Mother-Youth Acculturation Gaps and Health-Risking/Emotional Problems among Latin-American Adolescents.

Second-generation Latin-American adolescents tend to show higher levels of various health-risking behaviors and emotional problems than first-generation Latin-American adolescents. This cross-sectional study of 40 mother-adolescent dyads examined the association of mother-youth acculturation gaps to youth adjustment problems. Intergenerational acculturation gaps were assessed as a bidimensional self-report component and a novel observational measurement component. The Latin-American adolescents were predominantly second-generation of Mexican descent (M age = 13.42 years, SD = 0.55). Most of the mothers were born in Mexico (M age = 39.18 years, SD = 5.17). Data were collected from mothers, adolescents, and coders, using questionnaires, structured interviews, and videotaped mother-youth interaction tasks. Findings revealed generally weak support for the acculturation gap-distress hypothesis. In addition, stronger relative adherence to their heritage culture by the adolescents was significantly (p < .05, ES = 0.15) related to less engagement in early health-risking sexual behaviors, possibly reflecting selective acculturation processes. Mother-youth acculturation gaps in orientation to the heritage culture were the most salient dimension, changing the focus on the original formulation of the acculturation gap-distress hypothesis.

Emerging patterns of crack use in Mexico City.

BACKGROUND: Recent studies in Mexico have documented a significant increase in crack cocaine use, indicating the potential for an emerging drug epidemic. METHODS: Ethnographic observations and interviews were used describe the profiles and patterns of use among street-recruited crack users in Mexico City. The data came from an international research collaboration funded by the National Institutes of Health. RESULTS: A polythetic typology was developed based on five dimensions central to categorizing patterns of crack use behavior: frequency of use, duration of use, context, social networks, and social contracts. Four types of users were discovered applying these dimensions: dabblers, stable users, crack heads, and old heads. Although several similarities were documented between patterns of crack use in Mexico and those in the United States and Western Europe, several key aspects distinguished crack users in this population: (1) self-regulated use; (2) non-linear progression of crack; and (3) the influence of the dimensions pertaining to setting, social networks, and social contract as contributing to understanding of the previous two. Further, we provide a discussion of how specific contextual factors in Mexico may be giving rise to these emerging patterns. CONCLUSION: Compared to the U.S. and Europe, this study finds that the majority of crack users were able to self-regulate their use without major disruption to daily social functioning. As crack use spreads in Mexico and other Latin American countries, we need to recognize the importance of social context in developing more tailored health and social responses that are specific to these developing countries.

Migration among individuals with leprosy: a population-based study in central Brazil.

This study investigates social and clinical factors associated with migration among individuals affected by leprosy. A cross-sectional study was conducted among those newly diagnosed with leprosy (2006-2008), in 79 endemic municipalities in the state of Tocantins, Brazil (N = 1,074). In total, 76.2% were born in a municipality different from their current residence. In the five years before diagnosis 16.7% migrated, and 3.6% migrated after leprosy diagnosis. Findings reflect aspects associated with historical rural-urban population movement in Brazil. Indicators of poverty were prominent among before-diagnosis migrants but not after-diagnosis migrants. Migration after diagnosis was associated with prior migration. The association of multibacillary leprosy with migration indicates healthcare access may be an obstacle to early diagnosis among before-diagnosis migrants, which may also be related to the high mobility of this group.

Migration among individuals with leprosy: a population-based study in Central Brazil / Migração entre pessoas com hanseníase: estudo de base populacional no Centro-Oeste do Brasil / La migración entre personas con lepra: un estudio basado en la población en el centro de Brasil

This study investigates social and clinical factors associated with migration among individuals affected by leprosy. A cross-sectional study was conducted among those newly diagnosed with leprosy (2006-2008), in 79 endemic municipalities in the state of Tocantins, Brazil (N = 1,074). In total, 76.2% were born in a municipality different from their current residence. In the five years before diagnosis 16.7% migrated, and 3.6% migrated after leprosy diagnosis. Findings reflect aspects associated with historical rural-urban population movement in Brazil. Indicators of poverty were prominent among before-diagnosis migrants but not after-diagnosis migrants. Migration after diagnosis was associated with prior migration. The association of multibacillary leprosy with migration indicates healthcare access may be an obstacle to early diagnosis among before-diagnosis migrants, which may also be related to the high mobility of this group.

