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ABSTRACT: The recent impetus of tougher immigration-related measures passed at the state level raises concerns about the impact of such measures on the migration experience, trajectory, and future plans of unauthorized immigrants. In a recent and unique survey of Mexican unauthorized immigrants interviewed upon their voluntary return or deportation to Mexico, almost a third reported experiencing difficulties in obtaining social or government services, finding legal assistance, or obtaining health care services. Additionally, half of these unauthorized immigrants reported fearing deportation. When we assess how the enactment of punitive measures against unauthorized immigrants, such as E-Verify mandates, has affected their migration experience, we find no evidence of a statistically significant association between these measures and the difficulties reported by unauthorized immigrants in accessing a variety of services. However, the enactment of these mandates infuses deportation fear, reduces interstate mobility among voluntary returnees during their last migration spell, and helps curb deportees' intent to return to the United States in the near future.
Demography 03/2013; · 1.93 Impact Factor
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ABSTRACT: A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N = 693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23 and 0.80 %, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3 %) and last 12-months rates of unprotected sex (63.0 %), sex with multiple sexual partners (18.1 %), casual partners (25.7 %), and sex workers (8.6 %), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico.
AIDS and Behavior 05/2012; 16(6):1630-40. · 3.49 Impact Factor
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ABSTRACT: Home smoking bans significantly reduce secondhand smoke exposure among children, but parents may offer discordant reports on whether there is a home smoking ban. The purpose of this study was to examine national trends in (a) parental discordance/concordance in the reporting of home smoking bans and (b) correlates of discordant/concordant reports among two-parent households with underage children from 1995 to 2007.
Data from the 1995/1996, 1998/1999, 2001/2002, 2003, and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey were used to estimate prevalence rates and multinomial logistic regression models of discordant/concordant parental smoking ban reports by survey period.
Overall, the percentage of households in which the 2 parents gave discordant reports on a complete home smoking ban decreased significantly from 12.7% to 2.8% from 1995 to 2007 (p < .001). Compared with households where both parents reported a complete smoking ban, discordant reports were more likely to be obtained from households with current smokers (p < .01) across survey periods. Compared with households where both parents reported the lack of a complete home smoking ban, discordant reports were more likely among households with college graduates, no current smokers, and parents with Hispanic ethnicity (p < .05). Conclusions: Parental concordance on the existence of a home smoking ban increased from 1995 to 2007. This suggests estimates of home smoking bans based on just one parent may be more reliable now than they were in the past. Interventions to improve the adoption and enforcement of home smoking bans should target households with current smoker parents.
Nicotine & Tobacco Research 02/2012; 14(10):1170-9. · 2.58 Impact Factor
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ABSTRACT: Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in (1) the adoption of home smoking bans, (2) discrepancies in parental smoking ban reports and (3) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007.
The authors used data from the 1995-1996, 1998-1999, 2001-2002, 2003 and 2006-2007 Tobacco Use Supplement of the US Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period.
Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education or without infants were consistently less likely to report a home smoking ban over this period (p<0.05).
Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases.
Tobacco control 08/2011; 21(3):330-6. · 3.85 Impact Factor
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ABSTRACT: Participation of different community sectors, including the private business sector, is necessary to fight the HIV/AIDS epidemic. Local businesses may be reluctant to participate in HIV prevention because of fear of negative customer reactions and loss of revenue. This study examines the extent to which residents of two communities in San Diego, California, would support HIV prevention initiatives in local businesses. A population-based household survey (N = 200) is conducted in two communities with higher versus lower risk for HIV. The survey includes questions regarding the acceptability of HIV prevention activities, such as condom and brochure distribution in businesses, and history of exposure to HIV prevention activities in local businesses. Most residents agree that (a) business involvement in prevention activities would reduce HIV (92%), (b) free or low-cost condoms available in businesses could prevent the spread of HIV (90.9%) and increase condom accessibility (87%), and (c) they would prefer to shop at businesses that supported HIV prevention versus those that did not (87.4%). These findings suggest that HIV prevention in local businesses would be supported by residents and would be unlikely to adversely affect business profits. This information could be used to design interventions to engage local businesses in HIV-prevention efforts.
