Factors associated with drug-related harms related to policing in Tijuana, Mexico

Objective  

To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico.     

Factors associated with lead exposure in Oaxaca,Mexico

Lead intoxication risks were studied in a community of ceramic folk art workers in Oaxaca, a southern state of Mexico, where the manufacture of low-temperature lead ceramic ware is a family tradition and often the only source of income. Variables such as household characteristics, occupation, and lead exposure risk factors were explored. Study participants' mean blood lead concentration was 43.8 microg/dl (range=8.4-99.6 microg/dl), which is over the WHO guideline of 40 microg/dl for removing workers from exposure and is the concentration over which renal damage is accelerated. Best predictors for high blood lead concentrations by multivariable regression analysis were: occupation (P<0.0001), gender (P=0.0002), and the use of glazed stoneware (P<0.0001). This model explained 18% of blood lead variation among the study group. Exposure appears to be primarily associated with antiquated pottery manufacturing techniques and the high degree of contamination prevailing at the production sites, which in most cases are their living quarters. This consequently affects the lead levels of the entire community.     

Smoking, exposure to secondhand smoke, and smoking restrictions in Tijuana, Mexico.

OBJECTIVE: To estimate the prevalence of tobacco use, exposure to secondhand smoke, and smoking restrictions in the home and workplace among residents of Tijuana, one of Mexico's largest cities. METHODS: This cross-sectional household survey was conducted in Tijuana, Baja California, Mexico, during 2003 and 2004. A population-based sample of 400 Tijuana adult residents responded to a tobacco survey, and 397 of the surveys were analyzed. RESULTS: About 22.9% (95% confidence interval (CI): 18.7%-27.1%) of Tijuana adults reported current smoking, and 53.9% (95% CI: 48.8%-58.9%) reported chronic exposure to secondhand smoke. Approximately 44.4% (95% CI: 37.9%-50.9%) of Tijuana adults had a nonsmoking policy in their workplace, while 65.8% (95% CI: 61.0%-70.6%) of Tijuana households were smoke-free. CONCLUSIONS: The results underline the need for increased tobacco control efforts, particularly stricter enforcement of existing passive smoking regulations, in order to expand protection from secondhand smoke from private settings to public ones and to curb the tobacco epidemic in Tijuana and elsewhere in Mexico.     

The Prevalence of Musculoskeletal Complaints among Women in Tijuana,Mexico: Sociodemographic and Occupational Risk Factors

Abstract

The authors interviewed an age- and occupation-stratified sample of 466 women, aged 18–40, from 12 Tijuana neighborhoods, about sociodemographic characteristics, work and reproductive history, and musculoskeletal complaints. A total of 29.8% reported experiencing aches or pain in the low back, 38.3% in the upper back, 26.4% in the neck/shoulders, 18.2% in the hand/wrist, and 28.3% in the legs in the preceding year. Both sociodemographic and occupational factors were associated with these complaints. Very low educational attainment, having substandard housing, being the head of household, and being a migrant were each associated with an increased prevalence of one or more musculoskeletal complaints. In general, working outside the home increased the risk of musculoskeletal complaints. Compared with women who had not worked in the preceding 30-month period, those working in the maquiladora had 40–90% higher risks of upper back, neck/shoulder, and hand/wrist pain. Compared with women working outside the maquiladora, maquiladora women workers had 20% higher risks of low back, upper back, and neck/shoulder complaints. More detailed studies of the incidences of musculoskeletal disorders and of specific etiologic risk factors within the maquiladora industry are warranted. Future studies should concurrently evaluate sociodemographic risk factors.     

A skin test survey of valley fever in Tijuana, Mexico

Results of a study of the prevalence of valley fever among 1128 residents of Tijuana, Baja California are presented. Children from primary and middle schools (n = 497) and adults from technical institutes and maquiladoras (assembly plants) were tested for reaction to both spherulin and coccidioidin during 1985-1986, and they completed a questionnaire containing 23 variables on their socio-environment. Place of residence was mapped. The population sampled is largely middle class. Discriminant analysis indicates the distribution of positive cases is not clustered, nor can it be correlated with geomorphic factors such as mesa tops, canyons, or valley bottoms.     

