The overall goal of this project is to characterize the epidemiology of HIV and HCV among injecting drug users (IDUs) in Tijuana, Mexico. Recent data suggest a dynamic HIV sub-epidemic among IDUs on the northwestern Mexico-US border where injection drug use is now a major public health problem.
The aims of this proposal are: 1) To determine HIV, HCV and syphilis prevalence and estimate HIV incidence based on the detuned assay among IDUs in Tijuana; 2) To determine the extent to. which potentially modifiable individual, social and environmental factors influence the following outcomes among IDUs in Tijuana: i) prevalent HIV and HCV and incident HIV infections; ii) risk behaviors for blood borne infections (e.g., direct and indirect syringe sharing, shooting gallery attendance); iii) barriers to access and use of sterile syringes and injection paraphernalia within the context of legal syringe access through pharmacies. Individual level factors of interest include knowledge of HIV and HCV serostatus, recent onset injection and use of specific injection drug combinations (e.g., heroin and methamphetamine) and formulations (e.g., heroin tar versus powder); Social factors include emigration and personal network characteristics; Environmental factors include geospatial factors (e.g., distance from the border, frequency of border crossings, density of shooting galleries, pharmacies and drug treatment programs), and experiences with law enforcement. 3) To examine the social acceptability of interventions to reduce drug-related harm among the following stakeholders in Tijuana. To meet Aims 1 and 2, 2000 IDUs who have injected at least once in the prior 6 months will be recruited using respondent driven sampling, which will facilitate an unbiased estimate of HIV and HCV prevalence and associated risk behaviors. Face-to-face interviews will collect sociodemographic and behavioral data. To assess geospatial factors, we will use hand-held global positioning system devices to map cross-street locations of shooting galleries, pharmacies and drug treatment programs. To meet Aim 3,we will conduct in-depth interviews with three types of key informants (e.g., systems, interactor and street-level key informants). Although Mexico is considered a country of low HIV/AIDS prevalence with a concentrated epidemic, the window of opportunity for prevention is believed to be closing rapidly since IDU-associated HIV epidemics are often explosive and can quickly become generalized. This study will inform the development of culturally-appropriate interventions in one of the largest Mexican-U.S. cities, which has implications for policy making and program planning for both countries. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA019829-03
Application #
7262585
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Hartsock, Peter
Project Start
2005-09-15
Project End
2009-07-31
Budget Start
2007-08-01
Budget End
2008-07-31
Support Year
3
Fiscal Year
2007
Total Cost
$647,542
Indirect Cost
Name
University of California San Diego
Department
Family Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
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Melo, J S; Garfein, R S; Hayashi, K et al. (2018) Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings. Drug Alcohol Depend 182:67-73
Smith, Danielle M; Werb, Dan; Abramovitz, Daniela et al. (2016) Predictors of needle exchange program utilization during its implementation and expansion in Tijuana, Mexico. Am J Addict 25:118-24
Smith, Laramie R; Patterson, Thomas L; Magis-Rodriguez, Carlos et al. (2016) Engagement in the HIV Care Continuum among Key Populations in Tijuana, Mexico. AIDS Behav 20:1017-25
Hayashi, Hitomi D; Patterson, Thomas L; Semple, Shirley J et al. (2016) Risk Factors for Recent Intimate Partner Violence among Methamphetamine-Using Men and Women. J Psychoactive Drugs 48:135-45
Meacham, Meredith C; Rudolph, Abby E; Strathdee, Steffanie A et al. (2015) Polydrug Use and HIV Risk Among People Who Inject Heroin in Tijuana, Mexico: A Latent Class Analysis. Subst Use Misuse 50:1351-9
Armenta, Richard F; Abramovitz, Daniela; Lozada, Remedios et al. (2015) Correlates of perceived risk of HIV infection among persons who inject drugs in Tijuana, Baja California, Mexico. Salud Publica Mex 57 Suppl 2:s107-12
Mackey, Tim K; Strathdee, Steffanie A (2015) Responding to the public health consequences of the Ukraine crisis: an opportunity for global health diplomacy. J Int AIDS Soc 18:19410
Mehta, Sanjay R; Wertheim, Joel O; Brouwer, Kimberly C et al. (2015) HIV Transmission Networks in the San Diego-Tijuana Border Region. EBioMedicine 2:1456-63

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