Division of Global Public Health, University of California San Diego, San Diego, USA.
Department of Public Health, San Diego State University, San Diego, USA.
Drug Alcohol Rev. 2018 Apr;37 Suppl 1(Suppl 1):S277-S284. doi: 10.1111/dar.12630. Epub 2017 Nov 22.
Efforts to prevent injection drug use (IDU) are increasingly focusing on the role that people who inject drugs (PWID) play in facilitating the entry of others into this behaviour. This is particularly relevant in settings experiencing high levels of IDU, such as Mexico's northern border region, where cross-border migration, particularly through forced deportation, has been found to increase a range of health and social harms related to injecting.
PWID enrolled in a prospective cohort study in Tijuana, Mexico, since 2011 were interviewed semi-annually, which solicited responses on their experiences initiating others into injecting. Univariate and multivariable logistic regression analyses were conducted at the Preventing Injection by Modifying Existing Responses (PRIMER) baseline, with the dependent variable defined as reporting ever initiating others into injection. The primary independent variable was lifetime deportation from the USA to Mexico.
Among 532 participants, 14% (n = 76) reported initiating others into injecting, the majority of participants reporting initiating acquaintances (74%, n = 56). In multivariable analyses, initiating others into injecting was independently associated with reporting living in the USA for 1-5 years [adjusted odds ratio (AOR) = 2.42; 95% confidence interval (CI) 1.22-4.79, P = 0.01], and methamphetamine and heroin injection combined (AOR = 3.67; 95% CI 1.11-12.17, P = 0.03). Deportation was not independently associated with initiating others into injecting.
The impact of migration needs to be considered within binational programming seeking to prevent the expansion of epidemics of injecting and HIV transmission among mobile populations residing in the Mexico-USA border region.
预防注射吸毒（IDU）的努力越来越关注吸毒者（PWID）在促使他人进入这种行为方面所起的作用。在墨西哥北部边境等经历高水平 IDU 的地区，这种情况尤其相关，在这些地区，跨境移民，特别是通过强制驱逐出境，被发现会增加与注射相关的一系列健康和社会危害。
自 2011 年以来，在墨西哥蒂华纳参加一项前瞻性队列研究的 PWID 每半年接受一次采访，征求他们在诱导他人注射方面的经验。在预防注射通过修改现有反应（PRIMER）基线时，对单变量和多变量逻辑回归分析进行了分析，因变量定义为报告曾经诱导他人注射。主要的独立变量是一生中从美国被驱逐到墨西哥。
在 532 名参与者中，14%（n=76）报告说曾经诱导他人注射，大多数参与者报告说诱导熟人（74%，n=56）。在多变量分析中，诱导他人注射与报告在美国生活 1-5 年（调整后的优势比（AOR）=2.42；95%置信区间（CI）1.22-4.79，P=0.01）和海洛因与冰毒混合注射（AOR=3.67；95%CI 1.11-12.17，P=0.03）独立相关。被驱逐出境与诱导他人注射无关。
需要在寻求预防在居住在墨西哥-美国边境地区的流动人口中扩大注射和 HIV 传播的跨国方案中考虑移民的影响。