Sex Work Regulation and Sexually Transmitted Infections in Tijuana,Mexico

While reducing the transmission of sexually transmitted infections is a common argument for regulating sex work, relatively little empirical evidence is available regarding the effectiveness of these policies. We investigate the effects of highly publicized sex work regulations introduced in 2005 in Tijuana, Mexico on the incidence of trichomoniasis. State‐level, annual data for the 1995–2012 period are employed that include the incidence rates of trichomoniasis by age group and predictor variables. We find that the regulations led to a decrease in the incidence rate of trichomoniasis. Specifically, while our estimates are somewhat noisy, the all‐ages incidence rate in the 2005–2012 period is roughly 37% lower than what is predicted by our synthetic control estimates and corresponds to approximately 800 fewer reported cases of trichomoniasis per year. We find that the decreases are especially pronounced for 15–24 and 25–44 age cohorts. Copyright © 2016 John Wiley & Sons, Ltd.     

A Qualitative Exploration of Female Sex Work in Tijuana, Mexico

Previous research has documented high rates of STDs and increased risk of HIV infection among female sex workers (FSWs) in Mexico; however, little is known about the sexual risk behaviors of this population. The purpose of this study was to explore work history, context of sex work, sexual risk practices, client characteristics, attitudes toward condoms, and potential barriers to condom use in a sample of FSWs in Tijuana, Mexico. Analysis of qualitative data from 25 FSWs revealed that most women entered the sex trade at a young age ( M = 23 years), primarily as a result of financial need. Forty percent were single mothers supporting children. Women worked an average of 6-7 days per week; work shifts ranged from 4 to 13 hr per day. Clients were both Mexican and foreign (mostly American and Asian), and ranged in age from 18 to 80 years. Positive aspects of the job included flexible work hours and good income. Negative aspects of sex work included risks associated with physical assault, diseases, and unwanted pregnancies. Most clients did not want to use a condom and many offered additional money for unprotected sex. FSWs did not like to use condoms because they were perceived as uncomfortable. Most FSWs did not negotiate the use of condoms, had a low knowledge regarding the proper use of condoms, and were reticent to report their own unsafe sex practices. These results suggest the need to develop culturally appropriate safer sex interventions for FSWs in Mexican border cities.     

Trends of overweight and obesity among children in Tijuana, Mexico

The objectives of this study were to compare the trends of obesity from 2001-02 to 2006-07 in school children of Tijuana, Mexico and to investigate the relationship with the child's gender and type of school attended. Bietapic random sample was selected by cluster of schools and groups. Results of the 1684 children from 6-14 years of age assessed showed an overall prevalence of obesity (> 95(th)) of 28%. An overall increase of overweight and obesity of 7-percentage points (p=0.0003), from 41 to 48%, being higher among boys and younger girls. Prevalence of obesity was higher among boys and children from private schools.     

Deportation experiences of women who inject drugs in Tijuana, Mexico

Deportation from the United States for drug offenses is common, yet the consequences of deportation for women drug users are poorly documented. In 2008, in Tijuana, Mexico, we conducted an exploratory qualitative study of migration, deportation, and drug abuse by interviewing 12 Mexican injection-drug-using women reporting U.S. deportation. Women reported heavy drug use before and after deportation, but greater financial instability and physical danger following deportation than when in the United States. We identified an unmet need for health and social services among deported drug-using women, including HIV prevention, drug treatment, physical and mental health services, and vocational training. Binational coordination is needed to help deported women resettle in Mexico.     

