Bucardo J, Brouwer KC, Magis-Rodriguez C, et al. Historical trends in the production and consumption of illicit drugs in Mexico: Implications for the prevention of blood borne infections

Department of Psychiatry, School of Medicine, University of California-San Diego, San Diego, CA 92093, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 10/2005; 79(3):281-93. DOI: 10.1016/j.drugalcdep.2005.02.003
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ABSTRACT Mexico has cultivated opium poppy since before the 1900's and has been an important transit route for South American cocaine for decades. However, only recently has drug use, particularly injection drug use, been documented as an important problem. Heroin is the most common drug used by Mexican injection drug users (IDUs). Increased cultivation of opium poppy in some Mexican states, lower prices for black tar heroin and increased security at U.S.-Mexican border crossings may be contributing factors to heroin use, especially in border cities. Risky practices among IDUs, including needle sharing and shooting gallery attendance are common, whereas perceived risk for acquiring blood borne infections is low. Although reported AIDS cases attributed to IDU in Mexico have been low, data from sentinel populations, such as pregnant women in the Mexican-U.S. border city of Tijuana, suggest an increase in HIV prevalence associated with drug use. Given widespread risk behaviors and rising numbers of blood borne infections among IDUs in Mexican-U.S. border cities, there is an urgent need for increased disease surveillance and culturally appropriate interventions to prevent potential epidemics of blood borne infections. We review available literature on the history of opium production in Mexico, recent trends in drug use and its implications, and the Mexican response, with special emphasis on the border cities of Ciudad Juarez and Tijuana.

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Available from: Carlos Magis-Rodriguez, Sep 27, 2015
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    • " for infectious dis - eases ( Sirotin et al . 2010 ) . Drug abuse , including injection drug use , has increased in Tijuana in recent years ( Instituto Nacional de Salud Publica 2008 ) in part due to its location on a major U . S . - bound drug trafficking route . Mexican black tar heroin and crystal methamphetamine dominate the local drug trade ( Bucardo et al . 2005 ) . Although personal drug possession has been nationally decriminalized and harm reduction services are available in Tijuana , repressive policing practices and discrimination frequently impinge on injectors ' abilities to adopt safer behav - iors ( Pollini et al . 2011 ; Volkmann et al . 2011 ) ."
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    ABSTRACT: The relationships between female sex workers and their noncommercial male partners are typically viewed as sites of HIV risk rather than meaningful unions. This ethnographic case study presents a nuanced portrayal of the relationship between Cindy and Beto, a female sex worker who injects drugs and her intimate, noncommercial partner who live in Tijuana, Mexico. On the basis of ethnographic research in Tijuana and our long-term involvement in a public health study, we suggest that emotions play a central role in sex workers' relationships and contribute in complex ways to each partner's health. We conceptualize Cindy and Beto's relationship as a " dangerous safe haven " in which HIV risk behaviors such as unprotected sex and syringe sharing convey notions of love and trust and help sustain emotional unity amid broader uncertainties but nevertheless carry very real health risks. Further attention to how emotions shape vulnerable couples' health remains a task for anthropology.
    Anthropology of Consciousness 09/2015; 26(2):182-194. DOI:10.1111/anoc.12037
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    • "Tijuana and Ciudad Juarez are also situated along major drug trafficking routes into the United States. Both cities have experienced a rise in HIV prevalence and injection drug use (Bucardo et al., 2005) with IDUs estimated at 10,000 and 6500, respectively (Ramos et al., 2009). Mexico's growing HIV epidemic has been linked to structural conditions that increase HIV risk behaviors and other adverse outcomes among IDUs (Beletsky et al., 2013). "
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    ABSTRACT: Objective: This study quantitatively examined the prevalence and correlates of short-term sex work cessation among female sex workers who inject drugs (FSW-IDUs) and determined whether injection drug use was independently associated with cessation. Methods: We used data from FSW-IDUs (n=467) enrolled into an intervention designed to increase condom use and decrease sharing of injection equipment but was not designed to promote sex work cessation. We applied a survival analysis that accounted for quit-re-entry patterns of sex work over 1-year stratified by city, Tijuana and Ciudad Juarez, Mexico. Results: Overall, 55% of participants stopped sex work at least once during follow-up. Controlling for other characteristics and intervention assignment, injection drug use was inversely associated with short-term sex work cessation in both cities. In Ciudad Juarez, women receiving drug treatment during follow-up had a 2-fold increase in the hazard of stopping sex work. In both cities, income from sources other than sex work, police interactions and healthcare access were independently and significantly associated with shorter-term cessation. Conclusions: Short-term sex work cessation was significantly affected by injection drug use. Expanded drug treatment and counseling coupled with supportive services such as relapse prevention, job training, and provision of alternate employment opportunities may promote longer-term cessation among women motivated to leave the sex industry.
    Addictive Behaviors 06/2015; 45. DOI:10.1016/j.addbeh.2015.01.020 · 2.76 Impact Factor
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    • "International Journal of Drug Policy (2014), ARTICLE IN PRESS G Model DRUPOL-1334; No. of Pages 9 J.L. Syvertsen et al. / International Journal of Drug Policy xxx (2014) xxx–xxx 3 (Brouwer et al., 2006; Bucardo et al., 2005 "
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    ABSTRACT: Background Studies of injection drug-using couples suggest a gendered performance of risk in which men exert greater control over drug use and render their female partners vulnerable to HIV infection and other negative health outcomes. This study assesses gender roles in injection drug use as practiced among female sex workers and their intimate male partners within a risk environment marked by rapid socioeconomic changes. Methods We draw on quantitative surveys, semi-structured interviews, and ethnographic fieldwork conducted as part of cohort study of HIV/STI risk among female sex workers and their intimate, non-commercial partners along the Mexico-U.S. border. This study employed descriptive statistics and inductive analyses of transcripts and field notes to examine practices related to drug procurement, syringe sharing, and injection assistance among couples in which both partners reported injecting drugs in the past six months. Results Among 156 couples in which both partners injected drugs (n = 312), our analyses revealed that women's roles in drug use were active and multidimensional, and both partners’ injection risk practices represented embodied forms of cooperation and compassion. Women often earned money to purchase drugs and procured drugs to protect their partners from the police. Sharing drugs and syringes and seeking injection assistance were common among couples due to drug market characteristics (e.g., the use of “black tar” heroin that clogs syringes and damages veins). Both women and men provided and received injection assistance, which was typically framed as caring for the partner in need of help. Conclusion Our mixed methods study suggests that in certain risk environments, women are more active participants in injection-related practices than has often been revealed. This participation is shaped by dynamic relationship and structural factors. Our suggestion to consider gendered injection risk as a nuanced and relational process has direct implications for future research and interventions.
    The International journal on drug policy 09/2014; 25(5). DOI:10.1016/j.drugpo.2014.02.005 · 2.54 Impact Factor
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