HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City.

Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association between HIV-related stigma and HIV treatment adherence among gbMSM who use crystal meth in the MAMC. This study was undertaken as part of an exploratory study of crystal meth use in the MAMC. The data were collected from September to December 2021 through an encrypted online survey. Participants (n = 89) were gbMSM adults living with HIV who reported crystal meth use in the past month that were recruited through an online snowball sampling. The online survey included questions about HIV treatment adherence, sexual behaviors, the Alcohol, Smoking, and Substance Involved Screening Test, and the HIV-Related Stigma Mechanisms Scale. Logistic regression analyses assessed the association between HIV-related stigma and HIV treatment adherence. The multivariate logistic regression model showed that, controlling for health insurance [adjusted odds ratio (AOR) = 0.13; 95% confidence intervals (CI)  = 0.02-0.59] and educational level (AOR = 0.16; 95% CI = 0.02-0.88), non-adherence to HIV treatment was independently associated with higher HIV-related stigma (AOR = 1.06; 95% CI = 1.01-1.12). Public health policies must include HIV-related stigma and substance use in treating gbMSM with HIV.

Los trastornos mentales en México 1990-2021. Resultados del estudio Global Burden of Disease 2021 / Mental disorders in Mexico 1990-2021. Results from the Global Burden of Disease 2021 study

Resumen Antecedentes: Los trastornos mentales constituyen una de las principales causas de años vividos con discapacidad, si bien no se dispone de estimaciones recientes sobre su magnitud. Objetivo: Reportar las tendencias de prevalencia de trastornos mentales, los años vividos con discapacidad y los años de vida saludables perdidos por sexo, edad y entidad federativa de México. Material y métodos: Se utilizó la base de datos para México del Global Burden of Disease. Resultados: Se calcularon 18.1 millones de personas con algún trastorno mental en 2021, que representaron un incremento de 15.4 % respecto a 2019. Los trastornos depresivos y de ansiedad aumentaron de manera notable entre 2019 y 2021, lo cual posiblemente esté relacionado con COVID-19, el confinamiento y los duelos vividos durante la pandemia. Conclusiones: Los trastornos mentales se han incrementado considerablemente desde la única encuesta nacional de salud mental que utilizó criterios diagnósticos para evaluar las prevalencias. Es importante invertir en estudios epidemiológicos, prevención y atención de los trastornos mentales, los cuales se encuentran entre las primeras causas de años vividos con discapacidad en el país.

Abstract Background: Mental disorders are one of the main causes of years lived with disability, although there is a lack of recent estimates of their magnitude. Objective: To report the trends of mental disorders prevalence, years lived with disability and years of healthy life lost by sex, age and state in Mexico. Material and methods: The Global Burden of Disease database for Mexico was used. Results: There were an estimated 18.1 million persons with some mental disorder in 2021, which represented an increase of 15.4% in comparison with 2019. Depressive and anxiety disorders did significantly increase between 2019 and 2021, which is possibly related to COVID-19, the confinement and the situations of grief experienced during the pandemic. Conclusions: Mental disorders have considerably increased since the only national mental health survey that used diagnostic criteria to evaluate their prevalence. It is important to invest in epidemiological studies, prevention and care of mental disorders, which are among the leading causes of years lived with disability in the country.

Traducción, validación, y adaptación del español al Kreyol-creole haitiano de la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R-20)

Introducción. A pesar de la importante presencia de la población haitiana en países de América Latina, existen pocos estudios que evalúen la salud mental en esta población; una de las razones es la falta de instrumentos psicométricos en kreyol (creole haitiano). Objetivo. Adaptar la versión en español de la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R-20) al kreyol. Métodos. Estudio transversal de muestreo bietápico con 207 migrantes haitianos viviendo en Santiago de Chile, se tradujo y retrotradujo la Escala CESD-R-20 del español al kreyol. Resultados. 132 participantes respondieron la encuesta en kreyol y 75 en español. Las técnicas de detección de la dimensionalidad recomiendan retener un único componente y tres factores, con pocas excepciones a través de las muestras. Las soluciones factoriales llevan a retener un único factor, que presenta un Alfa de Cronbach =0.92 (IC: 0.90-0.94) adecuado. Estos resultados indican que se necesita un único factor. Discusión y conclusión. La adaptación del instrumento CESD-R-20 de español al kreyol obtiene evidencias de validez favorables y puede servir para iniciar nuevos estudios en población migrante haitiana en su trayecto por América Latina, si bien es necesario seguir ampliando el proceso de validación.

