Despite efforts to blanket high-mortality communities with no-cost naloxone, drug checking technologies, and alternatives to using opioids alone, there remains a considerable lack of knowledge about how exposure to these low-threshold interventions may impact rates of naloxone protection. People who used illicit opioids in New York City were surveyed between April 2019 and April 2022. Naloxone protection was defined as the proportion of opioid use events in the past 30 days when opioid use occurred with naloxone present and someone to administer it. Mixed-effect Poisson models examined correlates (syringe service program utilization, behavioral, and experiential factors) of naloxone protection among the overall sample and stratified by gender. Among 428 study participants (mean age 49 years, 64

OBJECTIVES:To examine the association of migration-related factors on mental health among Mexican-origin return migrants who lived in the United States and returned to Mexico, either voluntarily or through deportation. STUDY DESIGN:This is a cross-sectional study. METHODS:We used data from Tirando Muros, a mixed-methods multi-site study (2020-2023), including 275 return migrants in Mexico City recruited through ethnographic social mapping and respondent-driven sampling. Multivariable linear and logistic regression assessed the relationship of immigration history, social support, and social isolation on mental health (depressive symptoms, psychological distress, poor sleep). RESULTS:Depressive symptoms and psychological distress were significantly associated with greater social isolation and having left a child behind in the U.S. Poor sleep was associated with immigrating as a minor, social isolation, and multiple return migrations. Social support was protective for all outcomes. Deportation, compared to voluntarily return, was not associated with any mental health outcomes. CONCLUSIONS:Return migrants to Mexico face mental health risks, shaped more by social isolation and transnational family separation than by deportation alone. Findings underscore the need for culturally responsive, trauma-informed mental health services and social reintegration supports for returnees.

Co-occurring drug use among U.S.-born Latinas is underexamined. This study examines the relationship between polydrug use patterns and social inequality among low-income Mexican American women. Data stems from 199 Mexican American adult women collected during the follow-up period of Proyecto SALTO, a longitudinal cohort study. Latent class analysis (LCA) identified patterns of past month's marijuana, amphetamine, cocaine, and heroin use. Age-adjusted multinomial logistic regressions were conducted between covariates and latent classes. The LCA identified three classes: Non/Low-Use, 60.30% (n = 120); Marijuana Use, 27.64% (n = 55); and Polydrug Use, 12.06% (n = 24). Marijuana and Polydrug Use classes had lower socioeconomic status indicators compared to the Non/Low-Use group. Though our sample's drug use remains high compared to the general population, the largest class was Non/Low-Use. Low socioeconomic status and fractured family relationships were found to increase susceptibility for marijuana and polydrug use. Recognizing and addressing socioeconomic conditions is critical for tailored interventions.

Hispanic men in the United States, especially recent immigrants, are disproportionately affected by HIV and less likely to be reached by preventive interventions. This pilot study assessed: (a) the acceptability of engaging these men in the HIV Prevention and Care Continuum through father-son initiatives; and (b) their HIV prevention and mental health needs. Ethnographic methods identified high-HIV-incidence areas in Miami, focusing on venues frequented by this group. From 132 recruitment events, 57 recent immigrant fathers completed surveys on social, family, mental health, and HIV needs. Analyses show multiple health and social needs and barriers to care, with father-son programs being more acceptable than father-alone programs. Implications for community engagement, cross-generational interventions, and health service delivery are discussed.

We understand the current crisis of overdose deaths to be driven by widespread opioid use, characterized by distinct ‘waves’ of drug use. The first wave was driven by prescription opioids, the second by heroin, and the third by illicit, non-pharmaceutical fentanyl and fentanyl analogues (henceforth, fentanyl). The purpose of this study is to describe opioid initiation within each of the three waves from the perspective of people who use illicit opioids, with a focus on emerging pathways into fentanyl use. The authors recruited sixty people reporting past-30-day illicit opioid use in Dayton, Ohio. Participants completed a brief survey and a semi-structured in-depth qualitative interview, conducted from March to November 2020 with a total of 13 in-person and 47 virtual interviews. The qualitative interviews were transcribed in their entirety and analyzed thematically using NVivo 12. We noted supply-side changes as influencing trajectories in all three waves. However, we also noted differences in the experiences of prescription opioid and heroin initiation, with these trajectories influenced by pharmacological effects, pain management, curiosity, intergenerational use, pricing, and peers. In comparison, most participants were unaware that they were initiating fentanyl, and many reported overdosing with their first use of fentanyl. We identified a trajectory into fentanyl with limited to no prior heroin use among a few participants. The increased risk of overdose with initiation into fentanyl use further emphasizes the need for an expansion of naloxone distribution and the implementation of more comprehensive measures, such as overdose prevention centers, drug testing, and a safer supply. Further research on the dynamics of the ongoing overdose death crisis in the era of fentanyl and the 4th wave of the overdose crisis is critical in developing responsive prevention and intervention strategies.

