Deportation History Among HIV-Positive Latinos in Two US–Mexico Border Communities

Abstract

Background Health-related vulnerabilities associated with deportation are understudied. We conducted a cross-sectional study to identify factors associated with history of deportation from the U.S. to Mexico among HIV-positive Latinos. Methods From 2009-2010, we recruited a convenience sample from HIV clinics in San Diego, U.S. and Tijuana, Mexico. Results Of 283 participants, 25% reported a prior deportation. Factors independently associated with increased odds of deportation history were being male (AOR:2.77; 95%CI:1.18-6.48), having ≤high-school education (AOR:3.87;95%CI:1.84-8.14), ever using cocaine (AOR:2.46; 95%CI:1.33-4.57), and reporting personalized HIV-stigma: “some have told me HIV is what I deserve for how I lived” (AOR:2.23; 95%CI:1.14-4.37). Lower self-reported antiretroviral medication adherence (AOR:0.35; 95%CI: 0.12-0.96) and perceiving HIV-stigma: “most people believe a person who has HIV is dirty” (AOR:0.49; 95%CI: 0.25-0.94) were associated with decreased odds of deportation history. Conclusions Deportation is associated with specific socioeconomic indicators that are known to impact the health of individuals living with HIV.

Immigration as a Social Determinant of Health

“…In the United States, heightened immigration enforcement in recent years, including historic levels of deportation, has resulted in negative impacts on health and well-being (2,47,92), making immigration policy a salient issue for public health that requires greater attention. As debates over new immigration policies continue, reforms to the current set of laws need to consider health impacts, especially those on the 11 million undocumented people who live under discriminatory policies, experiencing prejudicial attitudes, and lacking access to critical health resources.…”

“…This focus on the health effects of immigration status fits more squarely with a broad, macrostructural social determinants of health lens. Finally, an important minority of articles discusses the direct impact of legal status, including the health effects of immigration enforcement actions such as detention, deportation, and family separation (47,48,85,92,116,126,131,138). Other articles focus on the stress and other impacts resulting from losing a family member through deportation (2,85,126,131,138).…”

“…For example, most children living in 2.3 million mixed-status families are US citizens by birth. They are directly affected by the undocumented status of their family members; they access health care benefits at a lower rate or receive delayed treatment (49,56), experience greater developmental risk in childhood (12,98,149), and experience higher levels of family conflict and stress (131), including the effects of deportation of individual household members, often parents (2,47,48,92,116,131). In addition, children are often left in the community of origin and experience negative effects of familial separation.…”

“…Doing so is especially important for undocumented people; for example, the vulnerabilities associated with deportation and family separation remain understudied, even though undocumented status is associated with socioeconomic indicators known to affect health. Recent studies have begun to examine the interaction between deportation and well-being, for example on mental health (2), drug use (116), and HIV risk (92). A recent systematic review of the health impact of immigration policies found that the majority of policies focused on the impact on access to health care rather than on specific health outcomes (82).…”

Common Mental Disorders at the Time of Deportation: A Survey at the Mexico–United States Border

“…Among the explanations for the increased prevalence of mental disorders among migrants, as compared to non-migrants, is that migration constitutes a stressful life experience, in which grief combines with difficulties in the adaptation to a new culture and, in many cases, the risk of discrimination and violence [7,8]. On the other hand, the effect of return migration, and particularly deportation, on health has been much less studied [9].…”