Introduction. Although the Haitian migrant population has a significant presence in Latin American countries, a few studies assess this population's mental health; one of the reasons is the lack of psychometric instruments in kreyol (Haitian Creole). Objective. Adapt the Spanish version of the Depression Scale of the Center for Epidemiological Studies (CESD-R-20) into kreyol. Methods. Based on a cross-sectional two-stage cluster sampling with 207 Haitian migrants living in Santiago de Chile, we conducted translation and back translation of the CESD-R-20 Scale from Spanish to kreyol; additionally, we reached an adapted version in Spanish. Results. In total, 132 participants answered the survey in Kreyol and 75 in Spanish. Dimensionality detection techniques recommend retaining a single component and three factors, with few exceptions across samples. Exploration of factor solutions leads to the retention of a single factor, which has an adequate Cronbach's alpha=0.92 (IC: 0.90;0.94). These results indicate that only one factor is needed. Discussion and conclusion. The adaptation of the Spanish CESD-R-20 instrument to Kreyol has obtained favorable validity evidence and can be used to initiate new studies on the Haitian migrant population on their journey through Latin America, although the validation process needs to be further extended.

HIV Stigma Mechanisms Scale: Factor Structure, Reliability, and Validity in Mexican Adults.

We aimed to validate the HIV Stigma Mechanisms Scale (HIV-SMS) in a sample of Mexican adults living with HIV, which differentiates between sources and mechanisms of stigma. Adults (n = 362) with a median age of 32 years old completed a web-based version in Spanish of the HIV-SMS as well as sociodemographic and HIV-related characteristics questionnaire. Exploratory factor analyses with weighted least squares and oblique rotation were performed to assess the construct validity of the scale. The Spanish translation for the Mexican population of the HIV-SMS has adequate internal consistency (Ω = 0.86) and demonstrated a structure similar to the original scale. After excluding the items related to community and social workers, a five-factor solution with internalized, promulgated, and anticipated stigma from family and healthcare workers showed adequate construct validity. The HIV-SMS is a valid and sensitive scale that can be used in a Mexican adult population living with HIV.

RESUMEN: El objetivo de este estudio fue validar la Escala de Mecanismos de Estigma de VIH (EME-VIH) en una muestra de adultos mexicanos que viven con VIH. Esta escala distingue entre fuentes y mecanismos de estigma. 362 adultos con una edad media de 32 años completaron vía web una versión en español de la EME-VIH así como preguntas acerca de sus características sociodemográficas y cuestiones relacionadas con el VIH. Se realizaron análisis factoriales exploratorios de mínimos cuadrados ponderados con rotación oblicua para evaluar la validez de constructo de la escala. La traducción al español de la EME-VIH para población mexicana tiene consistencia interna adecuada (Ω = 0.86) y muestra una estructura similar a la escala original. Después de excluir los ítems relacionados con trabajadores comunitarios y sociales, se encontró una solución con validez de constructo adecuada de cinco factores: estigma internalizado, promulgado y anticipado ejercido por la familia y personal de salud. La EME-VIH es una escala válida y sensible que puede usarse en población adulta mexicana que vive con VIH.

Emotional responses and coping strategies in adult Mexican population during the first lockdown of the COVID-19 pandemic: An exploratory study by sex / Respuestas emocionales y estrategias de afrontamiento en población adulta mexicana durante el primer confinamiento por la pandemia de COVID-19: un estudio exploratorio por sexo

