 190). We modeled any drinking in past year using logistic regression and heavy episodic drinking in past 30 days using Poisson regression. Despite a large proportion of abstainers, there were indications of hazardous drinking. Among current drinkers, 63% reported at least one heavy drinking episode in past 30 days. Ethnic discrimination increased, and social support decreased, odds of any drinking in past year. Social support moderated the associations of English use and ethnic discrimination with heavy episodic drinking.

Hazardous drinking and HIV-risk-related behavior among male clients of female sex workers in Tijuana, Mexico

BACKGROUND AND OBJECTIVES

Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behavior among male clients in Tijuana.

METHOD

Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous).

RESULTS

Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs.

DISCUSSION AND CONCLUSIONS

Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana.

SCIENTIFIC SIGNIFICANCE

We systematically described patterns and correlates of hazardous alcohol use among male clients of FSWs in Tijuana, Mexico. The results suggest that HIV/STI risk reduction interventions must target hazardous alcohol users, and be tailored to address alcohol use.

Predictors of Heavy Episodic Drinking and Weekly Drunkenness Among Immigrant Latinos in North Carolina

Few studies have examined correlates of heavy drinking among rural immigrant Latino men. This analysis identified correlates of typical week drunkenness and past 30-day heavy episodic drinking, within a sample of immigrant Latino men in rural North Carolina (n = 258). In the bivariate analyses, Mexican birth, entering the United States as an adult, and year-round employment were associated with increased odds of typical week drunkenness, and higher acculturation and affiliation with a religion with strict prohibitions against drinking alcohol were associated with lower odds of typical week drunkenness. Being older, Mexican birth, entering the United States as an adult, and lower acculturation were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol and completing high school were associated with decreased odds of heavy episodic drinking. In multivariable modeling, only religious affiliation was associated with typical week drunkenness. Mexican birth, entering the United States as an adult, and lower acculturation were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol and completing high school were associated with lower odds of heavy episodic drinking. The health of minority men in the United States has been neglected, and immigrant Latino men comprise a particularly vulnerable population. This analysis provides initial data on some factors associated with heavy drinking within a population about which little is known. Future studies should examine moderating or mediating factors between age, acculturation, religiosity, and heavy drinking that might be targets for behavioral interventions.

Determinants of problem drinking and depression among Latino Day laborers

Little is known about alcohol misuse and depression among Latino day laborers despite the fact that they encounter multiple stressors (e.g., job instability, unsafe work environments). A structural equation model tested the relationships among laborer stress, social support, health status, current alcohol misuse, and depression. A sample of 89 male, urban Latino day laborers completed measures assessing these constructs in 2011. Stress was negatively related to physical health status, which was associated with depression. Findings suggest that stressors specific to being a day laborer resulting from their work and living conditions generate and maintain health disparities in this vulnerable population.

Exploring migratory dynamics on HIV transmission: the case of Mexicans in New York City and Puebla, Mexico

Migration and population movement are increasingly viewed as important factors associated with HIV transmission risk. With growing awareness of the potential impact of migration on HIV transmission, several perspectives have emerged that posit differing dynamics of risk. We considered available data on the role of migration on HIV transmission among Mexican migrants in New York City and Puebla, Mexico. Specifically, we examined 3 distinct models of migratory dynamics of HIV transmission-namely, the structural model, the local contextual model, and the interplay model. In doing so, we reframed current public health perspectives on the role of migration on HIV transmission.

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.

Contextual influences on the drinking of male Latino immigrant day laborers

This study explored self-reported alcohol use of Mexican and Central American men who had recently migrated to the United States to work. Ethnographic observation took place at a day laborer hiring site in 2006-2007 and qualitative interviewing involved 120 men with divergent drinking patterns. Short interviews were conducted informally on the street, and interviews lasting 1-2 hours addressed day laborers' perspective about how life conditions shape where drinking takes place and how much alcohol gets consumed. Resulting situations, such as roommates bringing alcohol home for extended nights of drinking, and specific strategies used to avoid excess alcohol use are addressed.