Objective: Crack cocaine use has increased rapidly throughout Mexico, along with rising HIV and hepatitis C virus (HCV) infections among vulnerable groups. The Tirando Esquina: Interviniendo Muros de Salud (TE:IMS) project uses projection-mapping technology and is the first of its kind to reach and provide health education at an individual and community level to at-risk crack smoking populations in Mexico City. Setting: This intervention project took place in Mexico City. Design: A single-arm design was utilised. Method: The TE:IMS intervention used projection mapping, a community-based art form wherein 3-dimensional (3-D) images, videos and graphics are projected onto buildings in the community. A total of nine projection mapping episodes were projected and health promoters engaged individuals on the street to reinforce messaging and distribute safer crack kits. A sample of persons who use crack (n = 58) were recruited prior to the intervention to complete pretest-posttest evaluation questionnaires. Results: Findings provide evidence of initial effectiveness. Decreases pre- to posttest were found in weekly crack use (p < .05), sharing of paraphernalia (p = .002) and use of cans as pipes (p = .008), while increases were observed in the usage of Pyrex pipes (p = .002). While quantitative HIV knowledge assessments did not increase significantly, qualitative data suggest the intervention made a substantial impact on perceptions and knowledge of HIV among those who interacted with the health promoters and saw the projections. Conclusions: TE: IMS was successful in providing health education and harm reduction strategies at a community level to at-risk crack smoking populations in Mexico City. These findings provide evidence for the initial effectiveness of innovative education and harm reduction efforts in this population.

La presente investigación epidemiológica es parte del estudio binacional realizado entre Estados Unidos y México, llevado a cabo de 2011 a 2013 en 15 colonias de tres alcaldías de la Ciudad de México: 1) Iztapalapa (Ejército de Oriente, Canteras del Peñón, Santa Cruz Meyehualco, Santa Martha Acatitla, Juan Escutia y en la Central de Abasto); 2) Cuauhtémoc (Tepito-Morelos, Doctores, Tlatelolco y Centro Histórico); y, 3) Coyoacán (Santo Domingo, Carmen Serdán, CTM Culhuacán, San Pablo Tepetlapa y Pedregal de Carrasco). El estudio fue financiado por el National Institute on Drug Abuse (NIDA) (R21 DA031376) en colaboración con la Universidad del Sur de California (doctor Avelardo Valdez y doctora Alice Cepeda) y el Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (doctora Guillermina Natera), y forma parte de la in-vestigación internacional sobre el abuso de drogas y adicción. Consideramos que el aporte de este estudio es que pudo documentar la aparición, patrones y difusión del consumo de la droga conocida como piedra en varios barrios de la Ciudad de México.

Little is known about the experiences of minority stress among Latina women who have sex with both women and men (WSWM), a sexual and gender minority group situated at the intersection of multiple marginalized identities. The current article presents an exploratory study aimed at addressing this knowledge gap. The research utilized a flexible diary-interview method (DIM) to investigate stress-related experiences among Mexican American WSWM residing in an economically disadvantaged community in the U.S. during the third wave of the COVID-19 pandemic. A detailed description of the study is provided, including information on the background, methodology, participants' experiences, and how the project was managed remotely by a virtual research team. Twenty-one participants were asked to maintain a diary for a 6-week period spanning from March to September 2021. They submitted weekly entries in diverse formats (visual, audio, typed, and handwritten) through a user-friendly website or via mail while communicating regularly with researchers over the phone. Following the diarizing period, in-depth semi-structured interviews were conducted to clarify pertinent information within the entries and validate researchers' preliminary interpretations. Out of the initial 21 enrollees, 14 participants stopped diarizing at different stages, and nine completed the entire study. Despite facing challenges exacerbated by the pandemic, participants reported the diary-keeping process as a positive experience that offered an authentic outlet to share parts of their lives they seldom reveal. The implementation of this study highlights two significant methodological insights. Firstly, it emphasizes the value of employing a DIM to explore intersectional narratives. Secondly, it underscores the importance of adopting a flexible and sensitive approach in qualitative health research, particularly when engaging individuals from minoritized groups.

