Pandillas y salud: Correlates of gang membership among injection drug users (IDUs) in Tijuana, Mexico

Introduction:Gang membership (GM) is associated with drug use, infections and mortality. We examined correlates of gang membership among IDUs in Tijuana. Methods:We used respondent-driven sampling to recruit IDUs who injected in the last month. Participants underwent interviewer-administered interviews and testing for HIV, syphilis and TB. Weighted logistic regression identified correlates of GM. Results:Of 639 IDUs, 28% reported a history of GM. GM were younger than non-gang members (NGM) (35 vs. 38 years, p<.001) but otherwise demographically similar. GM were more likely to be younger at first injection (median:18 vs. 20 years, p<.001), inject methamphetamine (MA) (42% vs. 30%, p<.004), never clean used syringes (5% vs. 2%, p<.04), and less likely to inject cocaine (78% vs. 85%, p< .03). GM were more likely to report sexual debut before age 13 (34% vs. 26%, p<.05); however, condom use was similar for GM and NGM and no significant differences emerged in prevalence of HIV (4.5%) and active syphilis (6.8%). GM were more likely to have been incarcerated (96% vs. 89%, p<.005) and to have crossed the U.S. border in the last year (9.9% vs. 5.6%, p<.05). In weighted logistic regression analysis, incarceration (AdjOR 2.6; 95% CI:1.21–5.44), injecting MA (AdjOR 1.4; 95% CI:1.01–2.04) and sexual debut before age 13 (AdjOR 1.1;95% CI:1.00–1.15) were independently associated with gang membership.Conclusions:Risk behavior patterns vary among IDUs with histories of gang membership. Better understanding of associations between gang membership and drug- and sex-related risk behaviors could improve public health interventions.