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Search Results: 1 - 10 of 375 matches for " Remedios Lozada "
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Cigarette-Smoking Intensity and Interferon-Gamma Release Assay Conversion among Persons Who Inject Drugs: A Cohort Study
Sanghyuk S. Shin,Manuel Gallardo,Remedios Lozada,Daniela Abramovitz
Pulmonary Medicine , 2012, DOI: 10.1155/2012/828106
Abstract:
Cost-Effectiveness of an Intervention to Reduce HIV/STI Incidence and Promote Condom Use among Female Sex Workers in the Mexico–US Border Region
José L. Burgos,Julia A. Gaebler,Steffanie A. Strathdee,Remedios Lozada,Hugo Staines,Thomas L. Patterson
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0011413
Abstract: Previous research demonstrated efficacy of a brief behavioral intervention to reduce incidence of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico, cities on Mexico's border with the US. We assessed this intervention's cost-effectiveness.
Factors associated with drug-related harms related to policing in Tijuana, Mexico
Tyson Volkmann, Remedios Lozada, Christy M Anderson, Thomas L Patterson, Alicia Vera, Steffanie A Strathdee
Harm Reduction Journal , 2011, DOI: 10.1186/1477-7517-8-7
Abstract: IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing).Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug.IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs.A growing body of literature about the risk of HIV (human immunodeficiency virus) and other blood-borne infections among injection drug users (IDUs) has focused on the influence of risk environments that shape individual behaviors [1-4]. These approaches stem from the understanding that IDUs' behaviors are a product of individuals' behaviors and their shared environments [2-4]. Drug users' right t
Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico
Robin A Pollini, Perth C Rosen, Manuel Gallardo, Brenda Robles, Kimberly C Brouwer, Grace E Macalino, Remedios Lozada
Harm Reduction Journal , 2011, DOI: 10.1186/1477-7517-8-13
Abstract: Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency.Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription.IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.Injection drug users (IDUs) are at high risk of infection with HIV, hepatitis C (HCV) and other blood-borne pathogens transmitted by sharing syringes and other injection equipment. Globally, almost 20% of the world's 15.9 million IDUs are infected with HIV [1] and in some studies HCV prevalence among IDUs is >90% [2].Transmission of these pathogens can be prevented by eliminating syringe sharing among IDUs. This requires that sterile syringes be available at appropriate times and in sufficient quantit
Reducing harm from HIV/AIDS misconceptions among female sex workers in Tijuana and Ciudad Juarez, Mexico: A cross sectional analysis
Angela M Robertson, Victoria D Ojeda, Lucie Nguyen, Remedios Lozada, Gustavo A Martínez, Steffanie A Strathdee, Thomas L Patterson
Harm Reduction Journal , 2012, DOI: 10.1186/1477-7517-9-35
Abstract: From 2004–2006, FSWs aged ≥18?years in Tijuana and Ciudad Juarez participated in a behavioral intervention study and completed structured interviews. Measures included HIV knowledge assessment and factors within each domain of our theoretical framework for sex work harms: (1) socio-demographic factors that may lead to sex work, (2) sex work characteristics and behaviors that may lead to harm, and (3) mutually reinforcing harms that lead to sex work and result from it (e.g., drug abuse). Negative binomial regression identified factors independently associated with suboptimal HIV knowledge (i.e., incorrect responses during the HIV knowledge assessment).Among 924 FSWs, the median proportion of incorrect responses was nearly one third (28% incorrect). Examination of item responses revealed misconceptions regarding specific transmission and prevention mechanisms, including prevention of mother to child transmission. Suboptimal HIV knowledge was independently associated with older age, lower education, living in Tijuana (vs. Ciudad Juarez), inconsistent condom use for vaginal sex with male clients, and lacking prior HIV testing.Our application of a sex work harm reduction framework to the study of FSWs’ HIV knowledge is an important first step in enhancing HIV prevention efforts in Northern Mexican border cities. Our findings imply that interventions should identify and discredit local HIV misconceptions to improve knowledge of specific HIV transmission routes and self-protective strategies (e.g., condom negotiation). Interventions will require materials appropriate for women from diverse socio-economic backgrounds and may benefit from innovative harm reduction approaches such as peer education and outreach.Female sex workers (FSWs) face many physical and mental health harms through their occupation, including risk of disease acquisition (e.g., HIV and other sexually transmitted infections; STIs), physical and sexual violence, discrimination, criminalization and exploitat
Prevalence and Characteristics of Abuse Experiences and Depression Symptoms among Injection Drug-Using Female Sex Workers in Mexico
Monica D. Ulibarri,Sarah P. Hiller,Remedios Lozada,M. Gudelia Rangel,Jamila K. Stockman,Jay G. Silverman,Victoria D. Ojeda
Journal of Environmental and Public Health , 2013, DOI: 10.1155/2013/631479
Abstract: This mixed methods study examined the prevalence and characteristics of physical and sexual abuse and depression symptoms among 624 injection drug-using female sex workers (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico; a subset of 47 from Tijuana also underwent qualitative interviews. Linear regressions identified correlates of current depression symptoms. In the interviews, FSW-IDUs identified drug use as a method of coping with the trauma they experienced from abuse that occurred before and after age 18 and during the course of sex work. In a multivariate linear regression model, two factors—ever experiencing forced sex and forced sex in the context of sex work—were significantly associated with higher levels of depression symptoms. Our findings suggest the need for integrated mental health and drug abuse services for FSW-IDUs addressing history of trauma as well as for further research on violence revictimization in the context of sex work in Mexico. 