Exposure to ethnic discrimination has been conceptualized as a sociocultural stressor that is associated with lower self-rated health. However, this association remains understudied among Hispanics and less is known about constructs that may mitigate the effects of ethnic discrimination on self-rated health. Accordingly, this study aimed to (a) examine the association between ethnic discrimination and self-rated health among Hispanic emerging adults (ages 18-25), and (b) examine the extent to which self-esteem and resilience may moderate this association. A convenience sample of 200 Hispanic emerging adults from Arizona (n=99) and Florida (n=101) was recruited to complete a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Results indicate that higher ethnic discrimination was associated with lower self-rated health. Moderation analyses indicated that self-esteem functioned as a moderator that weakened the association between ethnic discrimination and self-rated health; however, resilience did not function similarly as a moderator. This study adds to the limited literature on ethnic discrimination and self-rated health among Hispanics and highlights that psychological factors, such as enhancing self-esteem, may help buffer the adverse effects of ethnic discrimination on health outcomes.

Background: The opioid epidemic in the United States has manifested differently across geographic regions and populations, with recent increases among racial/ethnic minorities and in the Western region of the U.S. This study provides an overview of the opioid overdose epidemic among Latinos in California and highlights high-risk areas in the state. Methods: Using publicly available data from California, we examined trends in opioid-related deaths (e.g., overdose) and opioid-related emergency department (ED) visits among Latinos at the county-level, as well as changes in opioid outcomes overtime. Results: Opioid-related death rates among Latinos (mostly Mexican-origin) in California remained relatively stable from 2006-2016, but started to increase in 2017 peaking at an age-adjusted opioid mortality rate of 5.4 deaths per 100,000 Latino residents in 2019. Prescription opioid-related deaths, compared to heroin and fentanyl, have remained the highest over time. However, fentanyl-related deaths began to increase dramatically in 2015. Lassen, Lake, and San Francisco counties had the highest 2019 opioid-related death rates among Latinos. Opioid-related ED visits among Latinos have steadily increased since 2006 with a sharp increase in rates in 2019. San Francisco, Amador, and Imperial counties had the highest 2019 rates of ED visits. Conclusions: Latinos are facing detrimental consequences associated with recent increasing trends in opioid overdoses. The identified high-risk counties may have vulnerable sub-populations of Latinos, such as those in northern rural regions, that have gone underrepresented in conventional surveillance health databases. Time sensitive policies and interventions are needed to curtail health consequences especially among "hidden " Latino populations.

We examine syndemic profiles of intimate partner violence, mental health, drug use, incarceration, and infectious diseases (HIV, HCV, and STIs) among a sample of adult Mexican American women who were affiliated with youth street gangs during adolescence through their relationships to boys and men. Latent class analysis included multiple factors along the following dimensions: intimate partner violence, drug use, mental illness, and incarceration. Five unique syndemic profiles were found with varying associations to HIV, HCV, and STI: (1) no syndemic, (2) intimate partner violence, no syndemic, (3) drug use, mental health, and incarceration syndemic, (4) intimate partner violence, drug use (without injection drug use), and mental health syndemic, and (5) intimate partner violence, drug use with injection drug use, mental health, and incarceration syndemic. To successfully prevent HIV, HCV, and STI among gang-involved girls and women, it is necessary to address syndemic factors.

Background Knowledge about the motivations for crack cocaine use and the long-term effects among people who inject heroin is limited. This study aims to understand motivations associated with this co-use drug pattern among aging men entrenched in established intergenerational heroin subcultures. Methods: A sample of 60 men with diverse injecting heroin use histories was recruited from low-income Mexican American urban communities for semi-structured ethnographic interviews using respondent-driven sampling. Qualitative analysis was then employed to provide an in-depth understanding of patterns and motivations of polydrug use among this older population. Results: The men discussed motivations including tolerance, curiosity and experimentation, a paradox of affordability, alternatives to the health hassles and stigma, and the cross-fertilization of drug markets. Concurrent and switching use patterns were primarily reported among those seeking a new or different high, while replacement patterns were reported by men in methadone treatment or by those who had tired of injection. Discussion: Findings translate to the on-going opioid crisis and the emerging trend in polysubstance use involving crack cocaine, methamphetamine and other psychostimulants among people who use heroin. More research is needed to investigate the full range of social and health consequences associated with these co-use patterns. Targeted and tailored prevention and treatment services are essential to improve outcomes among aging Mexican American men who use heroin and other persons with similar polydrug use patterns.

