Background : Sex trafficking is a human rights abuse that carries particularly negative health and social consequences, including HIV and sexually transmitted infections (STIs). While HIV/STI infection and sex trafficking have been linked in Asia, the context of these associations and their applicability in Mexico is poorly understood. Aims : Aims of this dissertation were to (1) Critically review evidence linking mobility, trafficking, and HIV vulnerability in Mexico and Central America; (2) Explore associations between features of the risk environment, sex work and drug use history, and underage sex work among female sex workers (FSWs) in Tijuana and Cd. Juarez, Mexico; and (3) Describe and "unpack" sex trafficking and its relationship to HIV/STI vulnerability among formerly trafficked FSWs in Tijuana. Methods : This study employed qualitative and quantitative methods to investigate sex trafficking, mobility and HIV vulnerability. In Chapter 2, a critical review of the epidemiology and context of HIV vulnerability among mobile populations in Central America and Mexico was conducted. Chapter 3 draws upon questionnaires and HIV/STI testing among FSWs (n=624) in Tijuana and Cd. Juarez. In Chapter 4, in-depth interviews were conducted with formerly trafficked FSWs in Tijuana (n=31). Results : Chapter 2 found that among mobile groups in Central America and Mexico, social isolation, socio-economic impacts of displacement, gender inequalities, and stigma/discrimination strongly shape HIV/STI risk. In Chapter 3, underage sex work entry was positively associated with inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe-sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry into sex work. In Chapter 4, sex trafficking was linked to elevated HIV/STI vulnerability through gender-based violence, economic vulnerability, migration, and stigma. Conclusions: These findings contribute to a foundation of knowledge to advocate for strategies to reduce sex trafficking and HIV. Multi-level, intersectoral interventions to prevent sex trafficking and HIV infection are needed for vulnerable youths, migrants, and FSWs in Mexico-U.S. border cities; recommended components include strengthening the response to gender-based violence, peer-delivered prevention, and the provision of shelter, food, job placements, and psychological support.

This book is a collection of papers reflecting the latest advances in geographic research on health, disease, and well-being. It spans a wide range of topics, theoretical perspectives, and methodologies - including anti-racism, post-colonialism, spatial statistics, spatiotemporal modeling, political ecology, and social network analysis. Health issues in various regions of the world are addressed by interdisciplinary authors, who include scholars from epidemiology, medicine, public health, demography, and community studies. The book covers the major themes in this field such as health inequalities; environmental health; spatial analysis and modeling of disease; health care provision, access, and utilization; health and wellbeing; and global/transnational health and health issues in the global south. There is also a specially commissioned book review in addition to the chapters included in these six sections. Together, these chapters show cogently how geographic perspectives and methods can contribute in significant ways to advancing our understanding of the complex interactions between social and physical environments and health behaviors and outcomes. This book was published as a special issue of Annals of the Association of American Geographers.

A global economic analysis of HIV infection amongst sex workers, finding that evidence based and rights affirming interventions are not implemented to the level that their efficacy warrants, and that doing so at scale would be cost effective and deliver significant returns on investment.

The colonias of the U.S.–Mexico border form a loose network of more than 2,500 settlements, ranging in size from villages to cities, that are home to over a million people. While varying in size, all share common features: wrenching poverty, substandard housing, and public health issues approaching crisis levels. This book brings together scholars, professionals, and activists from a wide range of disciplines to examine the pressing issues of economic development, housing and community development, and public and environmental health in colonias of the four U.S.–Mexico border states. The Colonias Reader is the first book to present such a broad overview of these communities, offering a glimpse into life in the colonias and the circumstances that allow them to continue to exist—and even grow—in persistent poverty. The contributors document the depth of existing problems in each state and describe how government agencies, nongovernmental organizations, and community activists have mobilized resources to overcome obstacles to progress. More than reporting problems and documenting programs, the book provides conceptual frameworks that tie poverty to institutional and class-based conflicts, and even challenges the very basis of colonia designations. Most of these contributions move beyond portraying border residents as hapless victims of discrimination and racism, showing instead their devotion to improving their own living conditions through grassroots organizing and community leadership. These contributions show that, despite varying degrees of success, all colonia residents aspire to a livable wage, safe and decent housing, and basic health care. The Colonias Reader showcases many situations in which these people have organized to fulfill these ambitions and provides new insight into life along the border.

This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.

The sister cities of the southwestern United States border are challenged by widespread environmental and health issues and limited access to help. And while different initiatives have been set up to improve health outcomes and lessen inequities in the border region, evaluation data are scarce. Culture and Health Disparities provides a perspective on U.S.-Mexico border health with an evidence-based guide for conceptualizing, implementing, and evaluating health interventions. Taking into account the unique qualities of border life and their influence on general wellbeing, this important volume offers detailed criteria for creating public health programs that are medically, culturally, and ethically sound. The book identifies gaps in intervention research on major health concerns in the area, relating them to disparity-reduction efforts in the rest of the U.S. and arguing for more relevant means of data gathering and analysis. The author also asserts that progress can be made on both sides of the border despite concurrent social and political problems in the region. Included in the coverage: The border region as a social system. The development of health disparities: a life-course model. A social systems approach to understanding health disparities. A critique of U.S.-Mexico border health interventions. Evaluating interventions to reduce healthcare disparities. Ethical issues in health interventions across cultures and contexts. A text for researchers and practitioners working to promote border health and reduce service inequalities, Culture and Health Disparities asks pertinent questions and provides workable, meaningful answers.