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Hendrickson ZM, De Jesus M, Barrington C, Cole SW, Kennedy CE, Sisson LN, Uzzi M, Donastorg Y, Perez M, Gomez H, Mbwambo J, Likindikoki S, Kerrigan DL. "You know that we travel a lot": Mobility narratives among female sex workers living with HIV in Tanzania and the Dominican Republic. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003355. [PMID: 38968203 PMCID: PMC11226099 DOI: 10.1371/journal.pgph.0003355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/22/2024] [Indexed: 07/07/2024]
Abstract
Female sex workers (FSW) are highly mobile, which may result in reduced access to and use of health services and increased risk for poor health outcomes, particularly for those living with HIV. Mobility includes spatial, temporal, and social elements that are not fully captured by quantitative measures. We conducted two rounds of in-depth interviews with FSW living with HIV in Iringa, Tanzania (n = 20), and Santo Domingo, Dominican Republic (n = 20), to describe mobility experiences and compare mobility narratives across settings. We integrated a thematic analysis of all interviews with a narrative analysis of a subset of 10 information-rich interviews (five in each country) with women who had recently traveled, for sex work or another reason, outside of their hometown. Across narratives, FSW living with HIV traveled locally or to seasonal destinations, for short and long periods. Social factors influencing mobility included economic drivers; risk of arrest, harassment, or violence; anonymity and/or familiarity; social relationships; and clients' mobility. Spatial, temporal, and social factors intersected in unique ways in FSW's mobility experiences, yet distinct mobility typologies were evident across settings and destinations. Together, mobility narratives of FSW living with HIV can inform quantitative research on mobility typologies in Tanzania, the Dominican Republic, and elsewhere. With the potential for economic circumstances, climate change, and other emergencies to increase people's mobility around the world, researchers and practitioners can learn from the lived experiences of FSW to inform whether and how to tailor and improve the accessibility of HIV care and treatment interventions based on spatial, temporal, and social characteristics of mobility.
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Affiliation(s)
- Zoé M. Hendrickson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Maria De Jesus
- School of International Service, American University, Washington, DC, United States of America
| | - Clare Barrington
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - S. Wilson Cole
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Caitlin E. Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Laura Nicole Sisson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Yeycy Donastorg
- Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Martha Perez
- Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Hoisex Gomez
- Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Jessie Mbwambo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Samuel Likindikoki
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Deanna L. Kerrigan
- Prevention and Community Health Department, Milken Institute School of Public Health, the George Washington University, Washington, DC, United States of America
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Bakely L, Correa-Salazar C, Rangel Gómez MG, González-Fagoaga JE, González AAA, Parrado EA, Riosmena F, Martinez-Donate AP. Exploring the Association Between Detention Conditions, Detention-Related Abuse, and Mental Health Among Deported Mexican Migrants. J Health Care Poor Underserved 2023; 34:1021-1036. [PMID: 38009112 PMCID: PMC10671122 DOI: 10.1353/hpu.2023.a903060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Migration, detention, and deportation are often rife with violence. This study sought to examine associations between pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants.
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Affiliation(s)
- Leah Bakely
- Dornsife School of Public Health, Drexel University
| | | | - María Gudelia Rangel Gómez
- Executive Secretary, Mexico Section of the United States-Mexico Border Health Commission, Research Professor, El Colegio de la Frontera Norte
| | | | | | - Emilio A Parrado
- Dorothy Swaine Thomas Professor of Sociology, Director, Population Studies Center, University of Pennsylvania
| | - Fernando Riosmena
- Professor, Demography and Sociology, Director, Institute for Health Disparities Research
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Martinez-Donate AP, Rangel G, Correa C, Bakely L, Gonzalez-Fagoaga JE, González AA, Amuedo-Dorantes C, Zhang X, Magis-Rodriguez C, Lê-Scherban F, Guendelman S, Parrado E. The next phases of the Migrante Project: Study protocol to expand an observatory of migrant health on the Mexico-U.S. border. Front Public Health 2023; 11:1032420. [PMID: 37139391 PMCID: PMC10150099 DOI: 10.3389/fpubh.2023.1032420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
Background Mexican migrants traveling across the Mexico-United States (U.S.) border region represent a large, highly mobile, and socially vulnerable subset of Mexican nationals. Population-level health data for this group is hard to obtain given their geographic dispersion, mobility, and largely unauthorized status in the U.S. Over the last 14 years, the Migrante Project has implemented a unique migration framework and novel methodological approach to generate population-level estimates of disease burden and healthcare access for migrants traversing the Mexico-U.S. border. This paper describes the rationale and history of the Migrante Project and the protocol for the next phases of the project. Methods/design In the next phases, two probability, face-to-face surveys of Mexican migrant flows will be conducted at key crossing points in Tijuana, Ciudad Juarez, and Matamoros (N = 1,200 each). Both survey waves will obtain data on demographics, migration history, health status, health care access, COVID-19 history, and from biometric tests. In addition, the first survey will focus on non-communicable disease (NCD), while the second will dive deeper into mental health and substance use. The project will also pilot test the feasibility of a longitudinal dimension with 90 survey respondents that will be re-interviewed by phone 6 months after completing the face-to-face baseline survey. Discussion Interview and biometric data from the Migrante project will help to characterize health care access and health status and identify variations in NCD-related outcomes, mental health, and substance use across migration phases. The results will also set the basis for a future longitudinal extension of this migrant health observatory. Analyses of previous Migrante data, paired with data from these upcoming phases, can shed light on the impact of health care and immigration policies on migrants' health and inform policy and programmatic responses to improve migrant health in sending, transit, and receiving communities.
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Affiliation(s)
- Ana P. Martinez-Donate
- Department of Community Health & Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Gudelia Rangel
- Mexico Section of the U.S.-Mexico Border Health Commission, Tijuana, Baja California, Mexico
| | - Catalina Correa
- Department of Community Health & Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Leah Bakely
- Department of Community Health & Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | | | - Ahmed Asadi González
- School of Medicine and Psychology, Autonomous University of Baja California (UABC), Tijuana, Baja California, Mexico
| | | | - Xiao Zhang
- School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | | | - Félice Lê-Scherban
- Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Sylvia Guendelman
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
| | - Emilio Parrado
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, United States
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Amuedo-Dorantes C, Bucheli JR, Martinez-Donate AP. Safe-zone schools and the academic performance of children in mixed-status households: Evidence from the 'between the lines' study. MIGRATION STUDIES 2023; 11:143-173. [PMID: 36909276 PMCID: PMC9996116 DOI: 10.1093/migration/mnac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In response to the intensification of immigration enforcement in the interior of the USA, some school districts have implemented 'safe-zone' policies to protect students' academic progression and well-being. Using primary data from a sample of US-born children of unauthorized migrants, we document the detrimental effect of stricter immigration enforcement on children's educational outcomes and the benefits of safe-zone policies. Our analyses show that restricting immigration authorities' access to schools and providing counseling on immigration-related issues are crucial policy components in strengthening children's focus, effort, expectations, parental involvement, and relationships. These findings highlight the damaging impact of immigration enforcement on US-citizen children in mixed-status households and advance our understanding of the role of local policies in mitigating these effects.
