188154 Established vs. new migrant status as a correlate of sexually transmitted infections and HIV risk behaviors among female sex workers in Tijuana, Mexico

Monday, October 27, 2008: 1:35 PM

Steven R. Machlin, MS , Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD
Victoria D. Ojeda, PhD, MPH , Department of Medicine, University of California, San Diego, La Jolla, CA
Steffanie Strathdee, PhD , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Maria Remedios Lozada, Dra , Patronato Pro-COMUSIDA, Tijuana, Mexico
Miguel Fraga, MD , Escuela de Medicina, University of California, Tijuana, CA, Mexico
Prisci Orozovich, MPH , Refugee Health Program, California Department of Public Health, Sacramento, CA
Carlos Magis-Rodriguez, MD, MPH , Secretaría de Salud, Centro Nacional para la Prevención del VIH/SIDA, Anzures, Mexico D.F., Mexico
Adela De la Torre, PhD , Center for Public Policy, Race, Ethnicity & Gender, University of California Davis, Davis, CA
Hortensia Amaro, PhD , Institute on Urban Health Research, Northeastern University, Boston, MA
Thomas Patterson, PhD , Dept of Psychiatry, University of California, La Jolla, CA
     
Objective: We examined associations between migrant status, HIV/STI prevalence and risky sexual and drug-using behaviors among Mexican female sex workers (FSWs) in Tijuana, Baja California (BC) among whom HIV prevalence is increasing.

Methods: FSWs aged >=18 years without known HIV infection living in Tijuana reporting recent unprotected sex with clients underwent interviewer-administered surveys and testing for HIV, syphilis, gonorrhea, and Chlamydia. Logistic regression was used to assess the relationship between migration, HIV/STIs and use of drugs and condoms.

Results: Of 471 FSWs, 78% were migrants born outside BC. Among migrant FSWs, prevalence of HIV, syphilis titers ≥1:8, gonorrhea, Chlamydia, and any STI was 7%, 27%, 8%, 16%, and 43% vs. 11%, 42%, 13%, 19%, and 58% among BC-born FSWs. Prevalence of syphilis and any STI was lower in migrants (p<0.01). Migrants reported lower current methamphetamine (p=0.001), marijuana (p=0.03), heroin (p<0.001), and speedball (p=0.01) use than BC-born FSWs. In regression analyses, new migrants to Tijuana (<=5yrs) had lower odds of HIV (AdjOR:0.20, p=0.02), syphilis (AdjOR:0.30, p=0.001), and any STI (AdjOR:0.45, p=0.008) than BC-born FSWs. Condom use during vaginal sex was greater among new migrants (AdjOR:1.93, p=0.02), whereas HIV/STI prevalence and condom use was similar to BC-born FSWs.

Conclusions: Recent migrant FSWs in Tijuana exhibit protective condom use behaviors, possibly contributing to lower HIV/STI prevalence. Established migrant status is associated with drug use, less condom use and greater vulnerability to STIs. Further study is needed to identify and promote protective factors that become outweighed by risk factors among female migrant FSWs.

Learning Objectives:
1. Session participants will be able to identify migration-related constructs applicable to the study of sexually transmitted infections. 2. Session participants will be able to identify significant correlates of sexually transmitted infections in female sex workers. 3. Session participants will be able to describe the risk environment for sexually transmitted infections within a U.S.-Mexico border context.

Presenting author's disclosure statement:

Not Answered

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Yes, I am qualified because I am the PI of the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Public Health Implications of Emerging Trends in Drug Use on the US-Mexico Border
See more of: Epidemiology