Este estudo investiga fatores sociais e clínicos associados à migração entre pessoas afetadas pela hanseníase. Estudo transversal entre recém- diagnosticados com hanseníase (2006-2008), em 79 municípios endêmicos do Estado de Tocantins, Brasil (N = 1.074). No total, 76,2% nasceram em município diferente de sua residência atual. Nos cinco anos antes do diagnóstico, 16,7% migraram, e 3,6% migraram após o diagnóstico da hanseníase. Resultados refletem aspectos associados com o movimento histórico da população rural-urbana no Brasil. Indicadores de pobreza foram proeminentes antes do diagnóstico de migrantes. A migração após o diagnóstico foi associada com migração anterior. A associação da forma multibacilar com migração indica que o acesso à saúde pode ser um obstáculo para o diagnóstico precoce de migrantes, o que pode também estar relacionado com a elevada mobilidade desse grupo.

Este estudio investiga los factores sociales y clínicos asociados con la migración entre las personas afectadas por lepra. Un estudio transversal se llevó a cabo entre las personas recién diagnosticadas con lepra (2006-2008), en 79 municipios endémicos en el estado de Tocantins, Brasil (N = 1,074). En total, el 76,2% nacieron en otro municipio diferente a su residencia actual. En los cinco años antes del diagnóstico el 16,7% emigró, y el 3,6% migró después del diagnóstico de lepra. Los resultados reflejan aspectos relacionados con el movimiento histórico de la población rural-urbana en Brasil. Los indicadores de pobreza fueron sobresalientes entre el grupo de migrantes antes del diagnóstico. La migración tras el diagnóstico se asoció a una migración anterior. La asociación de lepra multibacilar con migración indica que el acceso a la atención médica puede ser un obstáculo para el diagnóstico temprano en el grupo de migrantes antes de la migración.

Patterns of migration and risks associated with leprosy among migrants in Maranhão, Brazil.

Leprosy remains a public health problem in Brazil with new case incidence exceeding World Health Organization (WHO) goals in endemic clusters throughout the country. Migration can facilitate movement of disease between endemic and non-endemic areas, and has been considered a possible factor in continued leprosy incidence in Brazil. A study was conducted to investigate migration as a risk factor for leprosy. The study had three aims: (1) examine past five year migration as a risk factor for leprosy, (2) describe and compare geographic and temporal patterns of migration among past 5-year migrants with leprosy and a control group, and (3) examine social determinants of health associated with leprosy among past 5-year migrants. The study implemented a matched case-control design and analysis comparing individuals newly diagnosed with leprosy (n = 340) and a clinically unapparent control group (n = 340) without clinical signs of leprosy, matched for age, sex and location in four endemic municipalities in the state of Maranhão, northeastern Brazil. Fishers exact test was used to conduct bivariate analyses. A multivariate logistic regression analysis was employed to control for possible confounding variables. Eighty cases (23.5%) migrated 5-years prior to diagnosis, and 55 controls (16.2%) migrated 5-years prior to the corresponding case diagnosis. Past 5 year migration was found to be associated with leprosy (OR: 1.59; 95% CI 1.07-2.38; p = 0.02), and remained significantly associated with leprosy after controlling for leprosy contact in the family, household, and family/household contact. Poverty, as well as leprosy contact in the family, household and other leprosy contact, was associated with leprosy among past 5-year migrants in the bivariate analysis. Alcohol consumption was also associated with leprosy, a relevant risk factor in susceptibility to infection that should be explored in future research. Our findings provide insight into patterns of migration to localize focused control efforts in endemic areas with high population mobility.

Injecting transition risk and depression among Mexican American non-injecting heroin users.

INTRODUCTION: Existing research has documented high comorbid rates for injecting drug use (IDU) and social and health consequences including HIV infection, a condition that disproportionately affects U.S. Hispanic populations. Few studies have examined the specific associations between injecting transition risk among non-injecting heroin using (NIU) populations and mental health conditions. This study hypothesizes that injecting transition risk will be strongly associated with depression symptomatology controlling for age and gender among Mexican American NIUs. METHODS: Street-recruited NIUs (n=300) were administered structured interviews. The Mexican American sample was predominantly male (66%), unemployed (75%) with more than half experiencing incarceration in their lifetimes (58%). Depression was measured using the CES-D scale. Univariate and multivariate logistic regression analysis were employed to determine the associations between the dependent variable of heroin injecting transition risk and the key independent variables of depression symptomatology and other independent variables. RESULTS: Depression symptomatology was the strongest independent correlate of injecting transition risk. Those NIUs with high levels of depression symptomatology had more than three times the heroin injecting transition risk than those NIUs with low levels. Heroin use network influence was also found to be a strong correlate. Acculturation level was significantly associated with injecting transition risk. CONCLUSION: The comorbid condition of depression symptomatology and heroin use places Mexican American NIUs at elevated risk of contracting blood-borne pathogens such as HIV. Development of prevention and treatment strategies that target Hispanic non-injecting heroin users in socially disadvantaged communities should consider depression symptoms and develop interventions that build new social networks.

