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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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Objective: This study examines patterns of multimorbidity among elderly male inmates across four domains of health (chronic medical conditions, drug- and alcohol-related diseases, impairments, and mental and behavioral health) to understand the complex health care needs of this growing population. Method: We use the 2004 Survey of Inmates in State Correctional Facilities and Latent Class Regression Analysis to examine 22 health problems among 1,026 men aged 50 and older. Results: There are four groups of elderly male inmates: (a) relatively healthy (45.1%), (b) substance users with behavioral health issues (23.4%), (c) chronic unhealthy with impairments and violence/injury (23.6%), and (d) very unhealthy across all domains (7.9%). These groups have unique sociodemographic background and incarceration history characteristics. Conclusion: This study demonstrates the complexity of health for elderly inmates. Prison health should continue to be monitored to aid correctional and community health programs in understanding clinical risks, exposures, and health care needs for this population. [ABSTRACT FROM AUTHOR]

Female sex workers (FSW) represent a population confronted with an array of intersecting social problems. We explore the case of FSW in Nuevo Laredo and Ciudad Juarez to understand the everyday violence associated with sex work within the unique context of Mexico. Life history interviews were conducted with 109 FSW revealing violent acts by clients and other sex industry employees (bar owners, police, other FSW). The risk of violence by different types of persons associated with the sex work industry varied by venue and geographic area. Moreover, the violence was shaped by the social structural constraints of dominant gender ideologies. [ABSTRACT FROM AUTHOR]

Abstract: Rationale: A growing body of research has revealed disparities with respect to drug use patterns within Latino subgroups. However, the extent to which these potential disparities enable different Latino subgroups to respond favorably to treatment is unclear. Methods: This study analyzed a subset of multicross-sectional data (2006–2009) on Latinos collected from publicly funded facilities in Los Angeles County, CA (N =12,871). We used multilevel logistic regressions to examine individual and service-level factors associated with treatment completion among subgroups of first-time Latino treatment clients. Results: Univariate analysis showed that Cubans and Puerto Ricans were less likely to complete treatment than Mexicans and other Latinos. Cubans and Puerto Ricans entered treatment at an older age and with higher formal education than Mexicans, yet they were more likely to report mental health issues and use of cocaine and heroin as primary drugs of choice respectively. Multivariate analysis showed that age, having mental health issues, reporting high use of drugs at intake, and use of methamphetamines and marijuana were associated with decreased odds of completing treatment among all Latino subgroups. In contrast, age at first drug use, treatment duration, and referral monitoring by the criminal system increased the odds of completing treatment for all members. Conclusion: These findings have implications for targeting interventions for members of different Latinos groups during their first treatment episode. Promising individual and service factors associated with treatment completion can inform the design of culturally specific recovery models that can be evaluated in small-scale randomized pilot studies. [Copyright &y& Elsevier]

This paper examines childhood trauma, depression and psychological family and cultural stress among Mexican American male non-injecting users (NIU) of heroin in San Antonio, Texas. The research enhances the findings from a National Institute on Drug Abuse (NIDA) study, "Drug Related Gang Violence in South Texas", conducted from 1995-1997. A high rate of non-injecting heroin use among these young male Mexican-American gang members emerged as a special concern because of the serious health consequences associated with non-injecting heroin use. HIV and AIDS among Hispanics are attributed primarily to injecting drug use, followed by sexual transmission among heterosexuals and male-to-male sexual contact. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Previous research has found that disorderly life events in early adolescence are associated with problem behaviors in late adolescence and early adulthood. The objective of the study is to determine the patterns of associations among substance use and adolescence precocious transitions in a sample (N=160) of Mexican American gang members in San Antonio, Texas. The Mexican American male gang members are a poly drug using population as measured by their lifetime and current drug use patterns. A correlation and confirmatory factor analysis was conducted between substance use and precocious transitions that revealed two distinct groups of thug users in the Mexican American gang population: "hard" drug users and "party" drug users. Furthermore, factor analysis revealed underlying precocious transitions constructs that go beyond a precocious transitions index. Findings begin to identify the importance of disorderly life events as correlates of substance use among this unique population of gang members. [ABSTRACT FROM AUTHOR]

• Determine the consequences of maternal incarceration using longitudinal measures. • Maternal incarceration trajectories impact children's risk of imprisonment. • Mothers' sexual abuse experience links to intergenerational incarceration. • Mothers' juvenile justice imprisonment relates to children's risk of incarceration. 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. [ABSTRACT FROM AUTHOR]

Background: While the comorbidity of mental health and injecting heroin has been documented, current research is limited by describing the mental health of people who inject drugs without a comparison group and by the lack of research on nontreatment samples in the United States, particularly among Hispanics. The purpose of this study was to examine the association of injecting history (never, former, occasional, and daily) and multiple outcomes of global and mental health using a sample of U.S.-based Latinos not currently in treatment.Methods: Data are from a sample of street-recruited Mexican American young adult men (n=275) in San Antonio, TX. Multiple logistic regression and structural equation modeling were used.Results: Overall 54% of men reported lifetime injecting drug use (20.7% former users, 11.1% occasional users, and 21.9% daily users). We found varying prevalence rates of global and mental health status among different histories of injecting. After covariate adjustment, daily injecting remained strongly associated with all four outcomes: perceived poor health status (AOR=4.39; p≤0.001), psychological distress (AOR=2.78; p≤0.05), depression (AOR=4.37; p≤0.001), and suicidal ideation (OR=4.75; p≤0.001). Acculturation, gang membership, and incarceration history also emerged as important factors.Conclusion: This study provides new information about the relationship between mental health and injecting heroin use.Findings: Support the need to consider mental health states among people who inject drugs, and to examine varying histories of injecting with socially and culturally relevant factors. [ABSTRACT FROM AUTHOR]

Abstract: 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. [Copyright &y& Elsevier]

Herpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted infections in the United States. Despite this, there has been limited research on the correlates to HSV-2 among disadvantaged and marginalized women, particularly among Latinas. Data for the present analysis include 125 young adult Mexican-American women enrolled in a longitudinal study in a disadvantaged urban community in San Antonio, Texas. The current rate of tested HSV-2 infection is 56.8%. Our findings suggest strong comorbidity of genital herpes with injecting heroin use, Hepatitis C, sexual violence, incarceration, and mental illness. Contributing to this population's nexus of risk are the low rates of health service utilization among those infected with HSV-2. Integration between behavioral health and primary care, including access to preventative services, are essential for improving the health of Latinas living in disadvantaged neighborhoods.