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Affiliation(s)
- Catalina Amuedo-Dorantes
- Department of Economics and Business Management, University of California, Merced, CA 95343, USA
| | - José R Bucheli
- Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM, USA
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Cassels S, Cerezo A, Reid SC, Rivera DB, Loustalot C, Meltzer D. Geographic mobility and its impact on sexual health and ongoing HIV transmission among migrant latinx men who have sex with men. Soc Sci Med 2023; 320:115635. [PMID: 36640703 PMCID: PMC10866558 DOI: 10.1016/j.socscimed.2022.115635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023]
Abstract
An understudied social process that may determine variable HIV risk, testing, and linkage to care is geographic mobility, including immigration as well as short-term mobility, especially among sexual minority populations. We aimed to assess how geographic mobility over the lifecourse between Latin America and the U.S., and within the U.S., was linked to sexual risk and health behaviors among Latinx migrant men who have sex with men (MSM) in San Bernardino County, California. Qualitative analysis of 16 semi-structured interviews revealed four major domains of influence on participants' sexual risk behaviors. At the micro level, these included social environment/interpersonal factors (e.g., family and peer support) and geographic factors and pathways (e.g., migration journey to the U.S.). At the macro level data centered on cultural factors (e.g., gender norms in home country) and structural factors (e.g., HIV healthcare). Our results can illuminate and promote effective health policies and HIV reduction efforts for Latinx migrant MSM in metro areas.
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Affiliation(s)
- Susan Cassels
- Department of Geography, University of California, Santa Barbara, USA.
| | - Alison Cerezo
- Department of Counseling, Clinical, And School Psychology, University of California, Santa Barbara, USA
| | - Sean C Reid
- Department of Geography, University of California, Santa Barbara, USA
| | - David B Rivera
- Department of Counseling, Clinical, And School Psychology, University of California, Santa Barbara, USA
| | - Colin Loustalot
- Department of Geography, University of California, Santa Barbara, USA
| | - Dan Meltzer
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
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Sánchez-Alemán MA, Rogel-González AE, García-Cisneros S, Olamendi-Portugal M, Vergara-Ortega DN, Rincón-León HA, Herrera-Ortiz A. [High seroprevalence of syphilis and genital herpes in migrants in transit in Chiapas, MexicoAlta soroprevalência de sífilis e herpes genital em migrantes em trânsito por Chiapas, México]. Rev Panam Salud Publica 2023; 47:e71. [PMID: 37082541 PMCID: PMC10100594 DOI: 10.26633/rpsp.2023.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/28/2023] [Indexed: 04/22/2023] Open
Abstract
Objectives To determine the prevalence of antibodies against Treponema pallidum and herpes simplex virus type 2 (HSV-2), and to identify the factors associated with these infections among migrants in transit in Chiapas, Mexico. Methods Cross-sectional study conducted during 2021-2022, in three migrant shelters in Chiapas, Mexico. Participants answered a questionnaire and provided a blood sample to detect antibodies against Treponema pallidum and HSV-2. The study calculated seroprevalence and assessed associated factors using Chi-square (χ2) tests and odds ratios. Results A total of 462 migrants participated, with an average age of 31.2 years; 56.9% were women, and 41.1% came from Honduras. The seroprevalence of HSV-2 was 29.9%; for syphilis it was 4.5%, and it was higher in men (8.0%) than in women (1.9%). Among pregnant women, 15.4% had antibodies against syphilis. Notable variables associated with syphilis include being male, having a history of genital lesions, having same-sex partners, and seropositivity to HSV-2. Regarding HSV-2, factors associated with infection included being female, age, schooling, sleeping in the street, a history of HIV testing, early sexual debut, number of sexual partners, and syphilis. Conclusions A high prevalence of syphilis and HSV-2 was found among the migrant population evaluated. Syphilis is confirmed as a re-emerging infection, even in women. Migrants have vulnerabilities associated with sexual behavior, so prevention, diagnosis, and treatment measures should be focused on this population group.
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Affiliation(s)
- Miguel Angel Sánchez-Alemán
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - Angel Emanuel Rogel-González
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - Santa García-Cisneros
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - María Olamendi-Portugal
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - Dayana Nicté Vergara-Ortega
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - Héctor Armando Rincón-León
- Instituto Mexicano del Seguro SocialTapachulaChiapasMéxicoInstituto Mexicano del Seguro Social, Tapachula, Chiapas, México.
| | - Antonia Herrera-Ortiz
- Instituto Nacional de Salud PúblicaCuernavacaMorelosMéxicoInstituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
- * Antonia Herrera-Ortiz,
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Essayagh T, Essayagh M, Essayagh F, Rattal M, Bukassa G, Lemriss H, Mahdaoui EK, Himmouche N, Kouyate MF, Essayagh S. Prevalence and determinants of intercourse without condoms among migrants and refugees in Morocco, 2021: a cross-sectional study. Sci Rep 2022; 12:22491. [PMID: 36577780 PMCID: PMC9797539 DOI: 10.1038/s41598-022-26953-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
With the world's migratory flow, the risk of infection by the human immunodeficiency virus (HIV) among migrants is increasing. The prevalence of intercourse without condoms with a casual or commercial sex partner, a high-risk sexual behavior for HIV infection, is unknown among migrants. The purpose of this study was to determine the prevalence of intercourse without condoms among migrants and the risk factors associated with not using condoms. In Oujda, we conducted a cross-sectional survey of 416 sexually active migrants. We used a multistage sampling method. Face-to-face interviews were conducted with participants to collect socio-demographic information, disease perception, behavioral habits, sexual behavioral habits, and para-clinical parameters. A multivariate logistical regression analysis identified the risk factors associated with high-risk HIV sexual behaviors. The prevalence of intercourse without condoms with a casual or commercial sex partner was 72.8%, with a median age of 25.0 years, and 212 (69.9%) were males. The prevalence of HIV was 0.2%. Being homeless, having difficulty obtaining condoms, and only having a basic education were all risk factors for these sexual behaviors. Migrants with precarious living conditions are at increased risk of having intercourse without condoms. This group must be prioritized by strengthening public health programs targeting the health of migrants as well as the intervention of thematic non-governmental organizations. Vigilant monitoring of the HIV epidemic, with a focus on vulnerable populations, should be a high priority in Morocco.