Health consequences of long-term injection heroin use among aging Mexican American men.

OBJECTIVES: Research on the health consequences of long-term injection drug use (IDU) is limited. This article examines these consequences among aging, male Mexican American injecting heroin users. Concern for this group is crucial, given its health disparities and the association of IDU with disease transmission. METHOD: Aging, male Mexican American IDUs (N = 227) were recruited through intensive outreach. Participants self-reported health status, medical and substance use history, and completed behavioral and psychometric health scales. RESULTS: Results: Participants had significantly poorer self-rated health and negative health conditions. Selected medical conditions not associated with the heroin-use lifestyle (i.e., hypertension, diabetes, arthritis) were lower relative to the comparison samples. DISCUSSION: This population has a complex profile of health consequences linked to a heroin-using lifestyle. The study concludes that routine screening of infectious diseases and medical and behavioral conditions among aging substance using populations may contribute to reducing Hispanic health disparities.

High rates of transitions to injecting drug use among Mexican American non-injecting heroin users in San Antonio, Texas (never and former injectors).

OBJECTIVE: To assess the incidence and rate of transition to injecting among Mexican American noninjecting heroin users. METHODS: In a prospective cohort study of street-recruited MA-NIU in San Antonio, Texas, 2002-2005, participants were administered structured interviews and tested for Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). The analysis sample comprised former injection drug users (last injected >6 months ago, n=47) and those who had never injected drugs and tested HCV negative (n=219). A transition to injecting was defined as the first injection of illicit drugs since baseline interview. Transition rates were based on person-years at-risk (PYAR). Proportional hazards regression was used to estimate crude and adjusted (for significant differences between former and never injectors) hazard ratios and 95% confidence intervals of injecting history on transitioning to injecting. RESULTS: Sixty-three (24%) participants transitioned to injecting at a rate of 22.3/100 PYAR (95% CI: 17.2-28.2). Former-injectors were significantly more likely to transition than never injectors (43% or 20/47 vs. 20% or 43/219; p<0.001), and did so at a faster rate (40.4/100 PYAR, 95% CI: 24.6-60.0 vs. 18.5/100 PYAR, 95% CI: 13.4-24.4), with the crude HR=1.931 (95% CI: 1.116, 3.341) and adjusted HR=2.263 (95% CI: 1.192-4.294). CONCLUSIONS: The rate of transitioning to injecting was high and greater among former injectors. Of particular concern is the high rate of injecting initiation among never injectors. Future analyses will examine factors associated with injecting initiation, including individual susceptibility and behaviors, social networks, and the cultural and drug market context.

Homicidal Events Among Mexican American Street Gangs: A Situational Analysis.

This article examines the complexity of street gang homicides and focuses on situational factors that lead to gang members' susceptibility to this violent behavior within the context of a disadvantaged minority community. This study is based on an analysis of 28 homicides involving Mexican American gang members. The absence of immigrant youth involvement in these types of violent crimes is discussed. Findings demonstrate how locally embedded social processes associated with specific gang types, ecology, drugs, circumstances, and motives unfold into homicidal events. These findings may contribute to the development of street-based social programs focused on gang mediation, dispute resolution, and crisis intervention.

The Influence of Family and Peer Risk Networks on Drug Use Practices and Other Risks among Mexican American Noninjecting Heroin Users.

Noninjecting heroin use (NIU) is spreading among social networks of young Mexican American polydrug users. This article examines the influence of family and peer networks on NIU behavior and other drug practices and risks. This study delineates the extent to which a culturally relevant modification of the "network facilitation" theoretical approach can increase both a theoretical and practical understanding of drug use and related risk behaviors. Using the methods of analytic ethnography, it identifies, describes, and explains variations in the social networks among this marginalized population and how specific aspects of Mexican American culture (familismo, and collectivismo) affects risk behaviors.

CONDITIONS THAT INCREASE DRUG MARKET INVOLVEMENT: THE INVITATIONAL EDGE AND THE CASE OF MEXICANS IN SOUTH TEXAS.

Research on drug trafficking has not been able to discern the exact nature of illegal drug markets and the relationship between their individual and group participants. This article delineates the role of Mexican immigrants and Mexican-American participants involved in the stratified drug market of South Texas. This article synthesizes ethnographic materials drawn from two previous National Institute on Drug Abuse (NIDA) studies in order identify the different types of drug distribution behaviors that occur within the groups, the differentiated roles of individuals, the organizational framework, and most significantly, the processes that link market participants to others outside of the drug market. This illegal behavior can be interpreted as an adaptive mechanism that is a direct response to the marginal economic status imposed by macro socio-economical background factors. As well, we conclude that the specific foreground factors of the opportunities offered by the context, culture, and proximity of the U.S./Mexico border and invitational edges explain this behavior. There are both parallels and particular differences between the South Texas case and the structuring and functioning of informal legal and illegal markets that are characteristic of other economically disadvantaged communities.

The drugs-violence nexus among Mexican-American gang members.

This study examines hypotheses and builds models to help clarify the causal connections between drugs and violence outcomes among Mexican-American male gang members. The study uses cross-sectional data of 160 male gang members sampled from 26 gangs in a Southwestern city. A life-history /intensive interview using closed and open-ended questions and a violence risk psychometric test (PFAV) also employed 10 scenario questions to elicit self-produced accounts of the participant's last fight. Gang member participant's ages ranged from 14 to 25 years with a mean age of 18.5 years. The study concludes that drug use interacts with an individual gang member's risk for violence to affect violent behavior outcomes. Furthermore, an important situational variable explaining violent outcomes among respondents scoring high on the violence risk measure was whether the rival was using drugs that resulted in high intoxication levels. The study concludes that drugs have a modulating and mediating influence on violence that is conditioned by situational and individual level variables among members of these adolescent street gangs.

Measuring violence risk and outcomes among Mexican American adolescent females.

Central to the development of culturally competent violence prevention programs for Hispanic youth is the development of psychometrically sound violence risk and outcome measures for this population. A study was conducted to determine the psychometric properties of two commonly used violence measures, in this case for Mexican American adolescent females. The Conflict Tactics Scales (CTS2) and the Past Feelings and Acts of Violence Scale (PFAV) were analyzed to examine their interitem reliability, criterion validity, and discriminant validity. A sample of 150 low-risk and 150 high-risk adolescent females was studied. Discriminant validity was indicated by the perpetrator negotiation scale and by the victim psychological aggression and sexual coercion scales of the CTS2 and the PFAV. Analysis indicates that the CTS2 scales and the PFAV demonstrate adequate reliability, whereas strong criterion validity was evidenced by eight of the CTS2 scales and the PFAV.

The process of paradoxical autonomy and survival in the heroin careers of Mexican American women.

This study focuses on the process of paradoxical autonomy and survival in the heroin careers of Mexican American women. We explore how gender roles among Mexican American female heroin users influence the emergence of a paradoxical autonomy. Five key subprocesses of this autonomy were identified from 14 life history narratives: sustaining employment, working the welfare system, illegal activities, emotional aloofness, and loss of family and children. Dependency on drugs did not lead simply to the reproduction of traditional gender dependency but, paradoxically, seemed to contribute to a new type of gender autonomy. This autonomy did not necessarily make the survival less arduous, only more independent from gendered responsibilities associated with men and often with family and children. We discuss how this paradoxical autonomy is not acquired without ambiguity by some of these women, who place a value on maintaining relationships with men and family. Our study makes a contribution to a better understanding of the diverse processes by which Mexican American female heroin users struggle to survive. Although this struggle leads to a paradoxical autonomy from their traditional gender roles, it does little to change other barriers to self-development originating from poverty, ethnic discrimination, and the severity of their drug addiction.

Psychopathy Among Mexican American Gang Members: A Comparative Study.

High-risk Mexican American males were assessed for levels of psychopathy. The Hare Psychopathy Checklist-Screening Version was compared in a random sample of gang members with a matched community sample of violent non-gang members and samples of forensic and psychiatric patients and undergraduate students. Analysis involved t-test, chi-square, and Cronbach's alpha statistics. More than half of the gang sample were categorized as low, 44% as moderate, and only 4% as high on psychopathy. The gang members had higher scores on the total, affective, and behavioral scores than the non-gang members. High scores on adolescent antisocial behavior, poor behavioral controls, and lack of remorse were found in both samples. Gang members scored twice as high as non-gang members on lack of empathy. Both samples were lower on psychopathy than the forensics and higher than psychiatric patients and undergraduates. The results provide grounds for early intervention efforts for this high-risk population.