Department of Medicine, University of California, San Diego, School of Medicine, La Jolla, California, USA.
Rev Panam Salud Publica. 2012 May;31(5):403-10. doi: 10.1590/s1020-49892012000500008.
To compare distributions of human rights violations and disease risk; to juxtapose these patterns against demographic and structural environmental variables, and to formulate implications for structural interventions.
Female sex workers who inject drugs were surveyed in Tijuana and Ciudad Juarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs) were conducted (October 2008 to October 2009). Frequencies of individual and environmental factors, including police abuse, risk of HIV infection, and protective behaviors, were compared between sites using univariate logistic regression.
Of 624 women, almost half reported police syringe confiscation despite syringes being legal; 55.6% reported extortion (past 6 months), with significantly higher proportions in Ciudad Juarez (P < 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana, 36.5% in Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in Ciudad Juarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuana than in Ciudad Juarez (64.2% and 83.4%, P < 0.001), paralleling the lower prevalence of sexual risk behaviors there. Ciudad Juarez respondents reported significantly higher median number of monthly clients (6.8 versus 1.5, P < 0.001) and lower median pay per sex act (US$ 10 versus US$ 20, P < 0.001) (in the past month). Relative to Tijuana, security deployment, especially the army's presence, was perceived to have increased more in Ciudad Juarez in the past year (72.1% versus 59.2%, P = 0.001).
Collateral damage from police practices in the context of Mexico's drug conflict may affect public health in the Northern Border Region. Itinerant officers may facilitate disease spread beyond the region. The urgency for mounting structural interventions is discussed.
比较侵犯人权和疾病风险的分布；将这些模式与人口和结构环境变量并列，并为结构干预制定影响。
对墨西哥提华纳和华雷斯城的注射吸毒女性性工作者进行了调查。进行了结构访谈和性传播感染（STI）检测（2008 年 10 月至 2009 年 10 月）。使用单变量逻辑回归比较了个体和环境因素（包括警察滥用、艾滋病毒感染风险和保护行为）在两个地点的频率。
在 624 名女性中，近一半人报告说尽管注射器合法，但警察仍没收了注射器；55.6%的人报告说有敲诈勒索行为（过去 6 个月），华雷斯城的比例明显更高（P < 0.001）。报告称最近有警察索要性好处（提华纳为 28.5%，华雷斯城为 36.5%，P = 0.04）和性虐待（提华纳为 15.7%，华雷斯城为 18.3%）的情况很常见。提华纳的 STI 患病率明显低于华雷斯城（分别为 64.2%和 83.4%，P < 0.001），这与那里性风险行为的低患病率相一致。华雷斯城的受访者报告称，每月客户数量中位数明显更高（6.8 与 1.5，P < 0.001），性行为的中位数报酬更低（10 美元与 20 美元，P < 0.001）（过去一个月）。与提华纳相比，过去一年中，人们认为安全部署，特别是军队的存在，在华雷斯城增加了更多（72.1%与 59.2%，P = 0.001）。
在墨西哥毒品冲突的背景下，警察行为的附带损害可能会影响北部边境地区的公共卫生。流动警察可能会促使疾病传播到该地区以外。讨论了迫切需要进行结构干预的问题。