Abstract Introduction The COVID-19 outbreak has involved a permanent and significant increase of fear and worries related to the virus and the measures taken to avoid contagion, such as confinement. Objective To explore the relationship between emotional responses and coping strategies used to face the first confinement among the Mexican adult population and inquire about differences by sex. Method An exploratory study was conducted through a self-administered online survey. It included questions about sociodemographic characteristics, emotions about pandemic information, and coping strategies. An informed consent form was presented prior to data collection. Chi square and Kruskal-Wallis were performed for bivariate analyses. Results A total of 2,650 participants completed the survey (21.6% were men). Significantly more men than women reported feeling calm (p < .001), hopeful (p = .011), and indifferent (p = .002). In contrast, more women, compared to men significantly reported feeling worried (p < .001), fearful (p < 0.001), and sad (p < .001). More women reported being emotionally close to other people (p = .027), seeking help from friends and family to share emotions and concerns (p < .001), and they frequently prayed as a coping strategy regardless of their emotions (p = .005). Discussion and conclusion While women are the least affected by the contagion and their symptoms are milder than in men, they present the most negative emotions, particularly of worry, but they also used more caring and helpful behaviors in comparison with men. These results can serve as a basis for developing research with a gender perspective that delves into the differences by sex found in this study.

Resumen Introducción El brote de COVID-19 ha implicado un aumento significativo y permanente en el miedo y las preocupaciones relacionadas con el virus y las medidas de mitigación, como el confinamiento. Objetivo Explorar la relación entre emociones y estrategias de afrontamiento utilizadas durante el primer confinamiento en población adulta mexicana e indagar sus diferencias por sexo. Método Estudio exploratorio mediante una encuesta en línea autoadministrada. Se obtuvo el consentimiento informado antes de recopilar la información. Se utilizó estadística no paramétrica para los análisis bivariados. Las respuestas de estrategias de afrontamiento se analizaron como variables cuantitativas y se reportaron las medias. Resultados Un total de 2,650 participantes completaron la encuesta (21.6% fueron hombres). Significativamente, más hombres que mujeres informaron sentirse calmados (p < .001), esperanzados (p = .011) e indiferentes (p = .002). Más mujeres, en comparación con los hombres, informaron sentirse significativamente preocupadas (p < .001), temerosas (p < .001) y tristes (p < .001). Más mujeres informaron estar emocionalmente cercanas a otras personas (p = .027), buscar ayuda de amigos y familiares para compartir emociones y preocupaciones (p < .001) y utilizar frecuentemente la oración como una estrategia de afrontamiento (p = .005). Discusión y conclusión Aunque las mujeres son las menos afectadas por el contagio en comparación con los hombres, son las que presentan las emociones más negativas, particularmente de preocupación. Sin embargo, también han utilizado más comportamientos de cuidado y ayuda. Estos resultados pueden servir como base para desarrollar investigación con perspectiva de género que profundice en las diferencias por sexo encontradas en este estudio.

Prevalence and correlates of neck injection among people who inject drugs in Tijuana, Mexico.

INTRODUCTION AND AIMS: Injecting drugs in the neck has been related to adverse health conditions such as jugular vein thrombosis, deep neck infections, aneurysm, haematomas, airway obstruction, vocal cord paralysis and wound botulism, among others. We identified prevalence and correlates of neck injection among people who inject drugs (PWID) in Tijuana, Mexico. DESIGN AND METHODS: Beginning in 2011, PWID aged ≥18 years who injected drugs within the last month were recruited into a prospective cohort. At baseline and semi-annually, PWID completed interviewer-administered surveys soliciting data on drug-injecting practices. Logistic regression was used to identify predictors of injecting in the neck as the most frequent injection site at a single visit. RESULTS: Of 380 PWID, 35.3% injected in the neck at least once in the past 6 months, among whom 71.6% reported it as their most common injection site, the most common injecting site after the arms (47%). Controlling for age, years injecting and injecting frequency, injecting heroin and methamphetamine two or more times per day and having sought injection assistance were associated with injecting in the neck [adjusted odds ratios (AOR): 2.12; 95% confidence intervals (CI): 1.27-3.53 and AOR: 2.65; 95% CI: 1.52-4.53 respectively]. DISCUSSION AND CONCLUSIONS: Injecting in the neck was very common among PWID in Tijuana and was associated with polydrug use and seeking injection assistance. Tailoring harm reduction education interventions for individuals who provide injection assistance ('hit doctors') may allow for the dissemination of safe injecting knowledge to reduce injection-related morbidity and mortality.

