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Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and... more
Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre-post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown. Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the PEP on uptake of occupational safety procedures, as assessed through the incidence of needle stick injuries (NSIs) (primary outcome) and changes in knowledge of transmission, prevention and treatment of HIV and viral hepatitis; attitudes towards PWID, adverse behaviours that interfere with HIV prevention and protective behaviours (secondary outcomes). ESCUDO is a hybrid type I design that simultaneously tests an intervention and an implementation strategy. Using a modified stepped-wedge design involving all active duty street-level police officers in Tijuana (N=∼1200), we will administer one 3 h PEP course to groups of 20-50 officers until the entire force is trained. NSI incidence and geocoded arrest data will be assessed from department-wide de-identified data. Of the consenting police officers, a subcohort (N=500) will be randomly sampled from each class to undergo pre-PEP and post-PEP surveys with a semiannual follow-up for 2 years to assess self-reported NSIs, attitudes and behaviour changes. The impact on PWIDs will be externally validated through a parallel cohort of Tijuana PWIDs. Research ethics approval was obtained from the USA and Mexico. Findings will be disseminated through open access to protocol materials through the Law Enforcement and HIV Network. NCT02444403.
Men who have sex with men (MSM) in developing countries such as Mexico have received relatively little research attention. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, data on MSM are over a decade old. Our aims... more
Men who have sex with men (MSM) in developing countries such as Mexico have received relatively little research attention. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, data on MSM are over a decade old. Our aims were to estimate the prevalence and examine correlates of HIV infection among MSM in this city. We conducted a cross-sectional study of 191 MSM recruited through respondent-driven sampling (RDS) in 2012. Biological males over the age of 18 who resided in Tijuana and reported sex with a male in the past year were included. Participants underwent interviewer-administered surveys and rapid tests for HIV and syphilis with confirmation. A total of 33 MSM tested positive for HIV, yielding an RDS-adjusted estimated 20% prevalence. Of those who tested positive, 89% were previously unaware of their HIV status. An estimated 36% (95% CI: 26.4-46.5) had been tested for HIV in the past year, and 30% (95% CI: 19.0-40.0) were estimated to have ever used methamphet...
Research Interests: Risk Taking, Sex Work, Public Health, Mexico, Motivation, and 18 moreDrug Policy, Prospective studies, Humans, Prostitution, Female, Sexual Behavior, Regression Analysis, Injecting Drug Use, Follow-up studies, Sex Workers, Condom use, Adult, MEXICO, Female Sex Workers, Condoms, Health Effect, Sexually Transmitted Diseases, and Unsafe Sex
Research Interests: Microbiology, Research Methodology, Behavior, Virology, Developing Countries, and 26 moreHealth, Medicine, Logistic Regression, Mexico, Respondent Driven Sampling, Mobility, Population, Humans, Virus, Measurement, United States, Female, Male, Drug Addiction, Injecting Drug Use, Hiv Infection, Clinical Sciences, Prevalence, Middle Aged, Adult, Sex Factors, MEXICO, Risk Behavior, Environment, Logistic Models, and Population distribution
Research Interests: Program Evaluation, Health Promotion, Evaluation, Treatment Outcome, Risk Taking, and 19 morePublic Health, Adolescent, Urban Health, Counseling, Mexico, Self Efficacy, Humans, Public, Prostitution, Female, Condom use, Adult, MEXICO, Female Sex Workers, Behavioral Research, Condoms, Sexually Transmitted Diseases, Behavioral Intervention, and Unsafe Sex
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Research Interests: Research Methodology, Data Analysis, Behavior, Risk, Developing Countries, and 24 moreBias, HIV, Mexico, Respondent Driven Sampling, Biological Sciences, Sampling, Tuberculosis, Humans, Measurement, Female, Sexually transmitted infections, Male, Data Collection, Hiv Infection, Risk factors, Risk Factor, Adult, Hiv seropositivity, MEXICO, Risk Factors, Cross Sectional Studies, Sexually Transmitted Diseases, Monte Carlo Method, and Statistical Regression
J Acquir Immune Defic Syndr. Author manuscript; available in PMC 2009 August 29. ... J Acquir Immune Defic Syndr. 2009 May 1; 51(Suppl 1): S42S46. ... Department of Psychiatry, University of California, San Diego, La Jolla, CA and... more
J Acquir Immune Defic Syndr. Author manuscript; available in PMC 2009 August 29. ... J Acquir Immune Defic Syndr. 2009 May 1; 51(Suppl 1): S42S46. ... Department of Psychiatry, University of California, San Diego, La Jolla, CA and Mental Illness Research, Education and ...