To estimate the prevalence of HIV infection and individual risk practices for HIV and other sexually transmitted infections (STI), including unprotected vaginal and anal sex, same-sex sexual practices, sex with multiple and/or high-risk sexual partners, sex under the influence of alcohol and other drugs, and needle-sharing practices among four migrant populations traveling through the San Diego –Tijuana border: (a) Individuals from sending communities in Mexico to the Mexico-US border; (b) migrants traveling along the Mexico-US border; (c) migrants returning voluntarily to Mexico from the US; and (d) migrants returned from the US to Mexico by the US Border Patrol.
To identify factors associated with HIV risk behaviors among these four migrant subpopulations. Social, cultural, economic, legal, and environmental factors based on our Behavioral Ecological Model (BEM) will be emphasized. Among others, we will examine the effect of poverty, family disruption, acculturation, norms and values related to risk behaviors, reasons to migrate, legal situation in the US, access to health care services, including HIV/STI risk reduction services, and geographic and social isolation.
To estimate levels and patterns of health care access and utilization in the U.S. and Mexico among these four migrant subpopulations, including cross-border health seeking practices.
To identify determinants of health care access and utilization among migrants using the BEM and Andersen’s Behavioral Model of Health Services Use, with attention to socio-demographic predisposing resources, individual and structural enabling resources, and need factors.
To examine differences in HIV risk and health care access and utilization among the four migrant subpopulations traveling through the San Diego-Tijuana border region and among other subpopulations formed according to key demographic, socioeconomic, and migration characteristics.
To examine the geographic patterning of HIV risk behaviors and determinants in both Mexico and the US.
To examine the geographic patterning of health care access and utilization in both Mexico and the US.