Carlos Magis-Rodriguez

Publications (77) View all

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  Available from: Carlos Magis-Rodriguez

  Article: Inmigración y Sida en los municipios conurbados del área metropolitana de la ciudad de México

  Cecilia Inés Gayet, Carlos Magis Rodríguez
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  ABSTRACT: The paper aims to correlate internal and international migra-tion to AIDS in conurbated municipalities in Mexico City Metro-politan Area through the description of the characteristics of those migrants infected with AIDS. These characteristics are then compared to the ones of migrants in the region and to non-migrant AIDS cases, presenting a differential migration indicator of AIDS infected population. The results reveal that the original residence locations do not match the known regional immigra-tion pattern, which over-represents international migration as well as Jalisco and Baja California´s migration. The differential migration indicator shall prove that migration is higher among AIDS infected population than among the total population in the region.
  Economía, Sociedad y Territorio. 02/2013; 2(8):641-686.
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  Available from: María Teresa Hernández

  Article: The Effect of Migration on HIV High-Risk Behaviors among Mexican Migrants.

  Melissa Ann Sanchez, María T Hernández, Joel E Hanson, Alicia Vera, Carlos Magis-Rodríguez, Juan D Ruiz, Alvaro H Garza, Xóchitl Castañeda, Bart K Aoki, George F Lemp
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  ABSTRACT: BACKGROUND:: Previous studies have shown an association between Mexican migration to the U.S. and an increased frequency of HIV high-risk behaviors among male Mexican migrants. However, the individual level change in these behaviors after migration has not been quantified. OBJECTIVE:: To estimate the change in HIV high-risk behaviors among Mexican migrants after migration to the U.S. METHODS:: A case-crossover study was embedded in the California-Mexico Epidemiological Surveillance Pilot (CMESP), a targeted, venue-based, sampling survey. We implemented the study from July-November 2005, studying 458 Mexican migrants at sites in rural and urban areas in Fresno County and San Diego County and directly comparing individual HIV high-risk behaviors before and after migration. RESULTS:: After migration, there were increases in the odds of male migrants engaging in sex with a sex worker (O.R.=2.64,P<.0001), sex while under the influence of drugs or alcohol (O.R.=5.00,P<.0001), performing sex work (O.R.=6.00,P=.070), and sex with a male partner (O.R.=13.00,P=.001). Those male Mexican migrant subgroups at particularly elevated risk were those in the U.S. for over five years, those from the youngest age cohort (18-29 years old), or those frequenting high-risk behavior venues and male work venues. CONCLUSIONS:: Our results show that Mexican migrant men were significantly more likely to engage in several HIV high-risk behaviors after migration to the U.S. However, a smaller proportion of men reported low condom use following migration, indicating increased adoption of some prevention methods. Our results also identified subgroups of Mexican migrants at elevated risk who should be targeted for HIV prevention interventions.
  JAIDS Journal of Acquired Immune Deficiency Syndromes 09/2012; · 4.43 Impact Factor
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  Available from: Steffanie A Strathdee

  Article: Spatial Epidemiology of HIV Among Injection Drug Users in Tijuana, Mexico

