Description
Objective: The prevalence of injection drug use in Tijuana, Baja California, Mexico is one of the highest in Mexico. The objective of this study was to identify correlates of perceived HIV risk among injection drugs users (IDUs) in Tijuana. Methods: IDUs ≥ 18 years of age who had injected drugs in the past six months were recruited using respondent driven sampling (RDS) from 2006-2007 and underwent interviews and testing for HIV, syphilis and tuberculosis. Univariable and multivariable logistic regression with RDS adjustment was used to determine correlates of perceived HIV risk. Results: Of 1015 IDUs, 54.6% perceived themselves to be more likely to become HIV-infected relative to other IDUs in Tijuana, whereas 45.4% perceived themselves to be as likely or less likely to become HIV-infected. Factors independently associated with high perceived risk of HIV infection included: having health insurance (OR = 3.63, 95% CI: 1.83, 7.17), being homeless (OR = 2.45, 95% CI: 1.26,4.76), ever being deported from the US (OR = 2.38, 95% CI: 1.49, 3.82), using a syringe to divide drugs at least half the time (OR = 6.30, 95% CI: 2.12, 18.66), never or only sometimes using a new/sterile syringe to inject drugs (OR = 2.47, 95% CI: 1.61, 3.81), injecting drugs ≥4 days a week (OR = 2.14, 95% CI: 1.20, 3.80), not having sex in the past six months (OR = 3.41, 95% CI: 1.91, 6.09), never having had a prior HIV test (OR = 2.56, 95% CI: 1.60, 4.10), receiving something in exchange for sex in the past six months (OR = 2.31, 95% CI: 1.08, 4.96), and ever having had sex with an HIV-positive person (OR = 8.59, 95% CI: 3.13, 23.55). Conclusions: Findings suggest that the majority of IDUs in Tijuana recognize that they are at risk of HIV infection, and this recognition is associated with both high-risk behaviors and markers of vulnerability such as homelessness and deportation from the United States. The findings support efforts to encourage those who recognize their risk to adopt healthier behaviors. Such efforts should include the promotion of HIV testing and access to health care for this highly vulnerable population, coupled with free access to sterile syringes and drug abuse treatment which have been shown to reduce the risk of blood-borne infections.
