Health-damaging policing practices among persons who inject drugs in Mexico: Are deported migrants at greater risk?

Abstract

Background Evidence-based public health and criminal justice policies aimed at addressing the structurally vulnerable population of persons who inject drugs (PWID) and who are involved in the immigrant enforcement and deportation system are lacking. Policing practices are critical structural determinants of HIV among PWID and PWID in Mexico who have been deported from the US are at elevated risk of HIV. Methods From 2011–2013, 733 PWID were recruited to complete structured questionnaires, including past 6-month experiences with police. Eligible PWID were 18 years or older, had injected in the past month, and resided in Tijuana, Mexico with no intentions of moving. To determine if deportation status was associated with experiences of arrests and problematic policing practices, we conducted separate multivariate logistic regression models for independent policing variable. Results In multivariate analyses, deportation status was independently associated with higher odds of being arrested (Adjusted Odds Ratio (AOR): 1.45; 95% Confidence Interval (CI): 1.02–2.05), being asked for a bribe (AOR: 1.39; 95% CI: 1.05–2.04), and being forced to leave a place of residence (AOR: 2.00; 95% CI: 1.08–3.70) in the past 6 months. Conclusion Results highlight a previously poorly understood element of the US-deportation experience: migrants’ experiences with law enforcement post-deportation and the role of deportation policies and practices as structural drivers of public health risk in destination countries. We provide policy recommendations for Mexico and the US based on our findings, which have potential application in other countries seeking to improve enforcement and related policing practices from a public health perspective.

Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings

“…For example, in Vancouver, a well-established community of people who inject drugs is largely located in one geographic area (the Downtown Eastside neighbourhood) [46]. In contrast, Tijuana is characterised by high cross-border migration [47,48] and deportation in particular [49], along with high intraurban mobility and police intervention [50], which is disruptive to the formation and maintenance of social networks and may therefore impede the ability of people who inject drugs to develop and maintain lasting social networks, within which injection initiation assistance could occur [51,52].…”