Religion and selected health behaviors among Latinos in Texas

Though research has shown that religion provides a protective influence with respect to a number of health-related outcomes, little work has examined its influence on patterns of alcohol (especially binge drinking) and tobacco consumption among Latinos in Texas. Thus, we used a probability sample of Texas adults to test this relationship via logistic regression. Our results revealed that clear distinctions emerge on the basis of both denomination and frequency of attendance. Specifically, Protestants who regularly attend religious services are significantly more likely to be abstainers and to have never smoked, while those with no religious affiliation exhibit relatively unfavorable risk profiles. These findings persist despite a range of socio-demographic controls. Our study supports the assertion that religion may serve as an important protective influence on risky health behaviors.

Sexual health of Latino migrant day labourers under conditions of structural vulnerability

The purpose of this paper is to explore the context of the sexual health of Latino migrant day labourers in the USA, challenges to sexual health and ways of coping, with attention to conditions of structural vulnerability permeating the lives of this unique Latino population. Given the limited information about this topic and population, ethnographic research employing in-depth semi-structured interviews with 51 labourers, recruited through purposive sampling in the San Francisco Bay Area, was utilised. The sexual health aspirations of the men are deeply embedded in the core value and practice of Latino familismo or, in this case, the central goal of securing a family headed by men as providers and present husbands/fathers. However, such goals are frequently thwarted by the poverty engendering work and prolonged separations from home that characterise predominantly undocumented day labour in the USA. Resulting goal frustration, combined with pent up sexual urges, often lead to sexual risk in spite of efforts to cope with challenges to sexual health. Unless community-, state- and national-level interventions are developed to mitigate the pronounced structural vulnerability of migrant day labourers, individual level interventions to promote sexual health, and decrease risk and distress, are likely to have diminishing returns.

Alcohol use among Latinos: a comparison of pre-immigration, post-immigration, and US born Latinos

US born Latinos have higher rates of alcohol use than Latino immigrants. Yet, little is known about drinking patterns of Latinos before their immigration to the US This exploratory study compares the past month regular, binge, and heavy alcohol use patterns of Latino immigrants prior to immigration with that of post-immigration and US born Latinos. Data on past month alcohol use prior to immigration was collected from 516 recent adult Latino immigrants. Results were compared with US born and post-immigration Latinos using national aggregate data. Alcohol use patterns among Latino immigrants prior to immigration were similar to that of US born Latinos. Alcohol use patterns were lower among Latinos after immigration when compared to pre-immigration and US born Latinos. This study provides a foundation for further exploration of the drinking patterns of Latinos in the US before they immigrated to this country. Findings suggest more research is needed to uncover the underlying factors associated with the higher rates of alcohol use among Latinos prior to their immigration when compared to alcohol use patterns of post-immigration Latinos.

The role of social support and acculturative stress in health-related quality of life among day laborers in Northern San Diego

There is evidence to suggest that Latino day laborers experience higher levels of acculturative stress than Latinos in employment sectors in the US. Given the stress-buffering role that social support plays in minimizing the negative physical and mental health outcomes of stress, this study examined this relationship in a sample of 70 Latino Day laborers in the northern San Diego area(100% male, mean age = 27.7, SD = 9.1). Results from multivariate regression analyses showed that there was a significant interaction effect between social support and acculturative stress (P = 0.025) on physical health, indicating that higher levels of social support buffered the negative effects of acculturative stress on physical health.Acculturative stress and social support were not associated with mental health status. Overall, these findings suggest that fostering social support may be an essential strategy for promoting health among Latino male day laborers.

'Boots for my Sancho': structural vulnerability among Latin American day labourers in Berkeley, California

This paper addresses the structural vulnerability of Latin American undocumented day labourers in Northern California, as it is expressed in conversations on street corners where they wait for work. The intimate aspects of migrant experience become exemplified in jokes about the Sancho - a hypothetical character who has moved in on a day labourer's family and who enjoys the money he sends home. Joking turns to more serious topics of nostalgia and tensions with family far away, elements that come together with the fears and threats of labour on the corner and affect the way day labourers see themselves. Sexuality is rearticulated in the absence of women and masculinity becomes enmeshed in the contingencies of unregulated work and long-term separation from the people the men support. Together, these elements result in the articulation of threat to the immigrant body itself, which is exemplified by anxieties over homosexual propositions on the corner.