Health Promotion Practice 07/2011; 12(4):620-9.
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ABSTRACT: Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.
AIDS patient care and STDs 05/2010; 24(5):333-40. · 2.68 Impact Factor
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ABSTRACT: This study examines the association between home smoking ban status and home secondhand smoke exposure (SHSE) among Mexican-descent adults and children in three cities representing different levels of exposure to the California Tobacco Control Program.
From 2003-2004, a cross-sectional tobacco survey was conducted with a population-based sample of Mexican-descent adults in San Diego, California (N=1103) and Mexican adults in Tijuana (N=398) and Guadalajara (N=400), Mexico.
After adjustment for demographic, behavioral, cultural, and contextual covariates, a complete home smoking ban was associated with Mexican American and Mexican adults and children being less likely to experience SHSE in the home compared to their counterparts with partial or no smoking restrictions. The association was significant across the three survey sites, but stronger in San Diego than in any of the two Mexican cities.
Home smoking bans reduce the risk of home SHSE among Mexican Americans and Mexicans, regardless of the smoking status of the household residents and other individual and environmental variables. Even if household residents continue smoking and communitywide tobacco control efforts are suboptimal, the promotion of home smoking bans can protect adults and children from home SHSE.
Preventive Medicine 01/2009; 48(3):207-12. · 3.22 Impact Factor
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ABSTRACT: We examined the sexual behavior, sexual identities, and HIV risk factors of a community sample of Latino men to inform efforts to reduce Latinos' HIV risk.
In 2005 and 2006, 680 Latino men in San Diego County, California, in randomly selected, targeted community venues, completed an anonymous, self-administered survey.
Most (92.3%) respondents self-identified as heterosexual, with 2.2%, 4.9%, and 0.6% self-identifying as bisexual, gay, or other orientation, respectively. Overall, 4.8% of heterosexually identified men had a lifetime history of anal intercourse with other men. Compared with behaviorally heterosexual men, heterosexually identified men who had sex with both men and women were more likely to have had a sexually transmitted infection, to have unprotected sexual intercourse with female partners, and to report having sex while under the influence of alcohol or other drugs. Bisexually identified men who had sex with men and women did not differ from behaviorally heterosexual men in these risk factors.
Latino men who have a heterosexual identity and bisexual practices are at greater risk of HIV infection, and efforts to reduce HIV risk among Latinos should target this group.
American Journal of Public Health 12/2008; 99(1):125-32. · 3.93 Impact Factor
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ABSTRACT: Condom availability programs (CAPs) may increase access to condoms and contribute to increased condom use among youth. This study describes the characteristics, degree of satisfaction, and gender differences among users of a CAP implemented in two high schools in Tijuana (Baja California, Mexico). A kiosk distributing free male condoms was set up in two high schools in Tijuana. Kiosk users (N=570) were more likely to be male, young, and/or enrolled in a lower SES school. Most kiosk users were either sexually active or planning to have sex. Females were less likely to request condoms and to continue using the kiosk, but more likely to request information on other contraceptive methods. Results demonstrate the feasibility of implementing CAPs in Mexican schools and suggest that these programs can improve adolescents' condom access.
AIDS and Behavior 12/2006; 10(6):649-57. · 3.49 Impact Factor
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ABSTRACT: This research project examined the individual and combined effectiveness of an HIV prevention workshop and a free condom distribution program in four high schools in Tijuana, Mexico. Adolescents (N = 320) completed baseline measures on sexual practices and theoretical correlates and participated in a two-part study. In Study 1, students were randomly assigned to an HIV prevention workshop or a control condition, with a 3-month follow-up assessment. Results indicate three significant workshop benefits regarding HIV transmission by altering sexual initiation, access to condoms, and traditional beliefs regarding condoms. In Study 2, we set up a condom distribution program at two of the participating schools, and students completed a 6-month follow-up assessment. Results indicate that exposure to the workshop followed by access to the condom distribution program yielded two beneficial results for reducing HIV transmission: moderating sexual initiation and increasing condom acquisition. Access to the condom distribution program alone had no effects on behavioral and psychosocial correlates of HIV transmission. We discuss implications of these results.