Community-based survey of maquiladora workers in Tijuana and Tecate, Mexico

Responses to a survey of 177 maquiladora workers by specially trained peers suggest that transnational corporations operating the plants are ignoring Mexican regulations regarding hazard communication, training, health and safety committees, and uncontrolled hazards in the workplace. The "global standard" for workplace health and safety, often claimed by transnationals, should be made a reality.     

Trends of Overweight and Obesity Among Children in Tijuana,Mexico

The objectives of this study were to compare the trends of obesity from 2001–02 to 2006–07 in school children of Tijuana, Mexico and to investigate the relationship with the child's gender and type of school attended. Bietapic random sample was selected by cluster of schools and groups. Results of the 1684 children from 6–14 years of age assessed showed an overall prevalence of obesity (> 95^th) of 28%. An overall increase of overweight and obesity of 7-percentage points (p = 0.0003), from 41 to 48%, being higher among boys and younger girls. Prevalence of obesity was higher among boys and children from private schools.     

Latent Tuberculosis among Persons at Risk for Infection with HIV, Tijuana, Mexico

Because there is little routine tuberculosis (TB) screening in Mexico, the prevalence of latent TB infection (LTBI) is unknown. In the context of an increasing HIV epidemic in Tijuana, Mexico, understanding prevalence of LTBI to anticipate emergence of increased LTBI reactivation is critical. Therefore, we recruited injection drug users, noninjection drug users, female sex workers, and homeless persons for a study involving risk assessment, rapid HIV testing, and TB screening. Of 503 participants, the overall prevalences of TB infection, HIV infection, and TB/HIV co-infection were 57%, 4.2%, and 2.2%, respectively; no significant differences by risk group (p>0.05) were observed. Two participants had TB (prevalence 398/100,000). Incarceration in Mexico (odds ratio [OR] 2.28), age (OR 1.03 per year), and years lived in Tijuana (OR 1.02 per year) were independently associated with TB infection (p<0.05). Frequent LTBI in marginalized persons may lead to increases in TB as HIV spreads.     

Estimated Numbers of Men and Women Infected with HIV/AIDS in Tijuana, Mexico

Tijuana, Mexico, just south of San Diego, California, is located by the busiest land border crossing in the world. Although UNAIDS considers Mexico to be a country of “low prevalence, high risk,” recent surveillance data among sentinel populations in Tijuana suggests HIV prevalence is increasing. The aim of this study was to estimate the number of men and women aged 15 to 49 years infected with HIV in Tijuana. Gender and age-specific estimates of the Tijuana population were obtained from the 2000 Mexican census. Population and HIV prevalence estimates for at-risk groups were obtained from published reports, community based studies, and data from the Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA). Age-specific fertility rates for Mexico were used to derive the number of low and high-risk pregnant women. Numbers of HIV-positive men and women were estimated for each at-risk group and then aggregated. A high growth scenario based on current HIV prevalence and a conservative, low growth estimate were determined. A total of 686,600 men and women in Tijuana were aged 15 to 49 years at the time of the 2000 census. Considering both scenarios, the number of infected persons ranged from 1,803 to 5,472 (HIV prevalence: 0.26 to 0.80%). The majority of these persons were men (>70%). The largest number of infected persons were MSM (N = 1,146 to 3,300) and IDUs (N = 147 to 650). Our data suggest that up to one in every 125 persons aged 15–49 years in Tijuana is HIV-infected. Interventions to reduce ongoing spread of HIV are urgently needed. Brouwer, Strathdee, and Hogg are with the Division of International Health & Cross-Cultural Medicine, Department of Family and Preventive Medicine, School of Medicine, University of California, 9500 Gilman Drive,MC0622, La Jolla, San Diego, CA 93093-0622, USA; Magis-Rodríguez, Bravo-García, and Gayet are with the Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA), Secretaria de Salud, Mexico City,México; Patterson is with the Department of Psychiatry, University of California, San Diego, CA, USA; Bertozzi is with the Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México; Gayet is with the Facultad Latinoamericana de Ciencias Sociales (FLACSO), México, México; Hogg is with the Bristish Columbia Centre for Excellence in HIV/AIDS, Faculty of Medicine, University of British Columbia, Vancouver, Canada.     

