title: "Vivo para consumirla y la consumo para vivir" ["I live to inject and inject to live"]: high-risk injection behaviors in Tijuana, Mexico.
abstract: Injection drug use is a growing problem on the US-Mexico border, where Tijuana is situated. We studied the context of injection drug use among injection drug users (IDUs) in Tijuana to help guide future research and interventions. Guided in-depth interviews were conducted with 10 male and 10 female current IDUs in Tijuana. Topics included types of drug used, injection settings, access to sterile needles, and environmental influences. Interviews were taped, transcribed verbatim, and translated. Content analysis was conducted to identify themes. Of the 20 IDUs, median age and age at first injection were 30 and 18. Most reported injecting at least daily: heroin ("carga", "chiva", "negra"), methamphetamine ("crico", "cri-cri"), or both drugs combined. In sharp contrast to Western US cities, almost all regularly attended shooting galleries ("yongos" or "picaderos") because of the difficulties obtaining syringes and police oppression. Almost all shared needles/paraphernalia ["cuete" (syringe), "cacharros" (cookers), cotton from sweaters/socks (filters)]. Some reported obtaining syringes from the United States. Key themes included (1) pharmacies refusing to sell or charging higher prices to IDUs, (2) ample availability of used/rented syringes from "picaderos" (e.g., charging approximately 5 pesos or "10 drops" of drug), and (3) poor HIV/AIDS knowledge, such as beliefs that exposing syringes to air "kills germs." This qualitative study suggests that IDUs in Tijuana are at high risk of HIV and other blood-borne infections. Interventions are urgently needed to expand access to sterile injection equipment and offset the potential for a widespread HIV epidemic.
authors.affiliation: Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, University of California San Diego School of Medicine, San Diego, CA, USA. sstrathdee@ucsd.edu
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Wendy Davila
authors.initials: WD
authors.lastname: Fraga
authors.forename: Patricia
authors.initials: P
authors.lastname: Case
authors.forename: Michelle
authors.initials: M
authors.lastname: Firestone
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.forename: Saida Gracia
authors.initials: SG
authors.lastname: Perez
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Fraga
mesh_terms: D000293:Adolescent; D000328:Adult; D035841:Behavioral Research; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007391:International Cooperation; D007407:Interviews as Topic; D035846:Law Enforcement; D008297:Male; D008800:Mexico; D008875:Middle Aged; D018671:Needle-Exchange Programs; D010342:Patient Acceptance of Health Care; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology*