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The effect of migration on HIV high-risk behaviors among Mexican migrants
Presented by Melissa Sanchez, United States.
M.A. Sanchez1, M.T. Hernandez1, A. Vera1, C. Magis-Rodriguez2, J.D. Ruiz3, M.V. Drake4, G.F. Lemp1
1California HIV/AIDS Research Program, University of California, Office of the President, Oakland, United States, 2CENSIDA, Secretaria de Salud, Mexico, Mexico, 3Office of AIDS, California Department of Public Health, Sacramento, United States, 4University of California, Irvine, United States
Background: The impact of migration from Mexico to the U.S. has the potential to lead to an increased risk for HIV infection. Utilizing a crossover study design, we directly compared individual HIV high-risk behaviors before and after migration.
Methods: The California-Mexico Epidemiological Surveillance Pilot, a binational collaboration, combines targeted, venue-based sampling, outreach techniques, and survey methods to estimate HIV high-risk behavior. We collected data on behaviors prior to and after migration, creating matched-pair data for each subject, with each serving as his/her own control. Using exact conditional logistic regression, we estimated odds ratios with 95% confidence intervals, controlling for venue type and gender.
Results: In 2005, 364 Mexican male migrants were sampled from male work and community venues, bars, and clubs in rural and urban sites in California. Though results indicate a significant decrease after migration in the percentage of males reporting low condom use (83.1% vs. 65.3%, OR=0.19, CI 0.07-0.48, p=.0001) and use of shared needles (18.4% vs. 3.0%, OR=0.13, CI 0.02-0.51, p=.001) in the male work sites, more alarmingly, there is a significant increase after migration in the percentage in male work sites and bars and clubs adopting HIV high-risk behaviors related to sex with a sex worker (21.9% vs. 31.6%, OR=1.95, CI 1.15-3.40, p=.014), sex work (2.5% vs. 5.5%, OR=7.0, CI 1.08-158.96, p=.039), and sex while under the influence of drugs or alcohol (21.2% vs. 50.0% OR=21.14, CI 4.52-Infinity, p<.0001).
Conclusions: Migration’s significant effect on increased HIV high-risk behaviors among male Mexican migrants suggests that, without intervention, the HIV epidemic may expand among this population. The significant increases in HIV high-risk behavior in male work sites and bars and clubs make this population vulnerable to HIV transmission through their common work and social environments, particularly where women are infrequently present. These results suggest targeting prevention interventions to those venues where this hard-to-reach population is concentrated.