As gang activity in the United States continues to steadily increase, adolescents and young adults living in low-income neighborhoods are at disproportionate risk for violence offending and victimization. As research on youth violence has generally focused on males, scholars know much less about the females in these contexts who are particularly vulnerable to intimate partner violence (IPV) victimization given their connection with delinquent gang-involved young men. For these adolescent females, their victimization experiences are established and reinforced by the street-oriented gang environment to which they have been exposed. Further, scholars know very little about the nature, extent, and patterns of these young victims’ help-seeking behaviors. Research indicates that for Latinas, rates of disclosing victimization and underutilization of services are affected by cultural factors including gender roles, belief in preserving the family unit, shame, and patriarchal structures. Nevertheless, the extent of what scholars know about Latina victims remains limited. Using data from a fifteen-year longitudinal study of Mexican American women who were affiliated with male gang members as adolescents, the authors highlight young Latina women’s help-seeking response (social, legal, and health services) to their victimization experiences.

Research on the role of incarceration history on the mental health of imprisoned mothers reveals contradictory findings. These inconsistencies are potentially attributable to the different incarceration histories across samples masked by the use of a dichotomized incarceration history measure. This study used incarceration trajectories over the life course to determine the nature and array of incarceration experiences detrimental to mental health. Using the Survey of Inmates in State and Federal Correctional Facilities dataset (N = 881), we conducted logistic regressions to examine the associations between imprisoned mothers' incarceration trajectories and mental health problems. Findings suggested that incarceration trajectories were significantly associated with a post-traumatic stress disorder diagnosis and demonstrated a trend towards significance to be associated with anger symptoms and suicidal ideation. However, they were not significantly related to other mental health problems, such as depressive disorder and anxiety disorder. We concluded that mental health interventions need to be customized to the unique challenges encountered by subgroups of mothers with different incarceration experiences.

Despite growing research on women’s offending trajectories, knowledge on the imprisonment experiences of women who are mothers is limited. This study used a nationally representative dataset of state and federal prisoners to identify and characterize subgroups of mothers based on incarceration histories. Group-based trajectory modeling identified four groups with distinct incarceration trajectories: stable escalating group, moderate declining group, adolescence-peak group, and young-adulthood-peak group. Bivariate analyses then suggested that different incarceration trajectories were associated with adverse life experiences (i.e., foster care placement, sexual abuse experience) and confinement experiences (i.e., number of episodes of prison confinement). Discussed are the future research directions and implications for criminal justice policies and interventions targeting imprisoned mothers.

This analysis examined the role of impactful life events/stressful contextual factors and cannabis use in the patterns of illicit drug use. It utilized semi-structured qualitative interviews with 40 young adult medical cannabis patients and 22 non-patient users collected in Los Angeles during 2014-2015. Three patterns of illicit drug use emerged based on participants' narratives: regular/problematic, recreational/occasional, and never users. Among regular/problematic users, a common theme was the lasting impact of traumatic life events or stressful contextual factors on transition to and away from problematic drug use, and using cannabis to cope with negative after effects of drug use. In contrast, most recreational/occasional and never users, who reported impactful life events or stressful contextual factors, used cannabis to cope with those experiences. Family history of addiction and acceptance of cannabis use within a family as protective factors against illicit drug use among some recreational/occasional and never users was an unexpected finding.

While children with maternal incarceration experiences have substantially higher rates of criminal justice involvement than children without maternal incarceration experiences, research on the association between maternal imprisonment and children's criminal justice involvement reveals divergent findings. The inconsistencies are potentially attributable to the widespread use of a dichotomized maternal incarceration measure that masks different experiences across samples. This study used incarceration trajectories over the life course to determine the nature and array of maternal imprisonment histories associated with intergenerational incarceration. Using the Survey of Inmates in State and Federal Correctional Facilities dataset (N = 881), we conducted logistic regression to examine the relationship between maternal incarceration trajectories and children's risk of imprisonment. Findings suggested that children whose mothers followed the young-adulthood-peak trajectory had higher odds of being incarcerated than children whose mothers followed the moderate declining path. Moreover, the mother's experiences of sexual abuse and juvenile justice involvement were significantly associated with intergenerational incarceration. This study suggests the need to use comprehensive longitudinal maternal incarceration measures to understand its consequences. Rehabilitative rather than punishment-oriented interventions for mothers may lower the odds od intergenerational incarceration. Prevention programs that target the unique challenges od mothers following the young-adulthood-peak trajectory may also interrupt intergenerational imprisonment. Moreover, criminal justice reform should consider systematic racism and socioeconomic inequalities to reduce the criminal justice involvement of children from disadvantaged communities in the US.