Lugares Seguros: A mixed-methods study of injection drug use settings among female sex workers in Tijuana

Funding source NIDA K01DA032443, PI Peter Davidson

The US/Mexico border is home to an evolving HIV epidemic among vulnerable groups such as drug users, including female sex workers (FSWs), but little research has assessed the role of socio-spatial factors influencing the transmission of HIV in this region.

Geospatial and qualitative methods have been used for many years to explore factors associated with the spread of HIV among high risk populations, however emergent methodologies which combine the two have yet to applied to the study of HIV transmission.  Understanding the role of physical space in increasing or decreasing risk associated with injecting drug use, and understanding the social factors which lead already high risk individuals to consume drugs in specific types of location, are critical to improving both individual and community level interventions designed to reduce the spread of infectious disease in border regions.

This research project explores which factors FSW injectors see as ‘desirable’ and ‘undesirable’ in an injecting environment, and what social factors in their lives lead them to inject in ‘safer’ or ‘less safe’ environments from a public health perspective.  The work is being be conducted in a particularly high-risk population (in Tijuana, HIV prevalence among those who inject drugs is 4% for men, 10% for women, and 12% for women who also participate in sex work). Findings from the proposed research will be critical to bi-national efforts to develop tailored interventions for drug users at risk for HIV and other negative consequences of drug use, and for the development of future long-term research into the influence of ‘space and place’ on HIV risk among high risk injecting populations.