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Affiliation(s)
- Touria Essayagh
- grid.440487.b0000 0004 4653 426XLaboratoire Sciences et Technologies de la Santé, Institut Supérieur des Sciences de la Santé, Hassan First University of Settat, Settat, Morocco
| | - Meriem Essayagh
- Office National de Sécurité Sanitaire des Produits Alimentaires, Oujda, Morocco
| | - Firdaous Essayagh
- grid.20715.310000 0001 2337 1523Laboratoire Droit Privé et Enjeux de Développement, Faculté des Sciences Juridiques, Economiques et Sociales, Université Sidi Mohamed Ben Abdellah, Fès, Morocco
| | - Mourad Rattal
- grid.440487.b0000 0004 4653 426XLaboratoire Sciences et Technologies de la Santé, Institut Supérieur des Sciences de la Santé, Hassan First University of Settat, Settat, Morocco
| | - Germain Bukassa
- Department of Indigenous Services Canada/Government of Canada, Health Surveillance and Assessment Unit, First Nations and Inuit Health, Saskatchewan Region, Regina, SK Canada
| | - Hajar Lemriss
- grid.440487.b0000 0004 4653 426XLaboratoire Sciences et Technologies de la Santé, Institut Supérieur des Sciences de la Santé, Hassan First University of Settat, Settat, Morocco
| | - El Khansa Mahdaoui
- grid.463252.4Ministère de la Santé et de la Protection Sociale, Direction d’Epidémiologie et de Lutte contre les Maladies, Rabat, Morocco
| | - Naoufal Himmouche
- grid.440487.b0000 0004 4653 426XInstitut Supérieur des Sciences de la Santé, Laboratoire Ingénierie Didactique, Entrepreneuriat, Arts et Littératures, Hassan First University of Settat, Settat, Morocco
| | - Mady Fanta Kouyate
- Unité Investigation et Recherche, Département de Surveillance à l’Agence Nationale de Sécurité Sanitaire, Conakry, Guinea
| | - Sanah Essayagh
- grid.440487.b0000 0004 4653 426XLaboratoire Agroalimentaire et Santé, Faculté des Sciences et Techniques, Hassan First University of Settat, Settat, Morocco
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Erausquin JT, Sánchez J, Yu Pon A, Jhangimal M, Millender E, Peña Y, Ng W, Reina A, Nakad C, Quintana J, Herrera Veces R, Vistica G, Pinzón-Espinosa J, Cabezas-Talavero G, Katz J, Pascale JM, Rodríguez-Álvarez F, Gabster A. Sexual and reproductive health and access: Results of a rapid epidemiological assessment among migrant peoples in transit through Darién, Panamá. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:953979. [PMID: 36523789 PMCID: PMC9745017 DOI: 10.3389/frph.2022.953979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/31/2022] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF. METHODS This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4-11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings. RESULTS In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively. CONCLUSIONS This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá.
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Affiliation(s)
- Jennifer Toller Erausquin
- Department of Public Health Education, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, United States
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Joanne Sánchez
- Complejo Hospitalario Arnufo Arias de Madrid, Panamá City, Panamá
| | - Anyi Yu Pon
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Mónica Jhangimal
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Eugenia Millender
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Yudith Peña
- Community Development Network of the Americas, Panamá City, Panamá
| | - Winroy Ng
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Adelys Reina
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Candy Nakad
- Instituto de Medicina Tropical, Laboratorio de Protozoarios de Biología Molecular, Universidad Central de Venezuela, Caracas, Venezuela
| | - Joselid Quintana
- Community Development Network of the Americas, Panamá City, Panamá
| | | | - Grace Vistica
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Justo Pinzón-Espinosa
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
- Sant Pau Mental Health Group, Institut d’Investigació Biomèdica Sant Pau (IBB-San Pau), Hospital de la San Creu i Sant Pau, Universisat Autònoma de Barcelona, Barcelona, Spain
- Department of Medicine, School of Medicine, University of Barcelona, Barcelona, Spain
- Department of Clinical Psychiatry, School of Medicine, University of Panamá, Panamá City, Panamá
- Institut d’Investigació i Innovació Parc Tauli (I3PT), Sabadell, Spain
| | | | - Jennifer Katz
- Community Development Network of the Americas, Panamá City, Panamá
| | - Juan Miguel Pascale
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- Faculty of Medicine, University of Panamá, Panamá City, Panamá
| | | | - Amanda Gabster
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- National Research System of Panamá (SNI), Panamá, Panamá
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Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health 2021; 41:289-308. [PMID: 32237989 DOI: 10.1146/annurev-publhealth-040119-094211] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.
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Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| | - Thespina J Yamanis
- School of International Service, American University, Washington, DC 20016-8071, USA;
| | - Raymond A Ruiz
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
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10
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Martinez-Donate AP, Verdecias N, Zhang X, Gonzalez-Fagoaga JE, Asadi-Gonzalez AA, Guendelman S, Amuedo-Dorantes C, Rangel MG. Health Profile and Health Care Access of Mexican Migration Flows Traversing the Northern Border of Mexico. Med Care 2020; 58:474-482. [PMID: 32028523 PMCID: PMC7155382 DOI: 10.1097/mlr.0000000000001300] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The health of Latino migrants is most often studied with samples of immigrants settled in the United States or returned migrants in Mexico. We examine health outcomes and health care access of Mexican migrants traversing the Mexican border region to gain a better understanding of migrant health needs as they transition between migration phases. METHODS We used data from a 2013 probability survey of migrants from Northbound and Southbound migration flows in Tijuana, Mexico (N=2412). Respondents included Northbound migrants with and without US migration experience, Southbound migrants returning home from the United States or the Mexican border region, and migrants returning to Mexico via deportation. Descriptive statistics and regression models were estimated to characterize and compare their health status, behavioral health, and health care access across migration phases. RESULTS Northbound migrants with US migration experience, Southbound migrants from the United States, and deported migrants had worse levels of health insurance, health care utilization, and diabetes than Northbound migrants without US migration experience. Southbound migrants returning from the border reported worse self-rated health and deportees had higher odds of reported substance use compared with Northbound migrants without US migration experience. CONCLUSIONS Mexican migrants' health profile and health care access vary significantly across migration flows and generally are worse for migrants with US migration experience. The results add to our understanding of Mexican migrant health along the migration continuum and can inform services in sending, receiving, and intermediate communities.