1. Introduction The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life [1].” Examples of gender-based violence include but are not limited to intimate partner violence, sexual violence, sexual abuse of female children, sexual harassment and intimidation in the workplace, and commercial sexual exploitation [2, 3]. Various forms of gender-based violence against female sex workers (FSWs) have been documented worldwide [4–13]. Likewise, there is extensive literature examining the mental health consequences for women in general of gender-based violence [14–18]. However, less research has been done on the relationships between FSWs’ mental health status and gender-based violence, especially among FSWs who inject drugs (FSW-IDUs) in Mexico. Several studies find that many FSWs are enmeshed in chronic patterns of violence victimization and substance use resulting in elevated levels of psychological distress [8, 9, 19–21]. Most of this research has focused on psychological distress rather than on depression symptoms. FSWs’ early exposure to violence, such as childhood sexual abuse, may have long-term mental health consequences. For example, Surratt et al. [20] found that history of childhood abuse and recent violence victimization by clients were associated with serious mental illness among street-based FSWs in Miami, Florida. Cwikel et al. [22] found that
Parsing Social Network Survey Data from Hidden Populations Using Stochastic Context-Free Grammars
Art F. Y. Poon, Kimberly C. Brouwer, Steffanie A. Strathdee, Michelle Firestone-Cruz, Remedios M. Lozada, Sergei L. Kosakovsky Pond, Douglas D. Heckathorn, Simon D. W. Frost
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0006777
Abstract: Background Human populations are structured by social networks, in which individuals tend to form relationships based on shared attributes. Certain attributes that are ambiguous, stigmatized or illegal can create a ?hidden? population, so-called because its members are difficult to identify. Many hidden populations are also at an elevated risk of exposure to infectious diseases. Consequently, public health agencies are presently adopting modern survey techniques that traverse social networks in hidden populations by soliciting individuals to recruit their peers, e.g., respondent-driven sampling (RDS). The concomitant accumulation of network-based epidemiological data, however, is rapidly outpacing the development of computational methods for analysis. Moreover, current analytical models rely on unrealistic assumptions, e.g., that the traversal of social networks can be modeled by a Markov chain rather than a branching process. Methodology/Principal Findings Here, we develop a new methodology based on stochastic context-free grammars (SCFGs), which are well-suited to modeling tree-like structure of the RDS recruitment process. We apply this methodology to an RDS case study of injection drug users (IDUs) in Tijuana, México, a hidden population at high risk of blood-borne and sexually-transmitted infections (i.e., HIV, hepatitis C virus, syphilis). Survey data were encoded as text strings that were parsed using our custom implementation of the inside-outside algorithm in a publicly-available software package (HyPhy), which uses either expectation maximization or direct optimization methods and permits constraints on model parameters for hypothesis testing. We identified significant latent variability in the recruitment process that violates assumptions of Markov chain-based methods for RDS analysis: firstly, IDUs tended to emulate the recruitment behavior of their own recruiter; and secondly, the recruitment of like peers (homophily) was dependent on the number of recruits. Conclusions SCFGs provide a rich probabilistic language that can articulate complex latent structure in survey data derived from the traversal of social networks. Such structure that has no representation in Markov chain-based models can interfere with the estimation of the composition of hidden populations if left unaccounted for, raising critical implications for the prevention and control of infectious disease epidemics.
Social and Structural Factors Associated with HIV Infection among Female Sex Workers Who Inject Drugs in the Mexico-US Border Region
Steffanie A. Strathdee,Remedios Lozada,Gustavo Martinez,Alicia Vera,Melanie Rusch,Lucie Nguyen,Robin A. Pollini,Felipe Uribe-Salas,Leo Beletsky,Thomas L. Patterson
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0019048
Abstract: FSWs who inject drugs (FSW-IDUs) can acquire HIV through high risk sexual and injection behaviors. We studied correlates of HIV infection among FSW-IDUs in northern Mexico, where sex work is quasi-legal and syringes can be legally obtained without a prescription.
A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico
Morgan M Philbin, Remedios Lozada, María Zú?iga, Andrea Mantsios, Patricia Case, Carlos Magis-Rodriguez, Carl A Latkin, Steffanie A Strathdee
Harm Reduction Journal , 2008, DOI: 10.1186/1477-7517-5-36
Abstract: We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes.Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies.Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.Tijuana's rate of illegal drug use is the highest in Mexico, with 14.7% of the city's population reporting a lifetime prevalence of ever having used an illegal drug (including marijuana), three times that of the national average (5.3%) [1]. Tijuana is situated on a major international drug trafficking route, and Mexico is one of the most important producers of heroin and methamphetamine entering the United States [2]. Due in part to its location on major routes for drug trafficking and migration, Tijuana has one of Mexico's fastest growing injection drug using (IDU) populations [3,4]. In 2003, there were an estimated 6,000 active IDUs and 200 shooting galleries in Tijuana, although the actual number of IDUs is likely much larger [5]. W
Mexico's northern border conflict: collateral damage to health and human rights of vulnerable groups
Beletsky,Leo; Martinez,Gustavo; Gaines,Tommi; Nguyen,Lucie; Lozada,Remedios; Rangel,Gudelia; Vera,Alicia; McCauley,Heather L.; Sorensen,Andrea; Strathdee,Steffanie A.;
Revista Panamericana de Salud Pública , 2012, DOI: 10.1590/S1020-49892012000500008
Abstract: objective: 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. methods: 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. results: 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). conclusions: 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.
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