title: Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico.
abstract: OBJECTIVE
  We examined correlates of HIV infection among injection drug users (IDUs) in Tijuana, Mexico, a city bordering the United States, which is situated on major migration and drug trafficking routes.
  
  
  METHODS
  IDUs aged > or =18 years were recruited using respondent-driven sampling. Participants underwent antibody testing for HIV and syphilis and structured interviews. Weighted logistic regression identified correlates of HIV infection.
  
  
  RESULTS
  Of 1056 IDUs, the median age was 37 years, 86% were male, and 76% were migrants. HIV prevalence was higher in female participants than in male participants (8% vs. 3%; P = 0.01). Most IDUs testing HIV-positive were previously unaware of their serostatus (93%). IDUs reported injecting with a median of 2 people in the prior 6 months and had been arrested for having injection stigmata (ie, "track-marks") a median of 3 times. Factors independently associated with HIV infection were being female, syphilis titers consistent with active infection, larger numbers of recent injection partners, living in Tijuana for a shorter duration, and being arrested for having track-marks.
  
  
  CONCLUSIONS
  Individual, social, and environmental factors were independently associated with HIV infection among IDUs in Tijuana. These findings suggest the need to intervene not solely on individual risk behaviors but on social processes that drive these behaviors, including problematic policing practices.
authors.affiliation: Division of International Health and Cross Cultural Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA. sstrathdee@ucsd.edu
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Remedios
authors.initials: R
authors.lastname: Lozada
authors.forename: Robin A
authors.initials: RA
authors.lastname: Pollini
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.forename: Andrea
authors.initials: A
authors.lastname: Mantsios
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Abramovitz
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
authors.forename: Oralia
authors.initials: O
authors.lastname: Loza
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvelais
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis-Rodriguez
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
mesh_terms: D000328:Adult; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000453:epidemiology*
chemical_list: D015483:HIV Antibodies