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Affiliation(s)
| | - Niko Verdecias
- Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Xiao Zhang
- Carbone Cancer Center, University of Wisconsin, Madison, WI
| | | | - Ahmed A. Asadi-Gonzalez
- School of Medicine and Psychology, Universidad Autonoma de Baja California, Tijuana, BC, Mexico
| | | | | | - Maria G. Rangel
- Border Health Commission, Mexico Section, Tijuana, BC, Mexico
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11
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Cumulative Stress and Trauma from the Migration Process as Barriers to HIV Testing: A Qualitative Study of Latino Immigrants. J Immigr Minor Health 2020; 21:844-852. [PMID: 29961164 DOI: 10.1007/s10903-018-0784-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Immigrants are at increased risk for late HIV testing; however, there is limited understanding of how migration to the United States shapes HIV testing behaviors. This study examined the relationship between the migration process and HIV testing among Latino immigrants. Semi-structured, in-depth interviews were conducted in March and April 2017 with 34 Latino immigrants in New York City. Grounded theory guided analysis of the qualitative data. Results indicated that Latino immigrants experienced cumulative stress and trauma throughout the migration process that contributed to significant emotional and psychological consequences. Stress and trauma accumulated from the migration process posed barriers to HIV testing as Latino immigrants sought to avoid activities perceived as stressful, including learning one's HIV status. Targeted interventions that ameliorate the stressful effects of migration may facilitate preventive health behaviors among Latino immigrants.
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12
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Langellier BA, Martínez-Donate AP, Gonzalez-Fagoaga JE, Rangel MG. The Relationship Between Educational Attainment and Health Care Access and Use Among Mexicans, Mexican Americans, and U.S.-Mexico Migrants. J Immigr Minor Health 2019; 22:314-322. [PMID: 31127434 DOI: 10.1007/s10903-019-00902-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the study was to assess the relationship between educational attainment and health care access and use among Mexican-origin populations. Data from the 2012 Mexican National Health and Nutrition Study, the 2013 Project Migrante Health Care Access and Utilization Survey, and the 2013-2014 California Health Interview Survey were used to examine educational gradients in health insurance, medical home, and hospitalization among Mexicans in Mexico, northbound, southbound, and deported migrants, and U.S.-and foreign-born Mexican Americans. College graduates had greater odds of being insured relative to those with less than a high school degree among Mexicans (AOR = 1.48, p < 0.001), northbound migrants (AOR = 3.69, p < 0.001), and the foreign-born (AOR = 2.01, p < 0.01), and of having a medical home among Mexicans (AOR = 1.95, p < 0.001) and the foreign-born (AOR = 2.14, p < 0.05). Eliminating differences by educational attainment in the U.S. will require policy changes like making immigrants eligible for public insurance. In Mexico, it will require targeted outreach to enroll underserved populations in existing public insurance programs.
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Affiliation(s)
- Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Ana P Martínez-Donate
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - J Eduardo Gonzalez-Fagoaga
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, USA.,Mexico Section, U.S.-Mexico Border Health Commission, Tijuana, Mexico
| | - M Gudelia Rangel
- Mexico Section, U.S.-Mexico Border Health Commission, Tijuana, Mexico.,Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Mexico
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13
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Complex Patterns Across the Migration Process and Associated HIV Testing and Risk Behaviors among Latino Immigrants. Int J Behav Med 2019; 26:175-184. [PMID: 30635873 DOI: 10.1007/s12529-019-09768-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Migrants are at elevated risk for adverse HIV-related outcomes. Yet, there is limited understanding about the complexity of the migration process and the different migration experiences that may influence HIV testing and risk behaviors. This study examined whether patterns in immigrants' migration experience were associated with HIV risk and preventive behaviors. METHODS Surveys were conducted with Latino immigrant adults (n = 306) in New York City during the spring of 2017. Informed by formative interviews, variables were developed to assess the migration process and document information about Latino immigrants' experiences during six particular stages of migration (pre-departure, travel, destination, interception, return, and settlement). We conducted a Latent Class Analysis (LCA) to detect patterns in the migration experience among participants and examined the associations between the latent classes and HIV testing and risk behaviors. RESULTS LCA clustered participants into three migration experience classes: positive experience (50.3%), neutral experience (36.3%), and negative experience (13.4%). The migration classes were significantly associated with sociodemographic variables, including sex, age, and income. Different experiences during the migration process did not influence immigrants' past or current HIV testing or risk behaviors. However, the migration classes were associated with immigrants' future intentions to test for HIV with the positive migration experience class reporting greater intentions to test for HIV in the next 12 months than the negative experience class (aOR, 2.95; 95% CI, 1.21-7.17; p < .05). CONCLUSION Results suggest the applicability of a migration experience framework for understanding future HIV risk and preventive behaviors among immigrants.
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14
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Diaz CJ, Zeng L, Martinez-Donate AP. Investigating Health Selection Within Mexico and Across the US Border. POPULATION RESEARCH AND POLICY REVIEW 2018; 37:181-204. [PMID: 30270953 DOI: 10.1007/s11113-017-9456-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Despite acquiring lower levels of attainment and earnings, Mexican immigrants exhibit favorable health outcomes relative to their native-born counterparts. And while scholars attempt to reconcile this so-called paradoxical relationship with a variety of theoretical and empirical approaches, patterns of selective migration continue to receive considerable attention. The present study contributes to the literature on health selection by extending the healthy migrant hypothesis in a number of ways. First, we rely on a unique combination of data sets to assess whether the healthy are disproportionately more likely to migrate. We use the latest wave of the Mexican Family Life Survey and the 2013 Migrante Study, a survey that is representative of Mexican-born persons who are actively migrating through Tijuana. Pooling these data also allow us to differentiate between internal and US-bound migrants to shed light on their respective health profiles. Results provide modest support for the healthy migrant hypothesis. Although those who report better overall health are more likely to migrate, we find that the presence of certain chronic conditions increases migration risk. Our findings also suggest that internal migrants are healthier than those traveling to the US, though this is largely because those moving within Mexico reflect a younger and more educated population. This study takes an important step in uncovering variation across migrant flows and highlights the importance of the timing at which health is measured in the migration process.
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Affiliation(s)
- Christina J Diaz
- School of Sociology, University of Arizona, Social Sciences Building, 1145 E. South Campus Drive, Tucson, AZ 85721, United States
| | - Liwen Zeng
- School of Sociology, University of Arizona, Social Sciences Building, 1145 E. South Campus Drive, Tucson, AZ 85721, United States
| | - Ana P Martinez-Donate
- Dornslife School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
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15
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Page KR, Grieb SD, Nieves-Lugo K, Yamanis T, Taylor H, Martinez O, Yamasaki Y, Limaye R, Davis W, Beyrer C, Zea MC. Enhanced immigration enforcement in the USA and the transnational continuity of HIV care for Latin American immigrants in deportation proceedings. Lancet HIV 2018; 5:e597-e604. [PMID: 29997050 PMCID: PMC6211169 DOI: 10.1016/s2352-3018(18)30074-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.
