BackgroundMigrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico.MethodsWe conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors.ResultsAbout 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded.ConclusionThese findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.

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Background Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. Results Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. Conclusions International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela’s capacity to deal with this crisis, is critical to protecting rights and health in the country and region.

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Migration, detention, and deportation are often rife with violence. This study sought to examine associations among pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants.

The Venezuelan crisis has unleashed multiple forms of sociopolitical violence against its population and created a context of unmet needs, insecurity, and human rights violations. Outward migration caused by this situation has been linked to health emergencies in neighboring countries. Venezuelan migrant and refugee women and girls (VMRWG) are among the most affected. We conducted a cross-sectional qualitative and Participatory Action Research (PAR) project to characterize the risk environments for VMRWG across migration phases, analyzing pre-departure, transit, border crossing, and resettlement risk factors for health and security through semi-structured interviews ( n = 30) and human cartographies ( n = 16). We found cross border risk and protective factors that inform cross-border health initiatives, migration policies, and human rights efforts for both the migrant and host communities. Findings and Recommendations Migratory trajectories of VMRWG from Venezuela to Colombia represent a risk environment for women and girls, connecting cross-border contexts through armed actors’ control, culturally reinforced gender roles and limited social and economic resources. Long-term sustainable migratory policies that are culturally sensitive and include a gender-approach to health should operationalize how gender roles are intimately connected to HIV risk and mental health disparities through reinforced structural factors. Such policies must address these structural factors. The public health system needs to incorporate and align with programmatic efforts implemented by international platforms (United Nations Population Fund (UNFPA), AID4AIDS, and Médecins Sans Frontières (MSF) also known as Doctors Without Borders) targeting screening for infectious diseases (including HIV and mental health disparities) in border crossings and borderlands. Sustainable policies to bridge gaps between services and populations and to decrease growing HIV cases depends on these strategies. Policies and programs of local governments (city and municipality level) addressing mental health disparities need to be expanded through peer leaders and civil society networks of care to guarantee wellbeing and quality of life after resettlement. International efforts and collaborations should capitalize on the re-opening of the border to establish inter-sectoral collaborations with Venezuelan NGOs and civil society organizations on both sides of the border to address gender-based violence, follow-up of cases, and access to services in sending and receiving communities. In order to broach gaps and tackle access barriers in resettlement communities in Colombia, services must be provided in peripheric territories and neighborhoods where some vulnerable migrants resettle. These services must rely on health sector-community collaborations. Public health sector efforts should be integrated and coordinated with family and child services on a local and national level Instituto Colombiano de Bienestar Familiar (ICBF), gender working groups, shelters, and citywide supported initiatives like the House of Women) to provide and promote access to social resources (education, jobs, and housing) for migrant women. Health promotion strategies are necessary to decrease infectious diseases and violence-related trauma among migrants across borders. These strategies can include outreach through peer leaders, civil society organization campaigns, and HIV mobile testing and counselling. These services should be delivered in a culturally sensitive manner, capitalizing on in-place cross-border networks of support. In Colombia, sustainable efforts in policy and programs have been made to provide Venezuelans with access to health care and social services with the help of inter-sectoral working groups, national laws, and border commissions. However, there is an urgent need to expand the humanitarian response and the health sector coverage to gender-based violence impacting infectious disease risk and mental health trauma in host communities. Connecting pre- and post-migration contexts in South-to-South migration is paramount. Tackling these issues can improve the protection of human rights and resettlement conditions in host communities.