  Kimberly C. Brouwer, Melanie L. Rusch, John R. Weeks, Remedios Lozada, Alicia Vera, Carlos Magis-Rodríguez, Steffanie A. Strathdee
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  ABSTRACT: The northwest border city of Tijuana is Mexico's fifth largest and is experiencing burgeoning drug use and human immunodeficiency virus (HIV) epidemics. Because local geography influences disease risk, we explored the spatial distribution of HIV among injection drug users (IDUs). From 2006–2007, 1,056 IDUs were recruited using respondent-driven sampling and then followed for eighteen months. Participants underwent semiannual surveys, mapping, and testing for HIV, tuberculosis, and syphilis. Using average nearest neighbor and Getis-Ord Gi* statistics, locations where participants lived, worked, bought drugs, and injected drugs were compared with HIV status and environmental and behavioral factors. Median age was thirty-seven years; 85 percent were male. Females had higher HIV prevalence than males (10.2 percent vs. 3.4 percent; p = 0.001). HIV cases at baseline (n = 47) most strongly clustered by drug injection sites (Z score = –6.173, p < 0.001), with a 16-km2 hotspot near the Mexico–U.S. border, encompassing the red-light district. Spatial correlates of HIV included syphilis infection, female gender, younger age, increased hours on the street per day, and higher number of injection partners. Almost all HIV seroconverters injected within a 2.5-block radius of each other immediately prior to seroconversion. Only history of syphilis infection and female gender were strongly associated with HIV in the area where incident cases injected. Directional trends suggested a largely static epidemic until July through December 2008, when HIV spread to the southeast, possibly related to intensified violence and policing that spiked in the latter half of 2008. Although clustering allows for targeting interventions, the dynamic nature of epidemics suggests the importance of mobile treatment and harm reduction programs. La ciudad fronteriza de Tijuana, en la frontera noroeste de México, la quinta más grande del país, está padeciendo una tremenda epidemia de uso de drogas y de contagio con el virus de inmunodeficiencia humana (VIH). Debido a que la geografía local influye sobre el riesgo de contraer la enfermedad, exploramos la distribución espacial del VIH entre los usuarios de drogas inyectables (IDU, acrónimo inglés). Desde 2006-2007 se reclutaron para el estudio 1.056 IDUs utilizando un muestreo de base entre quienes respondieron, para ser seguidos luego durante dieciocho meses. Los participantes fueron sometidos a estudios de duración semestral, ubicación cartográfica y exámenes de laboratorio para VIH, tuberculosis y sífilis. Utilizando estadísticas del promedio de vecino más cercano y Geits-Ord GI*, las localizaciones donde los participantes vivían, trabajaban, compraban drogas y se las inyectaban, se compararon con el estatus del VIH y con factores ambientales y de comportamiento. La edad promedio fue de treinta y siete años; el 85 por ciento de los participantes fueron masculinos. Las mujeres registraron una más alta prevalencia del VIH que los varones (10.2 por ciento vs. 3.4 por ciento; p = 0.001). Los casos de VIH en el nivel base (n = 47) se agrupaban fuertemente alrededor de los sitios donde se producía la inyección de drogas (el puntaje de Z = 6.173, p < 0.001), con un punto crítico de 16-km2 cerca de la frontera México-EE.UU., el cual abarcaba todo el distrito de farol-rojo. Los correlatos espaciales del VIH incluyeron infección sifilítica, género femenino, edad más joven, mayor número de horas por día en la calle y un mayor número de compañeros de inyección. Casi todos los seropositivos con VIH se habían inyectado dentro de un radio de 2.5 manzanas de cada uno de ellos inmediatamente antes de la seroconversión. Solamente la historia de infección sifilítica y género femenino estuvieron fuertemente asociados con el VIH en el área donde ocurrieron casos incidentales de inyección. Las tendencias direccionales sugirieron una epidemia en gran medida estática hasta el tiempo transcurrido de julio a diciembre de 2008, cuando el VIH se difundió hacia el sudeste, algo posiblemente relacionado con la intensificación de la violencia y el incremento de la acción policial, que alcanzaron su pico en la segunda mitad del 2008. Aunque la aglomeración facilita la intervención claramente enfocada, la naturaleza dinámica de la epidemia sugiere la importancia de los tratamientos móviles y los programas de reducción del daño social.
  Annals of the Association of American Geographers 09/2012; 102(5):1190-1199. · 2.17 Impact Factor
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  Available from: Steffanie A Strathdee

  Article: Intraurban mobility and its potential impact on the spread of blood-borne infections among drug injectors in Tijuana, Mexico.

  Kimberly C Brouwer, Remedios Lozada, John R Weeks, Carlos Magis-Rodríguez, Michelle Firestone, Steffanie A Strathdee
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  ABSTRACT: We explored intraurban mobility of Tijuana, Mexico, injection drug users (IDUs). In 2005, 222 IDUs underwent behavioral surveys and infectious disease testing. Participants resided in 58 neighborhoods, but regularly injected in 30. From logistic regression, "mobile" IDUs (injecting ≥3 km from their residence) were more likely to cross the Mexico/U.S. border, share needles, and get arrested for carrying syringes-but less likely to identify hepatitis as an injection risk. Mobile participants lived in neighborhoods with less drug activity, treatment centers, or migrants, but higher marriage and home ownership rates. Mobile IDUs should be targeted for outreach and further investigation. The study's limitations are noted.
  Substance Use &amp Misuse 12/2011; 47(3):244-53. · 1.10 Impact Factor
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  Available from: Carlos Magis-Rodriguez

  Article: Distribution of sexually transmitted diseases and risk factors by work locations among female sex workers in Tijuana, Mexico.

  Melanie L A Rusch, Kimberly C Brouwer, Remedios Lozada, Steffanie A Strathdee, Carlos Magis-Rodríguez, Thomas L Patterson
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  ABSTRACT: Sex work is regulated in the Zona Roja (red light district) in Tijuana, Mexico, where HIV and sexually transmitted disease (STD) prevalence is high among female sex workers (FSWs). We examined the spatial distribution of STDs by work venue among FSWs in Tijuana. FSWs aged 18 years and older who reported unprotected sex with ≥ 1 client in the past 2 months underwent testing for HIV, syphilis, gonorrhea, and Chlamydia. HIV/STDs were mapped by venue (i.e., bar, hotel) and Getis-Ord Gi statistics were used to identify geographic hotspots. High-risk venues were then identified using a standardized STD ratio (high risk defined as a ratio ≥ 1.25). Logistic regression was used to assess correlates of working at a high risk venue. Of 474 FSWs, 176 (36.4%) had at least 1 bacterial sexually transmitted infection (STI); 36 (7.6%) were HIV-positive. Within the Zona Roja, 1 venue was identified as a geographic "hotspot," with a higher than expected number of HIV/STD-positive FSW (P < 0.05) as compared to neighboring venues. Using the STD ratio definition, 11 venues were identified as high-risk; FSWs working in these locations had higher education, were more likely to report always using drugs with sex, and having mostly US clients. They were less likely to be registered FSWs or to live at their work venue. A relatively few number of sex work venues accounted for a large proportion of the HIV/STI burden among FSWs in Tijuana. Structural interventions that focus on sex work venues could help increase STI diagnosis, prevention, and treatment among FSWs in Tijuana.
  Sexually transmitted diseases 10/2010; 37(10):608-14. · 2.58 Impact Factor