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Affiliation(s)
- Kathleen R Page
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Suzanne Dolwick Grieb
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Holly Taylor
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Rupali Limaye
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Chris Beyrer
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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16
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Horyniak D, Bojorquez I, Armenta RF, Davidson PJ. Deportation of non-citizen military veterans: A critical analysis of implications for the right to health. Glob Public Health 2018; 13:1369-1381. [PMID: 29243564 PMCID: PMC6561474 DOI: 10.1080/17441692.2017.1413123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Military personnel are commonly exposed to health-harming conditions during their service, resulting in higher rates of physical and mental health conditions compared with the general population. In an era of mass deportations, it is notable that non-citizen military veterans are not exempt from deportation. We utilised a human rights framework to conduct a critical analysis of potential health consequences of deportation for U.S. military veterans, identifying three ways in which veterans' rights to health may be constrained through deportation. First, honourably discharged deported veterans may be denied access to free or subsidised Veterans Affairs health services to which they would likely otherwise be entitled. Second, availability of and access to healthcare may be limited for reasons including barriers to enrolling in public insurance schemes, challenges navigating unfamiliar health systems and stigma and discrimination towards deported migrants. Finally, quality of available care may be sub-optimal due to limited expertise in service-related health issues and lack of evidence-based treatment for some health conditions (e.g. substance abuse/dependence). Binational multi-sectoral efforts are necessary to ensure that the rights to health of deported military veterans are adequately protected.
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Affiliation(s)
- Danielle Horyniak
- Division of Global Public Health, University of California San Diego, La Jolla, USA
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ietza Bojorquez
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Mexico
| | - Richard F. Armenta
- Division of Epidemiology, University of California San Diego, La Jolla, USA
- Department of Kinesiology, College of Education, Health and Human Services, California State University San Marcos, San Marcos, USA
| | - Peter J. Davidson
- Division of Global Public Health, University of California San Diego, La Jolla, USA
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17
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Horyniak D, Pinedo M, Burgos JL, Ojeda VD. Relationships Between Integration and Drug Use Among Deported Migrants in Tijuana, Mexico. J Immigr Minor Health 2018; 19:1196-1206. [PMID: 27778138 DOI: 10.1007/s10903-016-0518-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Deported migrants face numerous challenges which may elevate their risk for drug use. We examined relationships between integration and drug use among deported migrants in Tijuana, Mexico. A cross-sectional survey conducted at a free health clinic included 255 deported Mexican-born migrants residing in Tijuana ≥6 months. Multivariable logistic regression examined associations between variables across four integration domains (public participation, social connections, macro-level facilitators and foundations) and recent (past 6-month) drug use. The prevalence of recent drug use was 46 %. Having sought work in Tijuana in the past 6 months, greater household affluence, lifetime history of incarceration in both US and Mexico, and lacking health insurance were independently associated with recent drug use. Policies that support access to employment, adequate housing and healthcare in Mexico, particularly for justice-involved deportees, may facilitate successful integration and reduce potential stressors that may contribute to drug use.
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Affiliation(s)
- Danielle Horyniak
- Division of Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
- Centre for Population Health, Burnet Institute, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Miguel Pinedo
- Alcohol Research Group, University of California Berkeley, Emeryville, CA, 94608, USA
| | - Jose Luis Burgos
- Division of Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Victoria D Ojeda
- Division of Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
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18
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Affiliation(s)
- Rebecca Frilund
- Department of Geography and Geology, University of Turku, Finland
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19
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Martinez-Donate AP, Zhang X, Gudelia Rangel M, Hovell MF, Eduardo Gonzalez-Fagoaga J, Magis-Rodriguez C, Guendelman S. Does Acculturative Stress Influence Immigrant Sexual HIV Risk and HIV Testing Behavior? Evidence from a Survey of Male Mexican Migrants. J Racial Ethn Health Disparities 2017; 5:798-807. [PMID: 28840518 DOI: 10.1007/s40615-017-0425-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Ana P Martinez-Donate
- Dornsife School of Public Health, Drexel University, 458 Nesbitt Hall, 3215 Market St, Philadelphia, PA, USA.
| | - Xiao Zhang
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - M Gudelia Rangel
- Mexico Section of the US-Mexico Border Health Commission, Tijuana, Mexico
| | - Melbourne F Hovell
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | | | | | - Sylvia Guendelman
- School of Public Health, University of California, Berkeley, CA, USA
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20
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Carrillo G, Uribe F, Lucio R, Ramirez Lopez A, Korc M. The United States-Mexico border environmental public health: the challenges of working with two systems. Rev Panam Salud Publica 2017; 41:e98. [PMID: 28902281 PMCID: PMC6660844 DOI: 10.26633/rpsp.2017.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This report shares the challenges and opportunities encountered by a binational project that examined the availability of environmental and public health information for the United States-Mexico border area. The researchers interviewed numerous national and binational agencies on both sides of the border, endeavoring to develop a framework to advance the knowledge of academic and public health professionals in the area of environmental border health. However, the lack of standardized indicators and metrics in both countries validates the emergent need to establish a viable framework for the collection, analysis, and dissemination of environmental information. Recommendations for next steps are included.
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Affiliation(s)
- Genny Carrillo
- Department of Environmental and Occupational HealthSchool of Rural Public HealthMcAllen, TexasUnited States of AmericaDepartment of Environmental and Occupational Health, School of Rural Public Health, Texas A&M Health Science Center, McAllen, Texas, United States of America.,Send correspondence to Genny Carrillo,
| | - Felipe Uribe
- El Colegio de la Frontera Norte, CoahuilaEl Colegio de la Frontera Norte, CoahuilaCoahuilaMexicoEl Colegio de la Frontera Norte, Coahuila, Mexico.
| | - Rose Lucio
- Department of Environmental and Occupational HealthSchool of Rural Public HealthMcAllen, TexasUnited States of AmericaDepartment of Environmental and Occupational Health, School of Rural Public Health, Texas A&M Health Science Center, McAllen, Texas, United States of America.
| | - Alberto Ramirez Lopez
- Border Environmental Cooperation CommissionBorder Environmental Cooperation CommissionEl Paso, TexasUnited States of AmericaBorder Environmental Cooperation Commission, El Paso, Texas, United States of America.
| | - Marcelo Korc
- Sustainable Development and Human SecurityPan American Health OrganizationWashington, D.C.United States of AmericaSustainable Development and Human Security, Pan American Health Organization, Washington, D.C., United States of America.
