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Official websites use. Share sensitive information only on official, secure websites. Strathdee, Ph. We identified prevalence and correlates of HDSS use among injection drug users IDU in Tijuana, Mexico, where syringe purchase and possession is legal without a prescription. Beginning in , IDU who reported being 18 years or older, who injected drugs within the last month were recruited into a prospective study. Logistic regression was used to identify correlates of using HDSS. Efforts are needed to expand coverage of low-dead space syringes through existing syringe exchange programs. In Tijuana, besides the direct drug-related characteristics of both substance use and trafficking previously mentioned, there are demographic, social and political factors that contribute to an environment that heightens the risk of blood-borne infections for IDU. In there were 1,, registered people living in Tijuana, the fifth largest city in the country and the largest in the state of Baja California. The Tijuana-San Diego region is the busiest land border crossing in the world, with as many as , individuals crossing between the cities daily. Another factor that may increase the risk of blood-borne infections among IDU is the type of syringe that individuals use. As previously reported, 15 recruitment was conducted through targeted sampling, which consisted of street-based outreach in ten neighborhoods across Tijuana. The inclusion criteria included being 18 years or older, injecting drugs within the last month, being able to speak English or Spanish, currently living in Tijuana with no plans to move outside Tijuana over the next 24 months, and not currently participating in an intervention study. For this analysis, the sample was comprised by IDU that had completed the baseline and second visit and who answered questions about use of HDSS. The interviewer-administered surveys solicited data on sociodemographic, behavioral and contextual factors, including lifetime and 6-month drug use, and behaviors related to drug use such as needle and drug paraphernalia sharing, the type of syringe used, and other health conditions. Frequencies and medians were compared between those who ever used HDSS to those that did not. Univariate and multivariate logistic regressions were conducted to identify lifetime and past 6-months factors associated with HDSS use. For the final model, we tested for multicollinearity through a correlation matrix and a Wald test. Lack of access because of the late hour or because they could not afford to buy a new syringe was reported by 2. Using an HDSS to avoid injecting with a syringe used by someone else was reported by 0. In relation to frequency of injection, This difference was not significant. Both groups were predominantly male with Positive HIV status was reported by 2. Median age, years of injection drug use, monthly income, and HIV status were not significantly different. Descriptive statistics of high dead space syringe use HDSS. In both groups, most of the IDU used heroin the first time they injected drugs Cocaine was the second most common drug of initiation for 3. The age at first cocaine injection was 20 years for both groups, The median lifetime overdoses was one for both groups. Asking for help injecting was reported by None of these differences were significant. Although it is legal to carry syringes in Tijuana, only History of deportation from the US was reported by With respect to risky drug-related behaviors in the past 6 months, Distributive and receptive syringe sharing at least half the time were reported by more than one-third of participants in both groups, as was sharing the same dose with someone else. That is, almost all of those who engaged in syringe sharing have done so in a receptive behavior. Buying syringes that were preloaded with already prepared drug for at least half of injections was reported by only 5. Overall Reporting difficulty avoiding receptive needle sharing and other sharing injection equipment ranged between None of the past 6-month behaviors differed significantly across groups. In the univariate analyses, being male, having ever been stopped or arrested by the police, using cocaine as first drug injected, believing that in Tijuana it is illegal to carry syringes, a longer injection drug use trajectory per 10 year increase , being deported to Tijuana, earlier onset of first heroin injection per 10 year increase , and earlier year of first injection per 10 year increase were all significantly associated with an increased odds of HDSS use. There was collinearity between years injecting, age at first heroin injection and absolute year of first injection. That is, most of PWID used heroin at first injection. For this, we tested each of these variables in different multivariate models. The best fitting model included age at first heroin injection. Surprisingly, few drug-related behaviors were independently associated with use of HDSS; rather, social and structural factors predominated as correlates of HDSS use. IDU who reported ever being arrested by police were nearly twice as likely to report HDSS use, compared to those who had never been arrested. Our findings are consistent with previous evidence of the relationship between policing practices such as arrests and high-risk injection behaviors such as needle sharing in Tijuana and elsewhere. A closer collaboration between public health programs and policing strategies may also reduce the likelihood of engaging in risk behaviors. Those who were deported from the US were 1. The vulnerable condition and increased risk of Mexican IDU repatriated to Tijuana in relation to HIV and other health and behavioral conditions has previously been reported. In a qualitative study, IDU in Tijuana reported difficulties when trying to buy syringes at pharmacies. This conclusion is supported by prior findings of criminalization of syringe possession, which found that this is a risk factor for blood-borne infection among IDU. As such, this population is likely to benefit from interventions that can provide information on strategies to minimize behaviors such as use of HDSS that may heighten the risk of blood borne disease transmission, as well as information on the legality of carrying sterile syringes in Tijuana. Tijuana is one of the few cities with harm reduction programs in Mexico. Increasing the numbers of LDSS distributed, extending operating hours, and implementing educational programs may all improve the service provided by SEP. This study has several limitations. First, the cross-sectional design does not allow causal inferences. Second, there is no information regarding hepatitis C status and there is no statistical power to analyze the relationship between HIV status and HDSS use. Third, because of lack of statistical power it was not possible to analyze past-month HDSS use and hence, it may be that our findings do not represent present injection practices, which may imply that HDSS were used in other conditions such as prior to deportation. Overall, our findings suggest the need for a more extensive harm reduction program that expands the coverage of SEP, as well as education programs highlighting the increased risks associated with HDSS as well as the legal status of syringe possession in Mexico. Considering the geographic location of the study site, any effort to improve the health conditions of IDU in Tijuana may have an impact on international migrant health. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper. As a library, NLM provides access to scientific literature. Am J Drug Alcohol Abuse. Find articles by Claudia Rafful. William Zule , Dr. Find articles by William Zule. Dan Werb , Ph. Find articles by Dan Werb. Carlos Magis-Rodriguez , M. Find articles by Carlos Magis-Rodriguez. Steffanie A Strathdee , Ph. Find articles by Steffanie A Strathdee. Issue date May. PMC Copyright notice. Open in a new tab. Univariate and multivariate analysis of HDSS use. Declaration of interest The authors report no conflicts of interest. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Perception of legal status of carrying new syringes in. Cannot avoid receptive needle sharing with someone sick. Cannot avoid receptive needle sharing from a sex partner. Age at first heroin injection per 10 year increase. Perception of legal status of carrying new syringes in Tijuana.