Cigarette smoking and drinking behavior of migrant adolescents and young adults in Hanoi, Vietnam

PURPOSE

There has been a large migration from rural to urban areas in much of the developing world. In the past, this was less true in Vietnam, which remains largely agricultural; however, since the 1990s, economic reforms and loosening of government policies that had previously limited movement have led to a large increase in this rural to urban population movement. Risky health behaviors have been found among migrants in many other settings. The purpose of this research was to determine whether migrant adolescents and young adults in the city of Hanoi are more or less likely than local ones to engage in cigarette smoking and alcohol drinking health risk behaviors, to identify factors associated with these behaviors, and to suggest interventions to reduce these health risk behaviors among the study population.

METHODS

A cross-sectional survey of 4,550 adolescents and young adults aged 15-24 years was conducted in urban Hanoi in 2006. This study examines current use of cigarettes and alcohol by migration status using multivariate logistic regressions.

RESULTS

Cigarette smoking and drinking alcohol are male phenomena. The prevalence of cigarette smoking and alcohol drinking is high among adolescents and young adults in Hanoi and is more common among migrants who came from rural areas of other provinces than nonmigrants in the city. However, multivariate analysis revealed that migrants were neither more likely to smoke cigarettes nor drink alcohol than nonmigrants after controlling for other factors, such as age, full-time worker status, depression, and having close friends who smoke and/or drink.

CONCLUSIONS

The results suggest that interventions aiming at smoking and/or drinking reduction should pay more attention to adolescents, especially males, changing health risk behaviors at school and at work, and peer influence than their migration status.

Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico

BACKGROUND

Among male injection drug users (IDUs) in Tijuana, Mexico, U.S. deportation is associated with HIV transmission. Changing drug use behaviors following deportation, including the use of new drugs, may increase HIV risk but are understudied. We identify correlates of trying new drugs following male IDUs' most recent U.S. deportation to Mexico.

METHODS

In 2010, we recruited 328 deported male IDUs in Tijuana, Mexico. Questionnaires collected retrospective data on drug use and other HIV risk behaviors throughout migratory events. Logistic regression identified correlates of trying new drugs/combinations following their most recent deportations. Informed consent was obtained from all participants.

RESULTS

Nearly one in six men (n=52, 16%) tried new drugs following their most recent deportation, including heroin (n=31), methamphetamine (n=5), and heroin/methamphetamine combined (n=17). Trying new drugs following deportation was independently associated with U.S. incarceration (adjusted odds ratio [AOR]=3.96; 95% confidence interval [C.I.] 1.78, 8.84), increasing numbers of U.S. deportations (AOR=1.11 per deportation; C.I. 1.03, 1.20), feeling sad following deportation (AOR 2.69; C.I. 1.41, 5.14), and perceiving that one's current lifestyle increases HIV/AIDS risk (AOR 3.91; C.I. 2.05, 7.44).

CONCLUSIONS

Trying new drugs following U.S. deportation may be related to the unique contexts and stressors experienced by drug-abusing migrants as they attempt to reestablish their lives in Mexico. Findings imply an unmet need for health and social programs to alleviate pre- and post-deportation stressors faced by undocumented and return migrants in the U.S.-Mexico context.

Prevalence estimates of health risk behaviors of immigrant latino men who have sex with men

PURPOSE

Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain "hidden" from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina.

METHODS

A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS-weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008.

RESULTS

A total of 190 Latino MSM was reached; the average age was 25.5 years and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively.

CONCLUSIONS

Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern United States, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM.

