HIV Risks among Deportees on the California-Mexico Border

Victoria Ojeda, University of California, San Diego
Social and Behavioral Sciences
Thematic Priority Area: HIV-Related Disparities in Highly Impacted, Under-researched Populations
Innovative, Developmental, Exploratory Award (IDEA)

Background: The U.S. annually deports >900,000 Mexican nationals. Our team recently identified that deportees who are injection drug users (IDUs) are at an increased risk of testing positive for HIV. Yet, deportees are severely understudied population; data on their sex and drug use behaviors are unavailable. This study aims to fill this gap in the public health data by examining migrants’ sexual experiences during their stay in the U.S., during detention, and following deportation to Mexico. Our specific aims are: (1) To identify social and environmental migration-related factors associated with risky sexual behaviors that increase the risk of HIV infection among deportee IDUs; and (2) To examine the relationship between deportation history and risky drug use practices that may facilitate HIV transmission among deportees. Methods: We will interview 400 eligible adult male IDUs who were deported from the U.S. and who participated in Proyecto El Cuete (NIH: R01DA019829). They will respond to a new detailed questionnaire focusing on U.S. migration and deportation experiences. The questionnaire asks about detailed sexual and drug behaviors engaged in while in the U.S., detention, and post-deportation. Interviews may last 45 minutes to 1 hour. Questionnaire data will be analyzed using descriptive and multivariate statistical methods in order to asses the relationships between migration and deportation processes and unsafe sex and injection behaviors among deportee IDUs. Data from this study will be linked to Proyecto El Cuete data via a shared numeric code; this will permit us to include in our analyses other sociodemographic and HIV status data. California Needs: In 2006, 1.2 million deportable aliens were located in the U.S., ~90% are Mexican nationals; 12% were detained in San Diego. Deportees are at an elevated risk of testing positive for HIV; of particular interest to policymakers is whether deportees become HIV-infected in the U.S. or in Mexico. It is critical to improve our understanding of deportees’ health status and health behaviors especially since these persons may have ongoing sexual or substance using networks in California and Mexico. To stem the HIV epidemic in California, data on factors that predispose deportees to HIV are needed and will inform domestic and binational intervention and prevention programs. Innovative Aspects & Significance to HIV/AIDS Research: Novel aspects of this study include: 1) application of a conceptual framework that considers individual and social factors to understand the HIV risk of a binational population, 2) emphasis on a population that is large, though severely understudied, and 3) a sampling methodology that permits assessment of the roles of transnational social (i.e, sexual and drug using) networks. Potential impact & Long Term Objectives: As a new HIV/AIDS researcher, this pilot grant is invaluable in aiding the Principal Investigator’s efforts to establish her research agenda on HIV in vulnerable mobile populations. Dr. Ojeda will use CHRP-project findings to support the development of a subsequent R01 or R34 NIH behavioral intervention grant to reduce HIV-related risk behaviors in Mexican deportees. Results will also be used to refine instruments to be used in future studies on migration and HIV in Latino populations. Findings will be disseminated via professional meetings and peer-reviewed research articles.