Continued Street Drug Sales in Tijuana Puts Users at Risk of Coronavirus

Tijuana buy cocaine

A coronavirus outbreak in the Mexico border city of Tijuana has not stymied street-level heroin and methamphetamine sales, putting its large population of drug users at high risk of contracting and spreading the disease. Tijuana, which has recorded more than 2, positive cases and over deaths from the coronavirus, is a hotspot for drug consumption, with about 10, intravenous drug users. The city is also in the grips of a methamphetamine crisis. Between June and August , police stopped an average of people a month for drug possession, according to an investigation by Tijuanapress. Killings in the city have soared in recent years. In , the city recorded nearly 2, homicides, making it one of the most dangerous in Mexico. Though reminiscent of the carnage in the late s when cartels warred for drug smuggling routes, the bloodshed in Tijuana now is largely spurred by gangs battling it out for corner drug hotspots. While street drug prices have increased in the United States because of coronavirus lockdowns, the opposite has happened in Tijuana, where drug gangs have maintained or even lowered their prices to keep business running. He added that the informal jobs drug users relied upon — such as washing cars, cleaning tables and collecting recycling — have dried up with the lockdown, and dealers have dropped prices to accommodate them. And while precursor chemicals to make synthetic drugs like methamphetamine and fentanyl had been in short supply in Mexico, thanks to stoppages in shipping and air travel, there are signs this may be ending. Some kilograms of fentanyl precursors were discovered on May 25 at a Baja California port, concealed in powdered soap shipped from China, according to Zeta Tijuana. The organization assisted with a study that found traces of fentanyl in 55 of 59 drug samples of what Tijuana users said they believed to be heroin. While lethal overdoses from fentanyl, which can be 50 times more powerful than heroin, remain a top concern, Pacheco and Segovia both said they must also now contend with keeping the large population of intravenous drug users free of COVID as well. The overcrowded and close quarters in which users live — in dilapidated buildings or under bridges — make them susceptible to contagion. Many are already in poor health, with open wounds and respiratory problems. To keep users safe, Prevencasa has increased handouts of syringe packets, soap and hand sanitizer. The clinic has also remained open, with new health protocols, to test patients for the virus. Subscribe to our newsletter to receive a weekly digest of the latest organized crime news and stay up-to-date on major events, trends, and criminal dynamics from across the region. Donate today to empower research and analysis about organized crime in Latin America and the Caribbean, from the ground up. Skip to content. InSight Crime Analysis While street drug prices have increased in the United States because of coronavirus lockdowns, the opposite has happened in Tijuana, where drug gangs have maintained or even lowered their prices to keep business running. Several methamphetamine users have already tested positive. Stay Informed With InSight Crime Subscribe to our newsletter to receive a weekly digest of the latest organized crime news and stay up-to-date on major events, trends, and criminal dynamics from across the region.

Tijuana buy cocaine