A preliminary study of reproductive outcomes of female maquiladora workers in Tijuana,Mexico

Maquiladoras are plants on the Mexican side of the United States-Mexico border which are used largely by U.S. manufacturers to assemble premanufactured parts. We examined reproductive outcomes of women employed in electronics (N = 120) and garment (N = 121) maquiladora work compared to women employed in the service sector (N = 119) in Tijuana. Mexico. Women recruited by community health workers were interviewed about their reproductive history, sociodemographic characteristics, health behaviors, and characteristics of their current job. Length of regular menstrual cycle in the past year as well as time of conception and rates of fetal loss in the most recent pregnancy were similar across occupational groups. However, infants of garment maquiladora workers were 653 g lighter (95% confidence interval [CI]: ?1,041 g, ?265 g) and infants of electronic maquiladora workers were 337 g lighter (95% CI: ?682 g. 9 g) than infants of service workers after adjusting for potential confounders. The cause of these differences remains unclear. © 1993 Wiley-Liss, Inc.     

Factors associated with tuberculin reactivity in two general hospitals in Mexico.

OBJECTIVE: To identify risk factors associated with tuberculin reactivity in healthcare workers (HCWs). DESIGN: Cross-sectional survey of tuberculin reactivity (2 TU of purified protein derivative (PPD) RT23, using the Mantoux two-step test). SETTING: Two general hospitals located in a region with a high prevalence of tuberculosis and high bacille Calmette-Guerin (BCG) coverage. PARTICIPANTS: Volunteer sample of HCWs. RESULTS: 605 HCWs were recruited: 71.2% female; mean age, 36.4 (standard deviation [SD], 8.2) years; 48.9% nurses, 10.4% physicians, 26.8% administrative personnel; mean time of employment, 10.9 (SD, 6.7) years. PPD reactivity (> or =10 mm) was found in 390 (64.5%). Multivariate analysis revealed an association of tuberculin reactivity with occupational exposure in the hospital: participation in autopsies (odds ratio [OR], 9.3; 95% confidence interval [CI95], 2.1-40.5; P=.003.), more than 1 year of employment (OR, 2.4; CI95, 1.1-5.0; P=.02), work in the emergency or radiology departments (OR, 2.0; CI95, 1.03-3.81; P=.04), being physicians or nurses (OR, 1.5; CI95, 1.04-2.11; P=.03), age (OR, 1.04; CI95, 1.02-1.07 per year of age; P<.001), and BCG scar (OR, 2.1; CI95, 1.2-3.4; P=.005). CONCLUSIONS: Although the studied population has a high baseline prevalence of tuberculosis infection and high coverage of BCG vaccination, nosocomial risk factors associated with PPD reactivity were identified as professional risks; strict early preventive measures must be implemented accordingly.     

Knowledge and opinions of emergency contraceptive pills among female factory workers in Tijuana, Mexico

Workers in Mexico's maquiladoras (assembly plants) are mainly young, single women, many of whom could benefit from emergency contraceptive pills (ECPs). Because ECPs are readily available in Mexico, women who know about the therapy can obtain it easily. Do maquiladora workers know about the method? Could worksite programs help increase awareness? To investigate these questions, we conducted a five‐month intervention during which workers in three maquiladoras along the Mexico‐United States border could attend educational talks on ECPs, receive pamphlets, and obtain kits containing EC supplies. Among the workers exposed to our intervention, knowledge of ECPs increased. Reported ECP use also increased. Although our intervention apparently increased workers’ knowledge and use, the factory proved to be a difficult intervention setting. Problems we experienced included a factory closure and management/staff opposition to certain project elements. Future studies should continue to investigate work‐site interventions and other strategies to reach workers.