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21
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Cassels S, Jenness SM, Biney AAE, Dodoo FNA. Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana. Soc Sci Med 2017; 184:27-39. [PMID: 28501018 PMCID: PMC5525941 DOI: 10.1016/j.socscimed.2017.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 04/11/2017] [Accepted: 05/02/2017] [Indexed: 11/24/2022]
Abstract
Short-term mobility can significantly influence the spread of infectious disease. In order for mobile individuals to geographically spread sexually transmitted infections (STIs), individuals must engage in sexual acts with different partners in two places within a short time. In this study, we considered the potential of mobile individuals as bridge populations - individuals who link otherwise disconnected sexual networks and contributed to ongoing STI transmission. Using monthly retrospective panel data, we examined associations between short-term mobility and sexual partner concurrency in Agbogbloshie, Ghana. We also examined bridging by the location of sex acts and the location of sexual partners in concurrent triads, and whether mobile individuals from our sample were more likely to be members of geographic bridging triads. Although reported rates of sexual partnership concurrency were much higher for men compared to women, mobility was only associated with increased concurrency for women. Additionally, this association held for middle-distance mobility and short-duration trips for women. Taking into account the location of sex acts and the location of sexual partners, about 22% of men (21.7% and 22.4% for mobile and non-mobile men, respectively) and only 3% of women (1.4% and 3.3% for mobile and non-mobile women, respectively) were potential bridges for STIs over the last year. Our results highlight the gendered nature of mobility and sexual risk behavior, reflecting the normative social context that encourages women to conceal certain types of sexual behavior.
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Affiliation(s)
- Susan Cassels
- Department of Geography, University of California, Santa Barbara, CA 93106-4060, United States.
| | - Samuel M Jenness
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - Adriana A E Biney
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra, Ghana
| | - F Nii-Amoo Dodoo
- The Pennsylvania State University & University of Ghana, 211 Oswald Tower, University Park, PA 16802, United States
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22
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HIV Risk Behaviors and Correlates of Inconsistent Condom Use Among Substance Using Migrants at the Mexico/Guatemala Border. AIDS Behav 2017; 21:2033-2045. [PMID: 28238120 DOI: 10.1007/s10461-017-1726-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study assessed correlates of inconsistent condom use with casual partners and the prevalence of sexual risk behaviors and STIs in the Mexico/Guatemala border region using a sample of 392 migrants (303 men, 85 women) who reported current substance use or problem drinking. We ran separate univariate logistic regression models for men and women, and multivariate logistic regression models for men only. Prevalence of syphilis was 1.2% among women and 2.3% among men; HIV prevalence was 2.4% among women and 1.3% among men. Inconsistent condom use with casual partners was higher in women with greater education and lower among women who sold sex. In men, less access to free condoms, drug use with sexual partners, and drug use before sex were independently associated with inconsistent condom use with casual partners. Sexual and substance use risk behaviors were common, and HIV/STI prevention efforts should target both genders and expand beyond most-at risk populations.
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23
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Zhang X, Rhoads N, Rangel MG, Hovell MF, Magis-Rodriguez C, Sipan CL, Gonzalez-Fagoaga JE, Martínez-Donate AP. Understanding the Impact of Migration on HIV Risk: An Analysis of Mexican Migrants' Sexual Practices, Partners, and Contexts by Migration Phase. AIDS Behav 2017; 21:935-948. [PMID: 27888370 PMCID: PMC5837820 DOI: 10.1007/s10461-016-1622-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIV risk among Mexican migrants varies across migration phases (pre-departure, transit, destination, interception, and return), but there is limited knowledge about specific sexual behaviors, characteristics of sexual partners, and sexual contexts at different migration stages. To fill the gap, we used data from a cross-sectional population-based survey conducted in Tijuana, Mexico. Information on migration phase and last sexual encounter was collected from 1219 male migrants. Our findings suggest that compared to pre-departure migrants, repeat migrants returning from communities of origin were more likely to have sex with male partners, use substances before sex, and not use condoms; migrants in the transit phase in the Mexican border were more likely to have sex with casual partners and sex workers; and migrants in the interception phase were more likely to engage in anal sex and use substances before sex. Sexual behaviors, partners, and contexts vary significantly among migrants at different migration phases. Tailored HIV prevention programs targeting Mexican migrants need to be developed and implemented at all migration phases.
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Affiliation(s)
- Xiao Zhang
- UW Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Natalie Rhoads
- Department of Health Policy and Management, University of California-Los Angeles, Los Angeles, CA, USA
| | - Maria Gudelia Rangel
- Mexico Section of the U.S.-Mexico Border Health Commission, Tijuana, Baja California, Mexico
| | - Melbourne F Hovell
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Carol L Sipan
- Department of Health Sciences, University of California-Merced, Merced, CA, USA
| | | | - Ana P Martínez-Donate
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market St., Hesbitt Hall 458, Philadelphia, PA, 19104, USA.
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Martinez-Donate AP, Ejebe I, Zhang X, Guendelman S, Lê-Scherban F, Rangel G, Gonzalez-Fagoaga E, Hovell MF, Amuedo-Dorantes C. Access to Health Care among Mexican Migrants and Immigrants: A Comparison across Migration Phases. J Health Care Poor Underserved 2017; 28:1314-1326. [PMID: 29176097 PMCID: PMC5728113 DOI: 10.1353/hpu.2017.0116] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We examined differences in, and factors associated with, access to health services among Mexican im/migrants to the U.S. across migration phases, including pre-departure, destination, interception, and return. METHODS Using data from a cross-sectional survey conducted in Tijuana, Mexico (N = 1,541), we computed descriptive statistics and staged logistic regressions to estimate health care access indicators and factors associated with access to services. RESULTS Im/migrants at post-migration phases had lower likelihood of receiving health care and having a usual source of care, and higher rates of forgone care, than their counterparts at pre-departure. These differences were partly explained by length of migration phase, health insurance status, transportation barriers, and detention or imprisonment. CONCLUSIONS Mexican im/migrants face challenges in accessing health services across the migration continuum, especially at post-migration phases. Binational efforts to provide affordable insurance coverage and reduce transportation limitations and incarceration could contribute to improving health care access among Mexican im/migrants.
