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Prevalence and Correlates of Injecting with Visitors from the United States Among People Who Inject Drugs in Tijuana, Mexico


Cross-border infectious disease transmission is a concern related to drug tourism from the U.S. to Mexico. We assessed this risk among people who inject drugs (PWID) in Tijuana, Mexico. We measured the prevalence and identified correlates of injecting with PWID visiting from the U.S. among PWID in Tijuana using univariable and multivariable logistic regression. Of 727 participants, 18.5% injected during the past 6 months in Mexico with U.S. PWID described mostly as friends (63%) or acquaintances (26%). Injecting with U.S. PWID was independently associated with higher education [adjusted odds ratio (aOR) = 1.13/year], deportation from the U.S. (aOR = 1.70), younger age at first injection (aOR = 0.96/year), more lifetime overdoses (aOR = 1.08), and, in the past 6 months, backloading (aOR = 4.00), syringe confiscation by the police (aOR = 3.02) and paying for sex (aOR = 2.98; all p-values < 0.05). Nearly one-fifth of PWID in Tijuana recently injected with U.S. PWID, and their reported risk behaviors could facilitate cross-border disease transmission.

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The authors wish to thank the study participants for sharing their detailed histories, without which this research would not have been possible. We also wish to thank the Tijuana and San Diego research staff members whose compassion for the study population and dedication to the research objectives helped to acquire high quality data for this analysis.


This study was funded by the National Institutes of Health (R37 DA019829). RSG also received funding from the National Institutes for Health (R01 DA031074).

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Correspondence to R. S. Garfein.

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Bórquez, A., Garfein, R.S., Abramovitz, D. et al. Prevalence and Correlates of Injecting with Visitors from the United States Among People Who Inject Drugs in Tijuana, Mexico. J Immigrant Minority Health 21, 1200–1207 (2019).

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  • HIV
  • HCV
  • Injection drug use
  • Deportation
  • Drug tourism