Identifying the needs of LGBTQ immigrants and refugees in Southern Arizona

This article reports on the results of a needs assessment conducted for lesbian, gay, bisexual, transgender, and queer (LGBTQ) immigrants, asylees, refugees, and their allies in Southern Arizona, and it is the first study of its kind in the United States. Utilizing interview data collected with migrants, allies, and service providers in Tucson, Arizona, this article presents findings on the quality of service provision provided to this very underserved community pertaining to health care, housing, and legal services. The assessment shows that no services are provided specifically for LGBTQ migrants, and most LGBTQ migrants turn to family and friends when they have needs. The most significant result of this study pertains to the lack of cultural competence and an overall deficiency in terms of cultural awareness when it comes to the specific needs of LGBTQ migrants.

HIV and sexually transmitted disease risk among male Hispanic/Latino migrant farmworkers in the Southeast: Findings from a pilot CBPR study

BACKGROUND

Little is known about the HIV and sexually transmitted disease (STD) risk behaviors of Hispanic/Latino farmworkers. This study was designed to describe risk factors for HIV and STD infection, explore personal characteristics associated with condom use, and evaluate the feasibility of collecting self-report and biomarker data from farmworkers.

METHODS

Self-report and biomarker data were collected from a sample of male farmworkers living in 29 camps in North Carolina during the 2008 growing season.

RESULTS

Over half of the 100 male workers, mean age 37.1 (range 19-68) years, reported binge drinking during the past 12 months. Forty percent of those who reported having had sex during the past 3 months indicated that they were under the influence of alcohol. Knowledge of HIV and STD transmission and prevention was low. Among the 25 workers who reported having had sex during the past 3 months, 16 and 2 reported using a condom consistently during vaginal and anal sex, respectively, and nearly 1 out of 6 workers reported paying a woman to have sex. Two workers tested positive for syphilis.

CONCLUSIONS

Farmworkers in this sample demonstrated significant HIV and STD risks; however, when exploring potential bivariate associations with consistent condom use no statistically significant associations were identified perhaps due to the small sample size. Because it was feasible to collect self-report and biomarker data related to HIV and STDs from Hispanic/Latino farmworkers, research needed to further explore risks and develop interventions to reduce disease exposure and transmission among this vulnerable population.

Methamphetamine and cocaine use among Mexican migrants in California: the California-Mexico Epidemiological Surveillance Pilot

Methamphetamine and cocaine use have been associated with a vulnerability to HIV infection among men who have sex with men and among men who have sex with women but not specifically among Mexican migrants in the United States. The California-Mexico Epidemiological Surveillance Pilot was a venue-based targeted survey of male and female Mexican migrants living in rural and urban areas in California. Among men (n = 985), the percentage of methamphetamine/cocaine use in the past year was 21% overall, 20% in male work venues, 19% in community venues, and 25% in high-risk behavior venues. Among women, 17% reported methamphetamine/cocaine use in high-risk behavior venues. Among men, methamphetamine/cocaine use was significantly associated with age less than 35 years, having multiple sex partners, depressive symptoms, alcohol use, sexually transmitted infections (including HIV), and higher acculturation. Prevention interventions in this population should be targeted to specific migrant sites and should address alcohol, methamphetamine, and cocaine use in the context of underlying psychosocial and environmental factors.

The Mexican migration to the United States and substance use in northern Mexico

AIMS

To examine the impact of migration to the United States on substance use and substance use disorders in three urban areas of northern Mexico.

DESIGN

Cross-sectional survey of immigration-related experiences and life-time and past-year alcohol and drug use, in a representative sample of respondents aged 12-65 years.

SETTING

Interviews were conducted in the cities of Tijuana, Ciudad Juarez and Monterrey during 2005. Respondents were classified into three groups: (i) 'return migrants', (ii) 'relatives of migrants' and (iii) 'others in the general population'.

FINDINGS

A total of 1630 completed interviews were obtained for a response rate of 70.5%. 'Return migrants' were more likely to have used alcohol, marijuana or cocaine at least once in their life-time and in the last 12 months, more likely to develop a substance use disorder and more likely to have a 12-month substance use disorder compared with 'others in the general population'. Among 'return migrants', longer length of time in the United States and type of work performed as an immigrant were related to higher prevalence of substance use. Among 'relatives of migrants', migration experiences were not associated with increased prevalence of substance use compared with 'others in the general population'.

