This study assessed correlates of inconsistent condom use with casual partners and the prevalence of sexual risk behaviors and STIs in the Mexico/Guatemala border region using a sample of 392 migrants (303 men, 85 women) who reported current substance use or problem drinking. We ran separate univariate logistic regression models for men and women, and multivariate logistic regression models for men only. Prevalence of syphilis was 1.2% among women and 2.3% among men; HIV prevalence was 2.4% among women and 1.3% among men. Inconsistent condom use with casual partners was higher in women with greater education and lower among women who sold sex. In men, less access to free condoms, drug use with sexual partners, and drug use before sex were independently associated with inconsistent condom use with casual partners. Sexual and substance use risk behaviors were common, and HIV/STI prevention efforts should target both genders and expand beyond most-at risk populations.

Chagas disease results in the largest burden, in terms of disability-adjusted-life-years, of any parasitic disease in the Americas. Monitoring Chagas disease among migrants is critical to controlling its spread and to serving the needs of the migrant community. Therefore, we determined the prevalence and correlates of Chagas disease in regional and international migrant populations at the Mexico/Guatemala border. Data were collected as part of a larger study of human immunodeficiency virus (HIV) and migration. Participants were a sample of recent regional and international migrants who used an illicit substance or had recent problem drinking. infection was classified as testing positive on two different enzyme-linked immunosorbent assays (ELISAs). Interviewer-administered surveys captured sociodemographics, migration history, Chagas disease knowledge, and access to care. We enrolled 389 recent migrants, and the prevalence of Chagas disease was 3.1%. Only 19% of the participants reported having ever heard of the disease and less than 1% had been previously tested.-positive participants were more likely to have been born in a rural area or town than a city (92% yes versus 59% no, = 0.02) and have recently lived in a house with a makeshift roof (33% yes versus 8% no, < 0.01), walls (42% yes versus 13% no, < 0.01), or floor (50% yes versus 21% no, < 0.02), or cinderblock walls (92% yes versus 63% no, = 0.04). With migration rapidly changing the distribution of Chagas disease, more work needs to be done to create targeted surveillance programs and provide access to affordable treatment among Latin American migrants.

The Mexico-Guatemala border is the site of significant movement of people whose principal destination is the USA. The first step, to cross Mexico, is considered as one of the most dangerous routes in the world for undocumented migrants. For some male migrants and displaced persons from Honduras, El Salvador and Guatemala, initiating sex work in the Mexican border city of Tapachula has become a way to earn money to survive during the trip northward -providing funds to keep traveling and decrease the danger of being killed or kidnaped by organized crime groups. Non-injected drug use during sex work with men and/or women is a common praxis for this purpose, and is linked to HIV risk activities such as unprotected sex. Our study is based on ethnographic fieldwork with observation and interviews and within a relational approach understanding the processes subject/structure, sociopolitical/cultural and global/local, not as oppositions, rather as linkages visible through actors' points of view and praxis. The productions of politics and cultures related to structural vulnerability to HIV infection are embedded in local and global borderization processes where legal and illegal transnational forces, states' frameworks and social groups play a linked role. The economies of structural, symbolic and direct violence affect migratory patterns, institutional interactions and social and cultural relations with the local population. In this context, social representations and praxis about unprotected sex and drug use are the locus of struggling bodies at the border.

El objetivo de este artículo es explorar las estrategias que las personas con VIH (PV) atendidas en el Hospital General de Huixtla (HGH) del estado de Chiapas llevan a cabo para enfrentar el estigma asociado al Virus de Inmunodeficiencia Adquirida (VIH) y al Síndrome de Inmunodeficiencia Humana (sida). Con elementos conceptuales tomados de la teoría de la estructuración, se busca conocer los recursos disponibles y utilizados por PV para hacer frente al estigma. Para el análisis se consideran tres grupos cuyas necesidades y forma de vivir el estigma asociado al VIH/sida se diferencian entre sí: mujeres, hombres homosexuales y hombres heterosexuales. Los resultados demuestran que las PV, a la par que mantienen oculto el diagnóstico, teniendo como recurso social la información relacionada al VIH, reconstruyen la representación del VIH/ sida sin estigma, como estrategia para enfrentar el estigma asociado a dicho padecimiento en la comunidad donde residen.