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1.
J Health Care Poor Underserved ; 34(3): 1021-1036, 2023 Aug.
Article in English | MEDLINE | ID: mdl-38009112

ABSTRACT

Migration, detention, and deportation are often rife with violence. This study sought to examine associations between pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants.


Subject(s)
Mental Health Services , Transients and Migrants , Humans , Mental Health , Mexico/epidemiology , Emigration and Immigration
2.
PLOS Glob Public Health ; 3(2): e0001571, 2023.
Article in English | MEDLINE | ID: mdl-36963089

ABSTRACT

Gender, violence, and migration structurally impact health. The Venezuelan humanitarian crisis comprises the largest transnational migration in the history of the Americas. Colombia, a post-conflict country, is the primary recipient of Venezuelans. The Colombian context imposes high levels of violence on women across migration phases. There is little information on the relationship between violence and HIV risk in the region and how it impacts these groups. Evidence on how to approach the HIV response related to Venezuela's humanitarian crisis is lacking. Our study seeks to 1) understand how violence is associated with newly reported HIV/AIDS case rates for women in Colombian municipalities; and 2) describe how social violence impacts HIV risk, treatment, and prevention for Venezuelan migrant and refugee women undergoing transnational migration and resettlement in Colombia. We conducted a concurrent mixed-methods design. We used negative binomial models to explore associations between social violence proxied by Homicide Rates (HR) at the municipality level (n = 84). The also conducted 54 semi-structured interviews with Venezuelan migrant and refugee women and key informants in two Colombian cities to expand and describe contextual vulnerabilities to HIV risk, prevention and care related to violence. We found that newly reported HIV cases in women were 25% higher for every increase of 18 homicides per 100,000, after adjusting for covariates. Upon resettlement, participants cited armed actors' control, lack of government accountability, gender-based violence and stigmatization of HIV as sources of increased HIV risk for VMRW. These factors impose barriers to testing, treatment and care. Social violence in Colombian municipalities is associated with an increase in newly reported HIV/AIDS case rates in women. Violence hinders Venezuelan migrant and refugee women's access and engagement in available HIV prevention and treatment interventions.

4.
Front Public Health ; 10: 928385, 2022.
Article in English | MEDLINE | ID: mdl-35968453

ABSTRACT

Background: Migrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico. Methods: We conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors. Results: About 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded. Conclusion: These findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.


Subject(s)
COVID-19 , Transients and Migrants , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Cross-Sectional Studies , Humans , Mexico/epidemiology , Surveys and Questionnaires , Vaccination
5.
Glob Public Health ; 17(10): 2484-2499, 2022 10.
Article in English | MEDLINE | ID: mdl-35319352

ABSTRACT

This essay brings together different voices to reflect on several participatory research projects carried out in Colombia, based on human rights, 'empowerment', harm reduction, (im)mobility and forced migration, gendered and political violence, armed conflict, and the right to health of people in the social margins. We look back on nine years of activism to explore the foundations of what our friendships and relationships have come to know as a revolutionary ethos. We critically re-visit and reflect on the concept of 'the activist' in the realms of the human rights apparatus in Colombia, the academy and the Non-Profit Industrial Complex (NPIC). We look back on what was forged and what was lost to propose the critical concept of 'radical honesty and self-care' as the basis for a revolution that supports processes of healing and social justice. Finally, we imagine what 'healing' can look like, as committed activists despite our differences and positionalities. We engage with and problematise the different forms of activism that emerge in social struggles and we address self-criticisms, constant reflection, radical honesty and uncomfortableness as powerful tools in joining forces to continue social justice work and caring.


Subject(s)
Human Rights , Social Justice , Colombia , Humans , Violence
7.
Global Health ; 16(1): 118, 2020 12 17.
Article in English | MEDLINE | ID: mdl-33334370

ABSTRACT

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Subject(s)
COVID-19/prevention & control , Emigration and Immigration/statistics & numerical data , Human Rights/standards , Malaria/transmission , COVID-19/epidemiology , Economic Recession/statistics & numerical data , Human Rights/trends , Humans , Malaria/epidemiology , Refugees/statistics & numerical data , Venezuela/epidemiology
8.
Glob Public Health ; 15(10): 1479-1495, 2020 10.
Article in English | MEDLINE | ID: mdl-32310725

ABSTRACT

Through qualitative data collected with women affected by drug use and drug-related violence in Bogotá, this article explores the convergence of harm reduction rationales and violence prevention programming in the urban margins to advocate for women's health empowerment and health rights as victims of intergenerational trauma and violence. We propose a methodological shift of public health praxis from street-based outreach models to intimate spaces of intervention for health outcomes embodiment 1 as we continue to develop our community health model to work with marginalised communities in the urban global South. Through this work committed to social justice in marginalised urban communities, we seek to support women's health needs through harm reduction in historically marginalised communities in urban settings. Our results expose how multi-level gender-based violence affects women's health in their living spaces in the urban margins. Drawing from women's voices and narratives of urban violence, we call for a feminist alternative to traditionally masculinist and public-space oriented harm reduction practice for health empowerment in the urban margins.


Subject(s)
Harm Reduction , Urban Population , Violence , Female , Humans , Violence/prevention & control
9.
Glob Public Health ; 13(12): 1831-1845, 2018 12.
Article in English | MEDLINE | ID: mdl-29583079

ABSTRACT

Drawing from qualitative research conducted in a participatory action research framework with 28 transgender women in Colombia, this paper presents the stigma-related barriers to healthcare experienced by trans women and their experiences of multi-level violence within the healthcare system. The authors also discuss how advocacy work was conducted as part of the research process and how trans community leaders were involved throughout the project in order to promote policy-relevance and community-based implementation of findings. The paper concludes with a discussion of how the experiences of violence and stigmatisation within the health care system is linked to broader processes of structural stigma reproduced within Colombian society.


Subject(s)
Delivery of Health Care , Health Services Accessibility , Social Stigma , Transgender Persons , Violence , Adult , Colombia , Community-Based Participatory Research , Female , HIV Infections , Humans , Middle Aged , Social Class , Surveys and Questionnaires , Young Adult
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