"Right Here is the Gateway": Mobility, Sex Work Entry and HIV Risk Along the Mexico-U.S. Border.

Women comprise an increasing proportion of migrants. Many voluntarily migrate for sex work or practice survival sex, while others may be trafficked for sexual exploitation. To investigate how the context of mobility shapes sex work entry and HIV risk, we conducted in-depth interviews with formerly trafficked women currently engaged in sex work (n=31) in Tijuana, Mexico and their service providers (n=7) in Tijuana and San Diego, USA from 2010-2011. Women's experiences of coerced and deceptive migration, deportation as forced migration, voluntary mobility, and migration to a risk environment illustrate that circumstances driving and resulting from migration shape vulnerability to sex trafficking, voluntary sex work entry, and HIV risk. Findings suggest an urgent need for public health and immigration policies that provide integrated support for deported and/or recently arrived female migrants. Policies to prevent sex trafficking and assist trafficked females must also consider the varying levels of personal agency involved in migration and sex work entry.

Drug resistance in Mexico: results from the National Survey on Drug-Resistant Tuberculosis.

OBJECTIVE: To present estimations obtained from a population-level survey conducted in Mexico of prevalence rates of mono-, poly- and multidrug-resistant strains among newly diagnosed cases of pulmonary tuberculosis (TB), as well as the main factors associated with multidrug resistance (combined resistance to isoniazid and rifampicin). DESIGN: Study data came from the National Survey on TB Drug Resistance (ENTB-2008), a nationally representative survey conducted during 2008-2009 in nine states with a stratified cluster sampling design. Samples were obtained for all newly diagnosed cases of pulmonary TB in selected sites. Drug susceptibility testing (DST) was performed for anti-tuberculosis drugs. RESULTS: DST results were obtained for 75% of the cases. Of these, 82.2% (95%CI 79.5-84.7) were susceptible to all drugs. The prevalence of multidrug-resistant TB (MDR-TB) was estimated at 2.8% (95%CI 1.9-4.0). MDR-TB was associated with previous treatment (OR 3.3, 95%CI 1.1-9.4). CONCLUSIONS: The prevalence of drug resistance is relatively low in Mexico. ENTB-2008 can be used as a baseline for future follow-up of drug resistance.

Performance of public health surveillance systems during the influenza A(H1N1) pandemic in the Americas: testing a new method based on Benford's Law.

The A(H1N1) influenza pandemic has been a challenge for public health surveillance systems in all countries. An objective evaluation has not been conducted, as yet, of the performance of those systems during the pandemic. This paper presents an algorithm based on Benford's Law and the mortality ratio in order to evaluate the quality of the data and the sensitivity of surveillance systems. It analyses records of confirmed cases reported to the Pan American Health Organization by its 35 member countries between epidemiological weeks 13 and 47 in 2009. Seventeen countries did not fulfil Benford's Law, and mortality exceeded the regional average in 40% of the countries. The results suggest uneven performance by surveillance systems in the different countries, with the most frequent problem being low diagnostic coverage. Benford's Law proved to be a useful tool for the evaluation of a public health surveillance system's performance.