"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

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

“…These findings corroborate observations from our earlier in-depth interviews with IDUs in Mexico [14,17], as well as a growing body of literature that suggests policing practices in many international settings-the United States, Russia, Australia, Canada and now Mexico-have an adverse effect on the ability of IDUs to practice safe injecting behaviors [1,[10][11][12]15,16,20,21,28].…”

“…Studies from the United States and elsewhere show that police pressure is associated with use of shooting galleries, where drugs can be injected beyond view of police but syringe sharing is commonplace [13,16,30]. Similarly, in earlier qualitative interviews [14,17] in Tijuana and Ciudad Juarez, IDUs described attempting to reduce their risk of arrest by obtaining syringes at the location where they purchase and inject their drugs. This suggests that the relationship between arrest and syringe sharing documented in this study indicates a direct relationship between police practices and risky injection practices.…”

“…Overall, 92% were male and 99% considered themselves Hispanic or Latino. Median age was 34 years [interquartile range (IQR): [28][29][30][31][32][33][34][35][36][37][38][39][40] and median time since first injection was 12.5 years (IQR: [8][9][10][11][12][13][14][15][16][17][18][19].…”

“…Fears of police detection also lead to hurried injection, particularly in public places, resulting in sharing of syringes and other injection paraphernalia [10][11][12]14,15]. Further, there is evidence that aggressive policing practices lead to higher utilization of shooting galleries, where drugs can be used hidden from public view and previously used injection equipment is obtained readily [13,16,17].…”

“…In qualitative studies conducted in the two Mexico-US border cities of Tijuana, Baja California and Ciudad Juarez, Chihuahua (located across the border from San Diego, California, and El Paso, Texas/Las Cruces, New Mexico, respectively), IDUs voiced reluctance to carry syringes due to fear of police harassment, detainment and arrest [14,17]-despite the fact that syringes can be purchased legally and possessed without a prescription in Mexico. In the present study, we conducted subsequent cross-sectional studies in those two cities that investigated factors associated with receptive syringe sharing among IDUs.…”