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Mexico’s Northern Border Conflict: Collateral Damage to Health and Human Rights of Vulnerable GroupsLeo BeletskyNortheastern University - School of Law; Northeastern University - Bouvé College of Health Sciences Tommi GainesUniversity of California, San Diego – School of Medicine, Division of Global Public Health Lucie NguyenUniversity of California, San Diego (UCSD) - School of Medicine Remedios M. LozadaPatronado Pro-COMUSIDA Gudelia RangelUS-Mexico Border Commission Alicia VeraUniversity of California, San Diego (UCSD) - School of Medicine Heather McCauleyHarvard University - Harvard School of Public Health Andrea SorensenUniversity of California, Los Angeles (UCLA) - School of Public Policy & Social Research Steffanie A. StrathdeeUniversity of California, San Diego – School of Medicine, Division of Global Public Health Gustavo MartinezFederación Mexicana de Asociaciones Privadas (FEMAP) March 6, 2012 Pan American Journal of Public Health/Revista Panamericana de Salud Pública, Vol. 31, No. 5, pp. 403-410, 2012 Northeastern University School of Law Research Paper No. 89-2012 Abstract: Objectives: Given links between policing environment and infectious disease risk among vulnerable groups, we surveyed female sex workers who inject drugs in Tijuana and Ciudad (Cd.) Juarez. Data were used to 1. compare distributions of human rights violations and disease risk, 2. juxtapose these patterns against demographic and structural environment variables, and 3. formulate implications for structural interventions. Methods: Structured interviews and testing for sexually-transmitted infections (STIs) were conducted (October 2008-October 2009). Frequency of individual and environmental factors, including police abuse, HIV risk and protective behaviors were compared between sites using univariate logistic regression. Results: Of 624 women, almost half reported police syringe confiscation despite syringes being legal and 55.6% reported extortion (last 6 months), with significantly-higher proportions in Cd. Juarez (p< 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana, 36.5% in Cd. Juarez, p=0.04) and sexual abuse were commonplace (15.7% v 18.3%). Significantly lower prevalence of STIs in Tijuana (64.2% v 83.4%, p< 0.001) paralleled lower prevalence of sexual risk behaviors there. Cd. Juarez respondents reported significantly-higher median client loads (1.5 v 6.9, p< 0.001) and lower median pay per sex act (US$20 v US$10, p< 0.001) (last month). Relative to Tijuana, security deployment was perceived to increase more in Cd. Juarez (last year), especially army presence (59.2% v 72.1%, p=0.001). Conclusions: Collateral damage from police practices in the context of Mexico’s drug conflict may impact public health in the Northern Border Region. Itinerant officers may facilitate disease spread beyond the Region. The urgency for mounting structural interventions is discussed.
Number of Pages in PDF File: 16 Keywords: Female sex workers, injection drug users, conflict, structural environment, gender violence, HIV, infectious disease Accepted Paper SeriesDate posted: March 10, 2012 ; Last revised: November 13, 2012Suggested CitationContact Information
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