Spanish version of the Substance Use Risk Profile Scale: factor structure, reliability, and validity in Mexican adolescents.

To validate the Substance Use Risk Profile Scale (SURPS) in a sample of Mexican adolescents, this brief 23-item self-report questionnaire has been developed to screen four high-risk personality traits for substance misuse, to guide targeted approaches to prevention of addictions in adolescents. The scale has been previously validated in United Kingdom, Canada, Sri Lanka and China. A sample of 671 adolescents aged 11-17 completed a Spanish translation of the SURPS as well as other measures of personality and substance use. The Spanish translation of the SURPS has moderate internal consistency, and demonstrated a four-factor structure very similar to the original scale. The four subscales show good concurrent validity and three of the subscales were found to correlate with measures of substance use. The Spanish translation of the SURPS seems to be a valid and sensitive scale that can be used in a Mexican adolescent population.

The use of clinical trials in comparative effectiveness research on mental health.

OBJECTIVES: A large body of comparative effectiveness research (CER) focuses on the use of observational and quasi-experimental approaches. We sought to examine the use of clinical trials as a tool for CER, particularly in mental health. STUDY DESIGN AND SETTING: Examination of three ongoing randomized clinical trials in psychiatry addressing issues that would pose difficulties for nonexperimental CER methods. RESULTS: Existing statistical approaches to nonexperimental data appear insufficient to compensate for biases that may arise when the pattern of missing data cannot be properly modeled such as when there are no standards for treatment, when affected populations have limited access to treatment, or when there are high rates of treatment dropout. CONCLUSION: Clinical trials should retain an important role in CER, particularly in cases of high disorder prevalence, large expected effect sizes, difficult-to-reach populations, or when examining sequential treatments or stepped-care algorithms. Progress in CER on mental health will require careful consideration of appropriate selection between clinical trials and nonexperimental designs and on allocation of research resources to optimally inform key treatment decisions for each patient.

Mexican immigration to the U.S., the occurrence of violence and the impact of mental disorders

Objective: To study immigration, U.S. nativity, and return migration as risk factors for violence among people of Mexican origin in the U.S. and Mexico. Methods: Cross-sectional surveys in the United States (2001-2003; n=1,213) and Mexico (2001-2002; n=2,362). Discrete time survival models were used. The reference group was Mexicans living in Mexico without migrant experience or a migrant relative. Results: Mexican immigrants in the U.S. have lower risk for any violence (hazard ratio [HR] = 0.5, 95% confidence interval [95%CI] 0.4-0.7). U.S.-born Mexican-Americans were at higher risk for violence victimization of a sexual nature (for sexual assault, HR = 2.5, 95%CI 1.7-3.7). Return migrants were at increased risk for being kidnapped or held hostage (HR = 2.8, 95%CI 1.1-7.1). Compared to those without a mental disorder, those with a mental disorder were more likely to suffer any violence (HR = 2.3, 95%CI 1.9-2.7), regardless of the migrant experience. Conclusions: The impact of immigration on the occurrence of violence is more complex than usually believed. Return migrants are more likely to suffer violence such as being held hostage or beaten by someone other than a partner. .

Predictors of quit attempts and successful quit attempts in a nationally representative sample of smokers.

Although most current smokers report that they would like to quit, most quit attempts fail suggesting that predictors of quitting attempts may differ from those of successful attempts. We examined sociodemographic and clinical predictors of quit attempts and successful quit attempts in a nationally representative sample of US adults. Data was collected in 2001-2002 (Wave 1) and 2004-2005 (Wave 2). Almost 40% of individuals who had not previously attempted to quit, tried to quit over the next three years; only 4.6% of those who tried had succeeded at the time of the evaluation. Hispanics, Asians, individuals with high income, and those with college education were less likely to attempt to quit, whereas those with daily nicotine use, younger age at first use and most symptoms of dependence were more likely to do so. Having an educational level below high school and older age at first nicotine use were predictors of successful quitting. Despite relatively high rates of quit attempts, rates of success are extremely low, indicating a gap between the public health need of decreasing tobacco use, and existing means to achieve it. Although there is a need to encourage people to quit tobacco, there may be an equally large need to develop more effective interventions that increase the rate of successful quit attempts.