The Journal of Sex Research 09/2004; 41(3):267-78. · 2.53 Impact Factor
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ABSTRACT: Adolescents are at increasing risk for HIV infection in Mexico. Research on gender differences in risk behaviors and determinants is needed to develop effective HIV prevention interventions targeting Mexican adolescents. This study examined gender differences in the likelihood of unprotected sex and theoretical correlates among high school students in the border city of Tijuana. Three hundred seventy high-school students completed a face-to-face interview and a self-administered survey. Differences in sexual initiation, condom use, intentions to use condoms in the future, and attitudes towards condoms in this population were assessed. Although male students initiated sexual practices earlier than females, females were more likely to have unprotected sex. Females perceived themselves as more likely to avoid unprotected sex in the future and held more favorable attitudes about condoms. The results suggest that stereotypical gender roles and communication barriers place Tijuana female high school students at higher risk for HIV infection than their male peers.
AIDS Education and Prevention 05/2004; 16(2):172-86. · 1.59 Impact Factor
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ABSTRACT: This study examines the individual and environmental correlates of home smoking bans among a population-based sample of Mexican-Americans. Design. A telephone survey on tobacco use and home policies was conducted using stratified, random sampling of listed phone numbers.
Surveys were completed by telephone in San Diego, California.
The sample consisted of San Diego adult residents of Mexican descent (N=1103).
The interview included questions on home rules regarding smoking in the household and a number of potential correlates, based on the Behavioral Ecological Model (BEM). This model emphasizes the influence of family, social, and cultural factors on health behaviors.
Overall, 90.6% of all respondents reported a ban on smoking in the home. Multivariate analyses indicated that home bans on smoking are more likely among individuals that do not smoke, live with children, are more acculturated to U.S. society, report greater aversion to ETS, and/or report more social pressure against indoor smoking. In contrast, smoking bans are less likely among Mexican Americans who live with smokers.
Individual and environmental factors play a protective role by increasing the likelihood of smoking bans in the home of Mexican-descent individuals. These factors should be considered for the design of interventions to sustain and promote the adoption of smoking bans in the home among this and other populations.
American journal of health promotion: AJHP 21(4):229-36. · 2.37 Impact Factor
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ABSTRACT: To examine the extent to which theoretical fidelity, or precision in replicating theory-based recommendations, influenced the effectiveness of two walking programs based on social cognitive theory (SCT).
Two-group randomized controlled trial.
College town in Virginia.
Sixty-one sedentary adult women.
Two 12-week e-mail-based walking programs were compared. The high fidelity program was designed to more precisely follow SCT recommendations for operationalizing mastery procedures than the low fidelity program, which was designed to simulate how mastery procedures were operationalized in most existing SCT-based physical activity programs. Treatment contact and walking prescription were controlled across groups.
The 1-mile walk test of physical fitness and SCT measures were completed at baseline and posttest. Self-reported walking quantity was assessed at baseline, posttest, and 1-year follow-up. Walking logs were completed during the program. Process evaluation measures were completed at posttest.
Fifty women completed the study. The high fidelity group improved more than twice as much as the low fidelity group on 1-mile walk test time (86 vs. 32 seconds, p < .05), goal setting (p < .05), and positive outcome expectations (p < .05) and reported greater program satisfaction (p < .01).
Theoretical fidelity could advance the quality of physical activity interventions, which have often shown small effects.
American journal of health promotion: AJHP 20(2):85-95. · 2.37 Impact Factor
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ABSTRACT: To explore the feasibility of engaging community businesses in human immunodeficiency virus (HIV) prevention.
Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures, both of which were provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-program, and post-program. Customer feedback was obtained through an online survey.
Participants were selected from a San Diego, California neighborhood with a high rate of acquired immune deficiency syndrome.
Fifty-one business owners/managers who represented 10 retail categories, and 52 customers.
Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction, and business owners'/managers' willingness to provide future support for HIV prevention were measured.
Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data.
The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or who refused to participate (41%; p < .05). Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures (p < .05). More than 90% of customers supported distributing condoms and brochures in businesses, and 96% of business owners/managers described their program experience as positive.
Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested.
American journal of health promotion: AJHP 24(5):347-53. · 2.37 Impact Factor
