Acculturative trajectories descriptions and implications for health among 12 Mexican deported women who inject drugs

Abstract

Introduction. Between 1999-2007, the U.S. deported 4.8 million migrants to Mexico; of these, 1.1 million migrants were deported to the border city of Tijuana, Baja California. Deportees are often returned to unfamiliar communities where they may experience emotional and socioeconomic stressors that may raise their risk for engaging in unsafe behaviors. Objective. This exploratory study describes adaptation to the post-deportation environment among Mexican-born injection drug-using women. Method. In 2008, we conducted qualitative interviews in Tijuana with 12 women reporting U.S. deportation. Our analytic framework focused on acculturation stress, adaptation and social capital in relation to HIV risk, considering a gender perspective. Results. We found that the stress caused by the deportation experience and acclimating to the post-deportation community may have contributed to the women’s participation in high-risk HIV behaviors (e.g., unprotected sex, sex work). Female deportees reported limited access to post-deportation social capital resources (e.g., social support, healthy social networks). Social factors (e.g., discrimination, lack of a government identification) challenged women’s resettlement and likely contributed to economic and health vulnerabilities. Discussion and conclusion. These preliminary findings suggest that deportees may benefit from organized services at repatriation, including mental health screening. Macro-level interventions that address stigma and facilitate deportees’ economic integration may help stem engagement in risk behaviors.

The paradox of choice in the sexual and reproductive health and rights challenges of south-south migrant girls and women in Central America and Mexico: A scoping review of the literature

“…(2020) Quantitative Mexico-Guatemala border region 226 female sex worker using illicit substances aged 18 years and older, compares international migrants to internal migrants and local residents Explore the association of international migration with substance use and HIV/STI risk factors among female sex workers 14 Rangel et al. (2012) Quantitative Mexico northern border 51 females of 693 total respondent deportees, age range unspecified Estimate levels of HIV infection and behavioral risk factors among deported migrants 15 Rodriguez-Montejano et al. (2015) Qualitative Mexico northern border 12 female deportees with injection drug use aged 29–53 years Describes adaptation to the post-deportation environment among Mexican-born injection drug-using women 16 Kendall and Pelcastre (2010) Qualitative Mexico central region 26 female internal migrant factory workers, aged 15–49 years Explore perceptions of HIV and condom use among Mexican migrant female factory workers 17 Leyva-Flores et al.…”

“…There were 20 that looked at issues of sexually transmitted infections and other diseases of the genitourinary system. Only one paper also mentioned issues possibly indicative of psychosexual dysfunction and another mentioned cancers ( Acharya, 2010 ; Camarena Ojinaga et al., 2017 ), while 9 studies included mental and emotional health ( Medecins Sans Frontieres, 2017 ; Morris et al., 2013 ; Rodriguez-Montejano et al., 2015 ; Goldenberg et al., 2018 ; Medecins Sans Frontieres, 2020 ; Cardenas-Rodriguez and Vázquez Delgado, 2014 ; Acharya, 2019 ; Stephen, 2019 ; Wang et al., 2019 ). To be more specific, the study of risk factors, prevention interventions and detection of prevalence of sexually transmitted infections (often HIV) dominated, with only rare mention of other genitourinary problems such as urinary tract infections, abnormal vaginal discharge and other issues of gynecological illness and pain ( Acharya, 2010 ; Serván-Mori et al., 2013 ; Medecins Sans Frontieres, 2017 ).…”

“…In the studies, migration was generally associated with a higher incidence of sexually transmitted infections insofar as it was linked to risk behaviors such as unprotected and nonconsensual sex, multiple successive or concurrent sexual partners, sex work and drug use ( Camarena Ojinaga et al., 2017 ; Medecins Sans Frontieres, 2017 ; Goldenberg et al., 2012 ; Gandhi et al., 2015 ; Conners et al., 2017 ; Ojeda et al., 2012 ; Morris et al., 2013 ; Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 , Rocha-Jiménez et al., 2020 ; Pintin-Perez et al., 2018 ; Rangel et al., 2012 ; Rodriguez-Montejano et al., 2015 ; Kendall and Pelcastre, 2010 ). Adolescents and women in the early stages of their arrival who engaged in sex work were particularly vulnerable because of their limited knowledge of sexually transmitted infections and prevention measures ( Gandhi et al., 2015 ; Leyva-Flores et al., 2013 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ).…”

“…As such, they would forgo testing in some instances ( Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 ; Febres-Cordero et al., 2018 ). Coping with loneliness and isolation contributed to risk behaviors for infection, such as drug use, or multiple and concurrent sexual partnerships ( Rodriguez-Montejano et al., 2015 ). However, there was limited evidence as to how sexual health affected migratory decisions or trajectories.…”

“…For example, intimate partner and gender-based violence as well as nonconsensual sexual relations violate the right of bodily integrity and the ability to choose whether to be sexually active or not. If taken together, 30 articles touched on issues rooted in these varied aspects of bodily integrity and sexual relations (components four through seven) ( Acharya, 2010 ; Medecins Sans Frontieres, 2017 ; Goldenberg et al., 2012 ; Gandhi et al., 2015 ; Conners et al., 2017 ; Ojeda et al., 2012 ; Morris et al., 2013 ; Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 ; Pintin-Perez et al., 2018 ; Rocha-Jiménez et al., 2020; Rangel et al., 2012 ; Rodriguez-Montejano et al., 2015 ; Kendall and Pelcastre, 2010 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ; Servin et al., 2018 ; Medecins Sans Frontieres, 2020 ; Cardenas-Rodriguez and Vázquez Delgado, 2014 ; Acharya, 2019 ; Stephen, 2019 ; Wang et al., 2019 ; Zarco-Ortiz, 2018 ; Estrada-Tanck, 2017 ; Gustafsson, 2018 ; Angulo-Pasel, 2018 ; Rocha-Jimenez et al., 2016 ; Lopez et al., 2015 ). A total of 19 articles described aspects of access to sexual health services – largely for testing for sexually transmitted infections ( Acharya, 2010 ; Camarena Ojinaga et al., 2017 ; Serván-Mori et al., 2013 ; Medecins Sans Frontieres, 2017 ; Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 ; Pintin-Perez et al., 2018 ; Rangel et al., 2012 ; Rodriguez-Montejano et al., 2015 ; Leyva-Flores et al., 2013 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ; Servin et al., 2018 ; Medecins Sans Frontieres, 2020…”