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Affiliation(s)
| | - Ifna Ejebe
- School of Medicine and Public Health, University of Wisconsin, Madison
| | - Xiao Zhang
- School of Medicine and Public Health, University of Wisconsin, Madison
| | | | | | - Gudelia Rangel
- Mexico Section of the U.S.-Mexico Border Health Commission
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25
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Diaz CJ, Koning SM, Martinez-Donate AP. Moving Beyond Salmon Bias: Mexican Return Migration and Health Selection. Demography 2016; 53:2005-2030. [PMID: 27848222 PMCID: PMC5735845 DOI: 10.1007/s13524-016-0526-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite having lower levels of education and limited access to health care services, Mexican immigrants report better health outcomes than U.S.-born individuals. Research suggests that the Mexican health advantage may be partially attributable to selective return migration among less healthy migrants-often referred to as "salmon bias." Our study takes advantage of a rare opportunity to observe the health status of Mexican-origin males as they cross the Mexican border. To assess whether unhealthy migrants are disproportionately represented among those who return, we use data from two California-based studies: the California Health Interview Survey; and the Migrante Study, a survey that samples Mexican migrants entering and leaving the United States through Tijuana. We pool these data sources to look for evidence of health-related return migration. Results provide mixed support for salmon bias. Although migrants who report health limitations and frequent stress are more likely to return, we find little evidence that chronic conditions and self-reported health are associated with higher probabilities of return. Results also provide some indication that limited health care access increases the likelihood of return among the least healthy. This study provides new theoretical considerations of return migration and further elucidates the relationship between health and migration decisions.
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Affiliation(s)
- Christina J Diaz
- School of Sociology, University of Arizona, Social Sciences Building, Room 400, Tucson, AZ, 85721, USA.
| | - Stephanie M Koning
- Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI, 53726, USA
| | - Ana P Martinez-Donate
- Dornsife School of Public Health, Drexel University, Nesbitt Hall 458, 3215 Market Street, Philadelphia, PA, 19104, USA
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Yu YQ, Xu JJ, Hu QH, Yan HJ, Wang Z, Lu L, Zhuang MH, Chen X, Fu JH, Qin YL, Jiang YJ, Geng WQ, Shang H. High-risk behaviour and HIV infection risk among non-local men who have sex with men with less than a single year's residence in urban centres: a multicentre cross-sectional study from China. Sex Transm Infect 2016; 94:51-54. [PMID: 29348258 DOI: 10.1136/sextrans-2016-052744] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/24/2016] [Accepted: 08/20/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Traditionally, subjects' migration status has usually been defined on the basis of their registered residency status. We attempted to redefine migration based on the duration of residency in their cities of migration and to explore more precisely the impact of migration on HIV infection risk in men who have sex with men (MSM). METHODS A multisite cross-sectional study was conducted during 2012-2013 in seven Chinese cities. Questionnaire surveys were conducted and blood was drawn to test for antibodies to HIV, syphilis and herpes simplex virus-2 (HSV-2). MSM who were unregistered local residents and had resided in their cities of migration for ≤1 or >1 year were defined as migrant MSM, or transitional MSM, respectively. RESULTS Compared with transitional MSM and local MSM, migrant MSM had poorer HIV knowledge and higher rates of high-risk behaviour, including earlier sexual debut, multiple sexual partners, participation in commercial sex and recreational drug use. Multivariate logistic regression analysis showed that HIV prevalence among migrant MSM was higher than local MSM (p<0.05). This relationship, however, did not hold for transitional MSM and local MSM (p>0.05). Male sex work, recreational drug use, syphilis infection and HSV-2 infection were independently associated with HIV infection among migrant MSM. CONCLUSIONS Non-local MSM with shorter residence were at greater risk of HIV acquisition. More focus should be placed on HIV behavioural interventions targeting non-local MSM with temporary residence.
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Affiliation(s)
- Yan-Qiu Yu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Jun-Jie Xu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Qing-Hai Hu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong-Jing Yan
- Jiangsu Provincial Centers for Disease Control and Prevention, Nanjing, China
| | - Zhe Wang
- He'nan Provincial Centers for Disease Control and Prevention, Zhengzhou, China
| | - Lin Lu
- Yunnan Provincial Centers for Disease Control and Prevention, Kunming, China
| | - Ming-Hua Zhuang
- Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Xi Chen
- Hu'nan Provincial Centers for Disease Control and Prevention, Changsha, China
| | - Ji-Hua Fu
- Shandong Provincial Centers for Disease Control and Prevention, Jinan, China
| | - Yi-Lu Qin
- University of North Carolina Project-China, Guangzhou, China
| | - Yong-Jun Jiang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wen-Qing Geng
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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27
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Guerrero N, Zhang X, Rangel G, Gonzalez-Fagoaga JE, Martinez-Donate A. Cervical and Breast Cancer Screening Among Mexican Migrant Women, 2013. Prev Chronic Dis 2016; 13:E104. [PMID: 27513995 PMCID: PMC4993116 DOI: 10.5888/pcd13.160036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Information on cervical and breast cancer screening among Latinas in the United States is limited. Even less information is available on screening practices of migrant women who engage in circular migration. We examined rates of cervical and breast cancer screening and the extent to which sociodemographics and other characteristics explain screening practices of Mexican migrant women who return to Mexico from the United States. METHODS We used data from a cross-sectional probability survey of Mexico-born migrant women who returned, through Tijuana, to Mexico from the United States in 2013. The sample consisted of women who returned involuntarily (via deportation) or voluntarily; 177 reported authorized documentation status, and 36 reported unauthorized documentation status in the previous 12 months. Descriptive statistics were calculated and logistic regressions were estimated. RESULTS Of 36 undocumented migrant women, 8 (22.2%) had a Papanicolaou test and 11 (30.6%) had a mammogram in the previous year; of 177 documented migrants, 83 (46.9%) had a Papanicolaou test and 68 (38.4%) had a mammogram. Undocumented migrants were less likely than documented migrants to receive a Papanicolaou test (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.12-0.67); the likelihood was similar after adjustment for sociodemographic, migration, and acculturation factors (adjusted OR = 0.33; 95% CI, 0.12-0.90). Having health insurance (adjusted OR = 4.17; 95% CI, 1.80-9.65) and a regular source of health care (adjusted OR = 2.83; 95% CI, 1.05-7.65) were significant predictors of receiving a mammogram but not a Papanicolaou test. CONCLUSION Public health programs are needed to improve access to cervical and breast cancer screenings for Latina migrant women in general and undocumented circular migrants in particular.
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Affiliation(s)
- Natalie Guerrero
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Xiao Zhang
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Gudelia Rangel
- Mexico Section, U.S.-Mexico Border Health Commission, Tijuana, Mexico
| | | | - Ana Martinez-Donate
- Dornsife School of Public Health, Drexel University, 3215 Market St, Nesbitt Hall 458, Philadelphia, PA 19104.
