This article assesses the efficacy of the strategy of immigration control implemented by the US government since 1993 in reducing illegal entry attempts, and documents some of the unintended consequences of this strategy, especially a sharp increase in mortality among unauthorized migrants along certain segments of the Mexico–US border. The available data suggest that the current strategy of border enforcement has resulted in rechanneling flows of unauthorized migrants to more hazardous areas, raising fees charged by people‐smugglers, and discouraging unauthorized migrants already in the US from returning to their places of origin. However, there is no evidence that the strategy is deterring or preventing significant numbers of new illegal entries, particularly given the absence of a serious effort to curtail employment of unauthorized migrants through worksite enforcement. An expanded temporary worker program, selective legalization of unauthorized Mexican workers residing in the United States, and other proposals under consideration by the US and Mexican governments are unlikely to reduce migrant deaths resulting from the current strategy of border enforcement.

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HIV prevalence is rising, especially among high risk females in Tijuana, Baja California, a Mexico-US border city situated on major migration and drug trafficking routes. We compared factors associated with HIV infection among male and female injection drug users (IDUs) in Tijuana in an effort to inform HIV prevention and treatment programs. IDUs aged ≥18 years were recruited using respondent-driven sampling and underwent testing for HIV, syphilis and structured interviews. Logistic regression identified correlates of HIV infection, stratified by gender. Among 1056 IDUs, most were Mexican-born but 67% were born outside Tijuana. Reasons for moving to Tijuana included deportation from the US (56% for males, 29% for females), and looking for work/better life (34% for females, 15% for males). HIV prevalence was higher in females versus males (10.2% vs. 3.5%, p = 0.001). Among females (N = 158), factors independently associated with higher HIV prevalence included younger age, lifetime syphilis infection and living in Tijuana for longer durations. Among males (N = 898), factors independently associated with higher HIV prevalence were syphilis titers consistent with active infection, being arrested for having ‘track-marks’, having larger numbers of recent injection partners and living in Tijuana for shorter durations. An interaction between gender and number of years lived in Tijuana regressed on HIV infection was significant (p = 0.03). Upon further analysis, deportation from the U.S. explained the association between shorter duration lived in Tijuana and HIV infection among males; odds of HIV infection were four-fold higher among male injectors deported from the US, compared to other males, adjusting for all other significant correlates (p = 0.002). Geographic mobility has a profound influence on Tijuana's evolving HIV epidemic, and its impact is significantly modified by gender. Future studies are needed to elucidate the context of mobility and HIV acquisition in this region, and whether US immigration policies adversely affect HIV risk.

▪ Abstract  With nearly one in ten residents of advanced industrialized states now an immigrant, international migration has become a fundamental driver of social, economic, and political change. We review alternative models of migratory behavior (which emphasize structural factors largely beyond states' control) as well as models of immigration policy making that seek to explain the gaps between stated policy and actual outcomes. Some scholars attempt to explain the limited efficacy of control policies by focusing on domestic interest groups, political institutions, and the interaction among them; others approach the issue from an international or “intermestic” perspective. Despite the modest effects of control measures on unauthorized flows of economic migrants and asylum seekers, governments continue to determine the proportion of migrants who enjoy legal status, the specific membership rights associated with different legal (and undocumented) migrant classes, and how policies are implemented. These choices have important implications for how the costs and benefits of migration are distributed among different groups of migrants, native-born workers, employers, consumers, and taxpayers.

Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the substance use and deportation experiences of Mexicans deported from the United States. This pilot qualitative study describes illicit drug use behaviors among 24 Mexico-born male injection drug users (IDUs), ≥18 years old, residing in Tijuana, Mexico who self-identified as deportees from the United States. In-person interviews were conducted in Tijuana, Mexico in 2008. Content analysis of interview transcripts identified major themes in participants’ experiences. Few participants had personal or family exposures to illicit drugs prior to their first U.S. migration. Participants reported numerous deportations. Social (i.e., friends/family, post-migration stressors) and environmental factors (e.g., drug availability) were perceived to contribute to substance use initiation in the U.S. Drugs consumed in the United States included marijuana, heroin, cocaine, methamphetamine, and crack. More than half of men were IDUs prior to deportation. Addiction and justice system experiences reportedly contributed to deportation. After deportation, several men injected new drugs, primarily heroin or methamphetamine, or a combination of both drugs. Many men perceived an increase in their substance use after deportation and reported shame and loss of familial social and economic support. Early intervention is needed to stem illicit drug use in Mexican migrant youths. Binational cooperation around migrant health issues is warranted. Migrant-oriented programs may expand components that address mental health and drug use behaviors in an effort to reduce transmission of blood-borne infections. Special considerations are merited for substance users in correctional systems in the United States and Mexico, as well as substance users in United States immigration detention centers. The health status and health behaviors of deportees are likely to impact receiving Mexican communities. Programs that address health, social, and economic issues may aid deportees in resettling in Mexico.