CONCLUSION

This study found a link between migration to the United States and the transformation of substance use norms and pathology in Mexico. Future research on pre-migration involvement in substance use and data on the timing of events among return migrants is needed. Public health measures are likely to require cross-border coordination of research and service development.

Loneliness as a sexual risk factor for male Mexican migrant workers

HIV/AIDs risk among migrant workers is often examined through individual determinants with limited consideration of social context. We used data from systematic ethnographic observations, structured interviews (n = 50), and life history interviews (n = 10) to examine the relationship between loneliness and HIV/AIDS risk for recently arrived (within the last 3 years) male Mexican migrant workers in New York City. Higher levels of loneliness were strongly associated with frequency of sexual risk behavior (r = 0.64; P = .008). From our ethnographic observations, we found that loneliness was a dominant element in workers' migration experience and that 2 different kinds of social spaces served as supportive environments for dealing with loneliness: bars or dance clubs and Catholic churches. Loneliness should be addressed as a critical factor in reducing HIV/AIDS risk among Mexican male migrant workers.

Use of small incentives for increasing participation and reducing dropout in a family drug-use prevention program in a Spanish sample

Poor participation rates represent one of the most serious problems facing family-based drug-use prevention programs. Strategies involving incentives have been used to increase recruitment and retention of the target population of such interventions, but in Spain, such strategies for modifying behavior are unusual. The goal of the research was to study the use of small financial incentives (euro10 voucher) as a strategy to increase attendance and reduce dropout in a family drug-prevention program applied in the school context. Participants were 211 pupils (aged 12-13) and their parents. The results show that small financial incentives can be useful to increase the attendance of families in prevention programs and to reduce dropout.

The Effects of Problem Drinking and Sexual Risk Among Mexican Migrant Workers on Their Community of Origin

Although the financial remittances sent by male Mexican migrant workers residing in the United States can result in higher standards of living for their families and home communities, out-migration may lead to increased migrant problem drinking and sexual risk behaviors, which may in turn impact these same communities of origin. Based on semi-structured interviewing (n=60) and participant observation in a migrant sending community in central Mexico and a receiving community in the Northeastern United States, this paper explores the effects of out-migration on HIV risk and problem drinking among United States-based migrants from a small agricultural community in the Mexican state of Puebla. We argue that problem drinking and risky sexual behaviors among these migrant workers have had significant consequences for their home community in terms of diminished remittances, the introduction of HIV and other sexually transmitted infections, and loss of husbands or kinsmen to automobile accidents. Moreover, although rumor and gossip between the two communities serve as a form of social control, they may also contribute to increased problem drinking and sexual risk.

Sexual and alcohol risk behaviours of immigrant Latino men in the South-eastern USA

Little is known about the intersections of immigration, masculinity and sexual risk behaviours among recently arrived Latino men in the USA. Nine immigrant Latino men from three urban housing communities in the South-eastern USA used photovoice to identify and explore their lived experiences. From the participants' photographs and words, thirteen themes emerged within four domains. The immigration experience and sociocultural norms and expectations of masculinity were factors identified decreasing Latino men's sense of power and increasing stress, which lead to sexual risk. Latino community strengths and general community strengths were factors that participants identified as promoting health and preventing risk. These themes influenced the development of a conceptual model to explain risk among immigrant Latino men. This model requires further exploration and may prove useful in intervention development.

Predictors of Condom Use in Latino Migrant Day Laborers

This article reports on predictors of condom use with casual female sex partners on the part of Latino migrant day laborers in the San Francisco Bay Area. Results come from a secondary analysis of data from a cross-sectional survey using convenience sampling to interview 290 sexually active adult, male, migrant Latino day laborers. Regression analysis of sociodemographic background, behavioral, and psychosocial predictor factors revealed a number of significant findings. Men with wives or partners currently living in Mexico were almost 4.5 times more likely to use condoms with casual female sex partners compared to men accompanied by wives or partners in California. It was also found that men at high sexual risk for HIV with casual female partners were more than 5.5 times more likely to use condoms than men at low risk. Interpretations of findings and implications for HIV prevention with this unique and especially marginalized population of Latinos are discussed.