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Zhang X, Martinez-Donate AP, Simon NJE, Hovell MF, Rangel MG, Magis-Rodriguez C, Sipan CL. Risk behaviours for HIV infection among travelling Mexican migrants: The Mexico-US border as a contextual risk factor. Glob Public Health 2016; 12:65-83. [PMID: 26878494 DOI: 10.1080/17441692.2016.1142591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Mexico-US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico-US border region (Border, n = 553) with migrants arriving at the border from Mexican sending communities (Northbound, n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively, p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA.
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Affiliation(s)
- Xiao Zhang
- a Department of Population Health Sciences , University of Wisconsin-Madison , Madison , USA
| | - Ana P Martinez-Donate
- b Department of Community Health and Prevention , Drexel University , Philadelphia , USA
| | - Norma-Jean E Simon
- a Department of Population Health Sciences , University of Wisconsin-Madison , Madison , USA
| | - Melbourne F Hovell
- c Graduate School of Public Health , San Diego State University , San Diego , USA
| | | | - Carlos Magis-Rodriguez
- e Sexually Transmitted Infections Research Center, HIV/AIDS Program , Mexico City , Mexico
| | - Carol L Sipan
- f Department of Health Sciences , University of California-Merced , Merced , USA
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Pinedo M, Sim DEK, Giacinto RE, Zúñiga ML. An Exploratory Study of Internal Migration and Substance Use Among an Indigenous Community in Southern Mexico. FAMILY & COMMUNITY HEALTH 2016; 39:24-30. [PMID: 26605952 PMCID: PMC4661784 DOI: 10.1097/fch.0000000000000085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The primary aim of this study was to explore the association between internal migration experience within Mexico and lifetime substance use among a sample of 442 indigenous persons from Yucatan, Mexico. Adjusting for potential confounding, correlates of lifetime substance use were assessed among participants with and without internal migration experience. Internal migration to a tourist destination was independently associated with higher odds (adjusted odds ratio: 2.1; 95% confidence interval: 1.3-3.4) of reporting lifetime substance use. Findings suggest that environmental contexts of internal migration may be of importance in shaping vulnerability to substance use.
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Affiliation(s)
- Miguel Pinedo
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Alcohol Research Group, Emeryville, CA
| | - D. Eastern Kang Sim
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Rebeca Espinoza Giacinto
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - María Luisa Zúñiga
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- School of Social Work, San Diego State University, San Diego, CA
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Martinez-Donate AP, Rangel MG, Zhang X, Simon NJ, Rhoads N, Gonzalez-Fagoaga JE, Gonzalez AA. HIV Prevention Among Mexican Migrants at Different Migration Phases: Exposure to Prevention Messages and Association With Testing Behaviors. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:547-65. [PMID: 26595267 PMCID: PMC4751078 DOI: 10.1521/aeap.2015.27.6.547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Mobile populations are at increased risk for HIV infection. Exposure to HIV prevention messages at all phases of the migration process may help decrease im/migrants' HIV risk. We investigated levels of exposure to HIV prevention messages, factors associated with message exposure, and the association between exposure to prevention messages and HIV testing behavior among Mexican im/migrants at different phases of the migration process. We conducted a cross-sectional, probability survey of Mexican im/migrants (N = 3,149) traveling through the border city of Tijuana, Mexico. The results indicate limited exposure to prevention messages (57-75%) and suboptimal last 12-month HIV testing rates (14-25%) across five migration phases. Compared to pre-departure levels (75%), exposure to messages decreases at all post-departure migration phases (57-63%, p < .001). In general, exposure to prevention messages is positively associated with greater odds of HIV testing at the pre-departure, destination, and interception phases. Binational efforts need to be intensified to reach and deliver HIV prevention to Mexican im/migrants across the migration continuum.
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Affiliation(s)
- Ana P. Martinez-Donate
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - M. Gudelia Rangel
- U.S.-Mexico Border Health Commission, Mexico Section, Tijuana, Baja California, Mexico
| | - Xiao Zhang
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Norma-Jean Simon
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Natalie Rhoads
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Ahmed Asadi Gonzalez
- School of Medicine and Psychology, Autonomous University of Baja California (Universidad Autonoma de Baja California), Tijuana, Baja California, Mexico
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HIV Phylogeographic Analyses and Their Application in Prevention and Early Detection Programmes: The Case of the Tijuana-San Diego Border Region. EBioMedicine 2015; 2:1296-7. [PMID: 26629516 PMCID: PMC4634359 DOI: 10.1016/j.ebiom.2015.08.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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32
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Martínez-Donate AP, Rangel MG, Rhoads N, Zhang X, Hovell M, Magis-Rodriguez C, González-Fagoaga E. Identifying opportunities to increase HIV testing among mexican migrants: a call to step up efforts in health care and detention settings. PLoS One 2015; 10:e0123631. [PMID: 25860261 PMCID: PMC4393219 DOI: 10.1371/journal.pone.0123631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/02/2015] [Indexed: 11/18/2022] Open
Abstract
HIV testing and counseling is a critical component of HIV prevention efforts and core element of current “treatment as prevention” strategies. Mobility, low education and income, and limited access to health care put Latino migrants at higher risk for HIV and represent barriers for adequate levels of HIV testing in this population. We examined correlates of, and missed opportunities to increase, HIV testing for circular Mexican migrants in the U.S. We used data from a probability-based survey of returning Mexican migrants (N=1161) conducted in the border city of Tijuana, Mexico. We estimated last 12-months rates of HIV testing and the percentage of migrants who received other health care services or were detained in an immigration center, jail, or prison for 30 or more days in the U.S., but were not tested for HIV. Twenty-two percent of migrants received HIV testing in the last 12 months. In general, utilization of other health care services or detention for 30 or more days in the U.S. was a significant predictor of last 12-months HIV testing. Despite this association, we found evidence of missed opportunities to promote testing in healthcare and/or correctional or immigration detention centers. About 27.6% of migrants received other health care and/or were detained at least 30 days but not tested for HIV. Health care systems, jails and detention centers play an important role in increasing access to HIV testing among circular migrants, but there is room for improvement. Policies to offer opt-out, confidential HIV testing and counseling to Mexican migrants in these settings on a routine and ethical manner need to be designed and pilot tested. These policies could increase knowledge of HIV status, facilitate engagement in HIV treatment among a highly mobile population, and contribute to decrease incidence of HIV in the host and receiving communities.
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Affiliation(s)
- Ana P. Martínez-Donate
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
- * E-mail:
| | | | - Natalie Rhoads
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Xiao Zhang
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Melbourne Hovell
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Carlos Magis-Rodriguez
- Centro de Investigaciones en Infecciones de Transmision Sexual, Programa de VIH y SIDA de la Ciudad de Mexico, la Ciudad de Mexico, Mexico
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