Steffanie A Strathdee
Biographic Data
| ID | 187609 |
|---|---|
| NAME | Steffanie A Strathdee |
| GIVEN NAMES | Steffanie A |
| FAMILY NAME | Strathdee |
| SIGNATURE | STRATHDEE S A |
| AFFILIATIONS | University of California San Diego |
| ORCID | 0000-0002-7724-691X |
| VERIFIED | Yes |
| TOTAL WORKS | 268 |
| TOTAL CITATIONS | 463 |
| AUTHOR COUNT | 268 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1997 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 10 |
US overdose mortality saw first drop below the Jalal-Burke exponential growth curve in 2024
BACKGROUND: Between 1979 and 2016, US overdose death rates rose in a smooth fashion, described by Jalal and Burke using an exponential growth curve that fit observed data nearly perfectly. Fluctuations above this curve have subsequently been seen during shocks related to drug supply and the COVID-19 pandemic. However, large-magnitude dips below the curve have never been demonstrated. Given that overdose mortality began sharply falling during 2023…
Willingness to Receive Latent Tuberculosis Infection Treatment Among Migrants in Tijuana, Baja California, Mexico
Over 80% of tuberculosis cases in the United States are due to reactivation of untreated latent tuberculosis infection (LTBI), most of whom were foreign born. LTBI treatment can greatly lower the risk of progression to active TB disease, and shorter treatment regimens increase the potential of migrants and other persons in vulnerable conditions, to complete treatment. We conducted across-sectional study to assess willingness to complete a one-mon…
PrEP as a “Hidden Message”
Within the context of this PrEP demonstration project, partner dynamics impacted PrEP adherence for HIV-negative cisgender women in serodiscordant relationships. We urge further investigation of relationship dynamics and PrEP adherence and persistence specifically among US-based cisgender women
Adverse migration experiences, border community stress, and the mental health of asylum-seeking women in transit at the Mexico-U.S. border
We evaluated the association between adverse migration experiences, border community stress, and mental health symptoms in a community-recruited sample of asylum-seeking women. As part of a mixed-methods, community-academic partnership, we analyzed cross-sectional questionnaires conducted with asylum-seeking women at the Tijuana-San Diego border (N=151) between Feb-July 2024. Symptoms of anxiety (56.6%), moderate-to-severe depression (45.9%), and…
Motivational interviewing to increase drug checking and reduce overdose rates among people who use drugs
ClinicalTrials.gov, NCT06855836. Registered February 28, 2025. https://clinicaltrials.gov/study/NCT06855836?term=NCT06855836/rank=1
Linkage to hepatitis C virus care in a binational cohort study of People who inject drugs on the U.S.-Mexico border
Our study shows poor linkage to HCV-related care among PWID in both San Diego and Tijuana, along with low treatment completion. MOUD programs could be an efficient touchpoint to improve access to HCV care
Modeling the impact of changing drug markets and structural determinants on HCV and/or HIV transmission among people who inject drugs in the United States
Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020–2021
WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID-especially those who are unsheltered
WaSH insecurity and anxiety among people who inject drugs in the Tijuana-San Diego border region
The lack of specific WaSH services, particularly lack of drinking water, toilets, and daily showers were associated with higher levels of anxiety among PWID in the Tijuana-San Diego border region. Women experiencing homelessness were especially vulnerable. WaSH interventions that provide safe, 24-h access may help to reduce anxiety and health risks associated with WaSH insecurity
Safe Injection Self-Efficacy is Associated with HCV and HIV Seropositivity Among People Who Inject Drugs in the San Diego–Tijuana Border Region
Long-acting Injectable PrEP Interest and General PrEP Awareness among People who Inject Drugs in the San Diego-Tijuana Border Metroplex
A mixed methods study to inform fatal overdose prevention in San Diego, California
Modeling the impact of a supervised consumption site on HIV and HCV transmission among people who inject drugs in three counties in California, USA
Our models suggest that SCS is an important intervention to enable HCV elimination and could help end the HIV epidemic among PWID in California. It could also have additional benefits such facilitating pathways into drug treatment programs and preventing fatal overdose
Water, sanitation and hygiene insecurity predict abscess incidence among people who inject drugs in a binational US–Mexico metropolitan area
PWID in the Tijuana-San Diego metropolitan area reported facing high rates of insecurity accessing WASH services. Abscess incidence was higher (four to nine times) than observed rate among PWID cohorts in other settings. Access to continuously available toilet facilities, bathing infrastructure, and safe water sources for preparing drugs for injection could prevent abscesses among PWID. Accessible WASH infrastructure should be ensured among PWID …
Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the Covid-19 pandemic
Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time
Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings
Managing HIV During the Covid-19 Pandemic
Drug checking in the fentanyl era
Our findings highlight low rates of DCS awareness and utilization, inequities by race/ethnicity and housing situation, high interest in advanced spectrometry DCS versus FTS, and the potential role of SSPs in improving access to DCS, especially among racial/ethnic minorities
Unlocking deflection
Characterizing Drug use Typologies and Their Association with Sexual Risk Behaviors
The online version contains supplementary material available at 10.1007/s13178-023-00861-9
Covid-19 vaccine uptake among people who inject drugs in Tijuana Mexico
Background: SARS-CoV-2 prevalence is elevated among people who inject drugs (PWID). In Tijuana, Mexico, COVID-19 vaccines became available to the general population in June 2021, but uptake among PWID was <10%. We studied COVID-19 vaccine uptake among PWID in Tijuana following implementation of a pop-up vaccination clinic. Methods: Beginning in October, 2020, PWID in Tijuana aged ≥18 years were enrolled into a longitudinal cohort study. At baseli…
The impact of the Covid-19 pandemic among migrants in shelters in Tijuana, Baja California, Mexico
INTRODUCTION: Migrants, especially those in temporary accommodations like camps and shelters, might be a vulnerable population during the COVID-19 pandemic, but little is known about the impact of the pandemic in these settings in low-income and middle-income countries. We assessed SARS-CoV-2 seropositivity and RNA prevalence, the correlates of seropositivity (emphasising socially determined conditions), and the socioeconomic impacts of the pande…
Gender and the first‐time provision of injection initiation assistance among people who inject drugs across two distinct North American contexts
Prevalence of Sars-CoV-2 infection in Baja California, Mexico
Between March 2020 and February 2021, the state of Baja California, Mexico, which borders the United States, registered 46,118 confirmed cases of COVID-19 with a mortality rate of 238.2 deaths per 100,000 residents. Given limited access to testing, the population prevalence of SARS-CoV-2 infection is unknown. The objective of this study is to estimate the seroprevalence and real time polymerase chain reaction (RT-PCR) prevalence of SARS-CoV-2 inf…
Interrupted transit and common mental disorders among migrants in Tijuana, Mexico
BACKGROUND: Policies of migration contention can interrupt the transit of people on the move, forcing them to remain in wait in non-destination countries. This liminal condition might impact negatively on migrants' mental health. AIMS: To assess the relationship between interrupted transit and common mental disorders (CMD; symptoms of depression or anxiety), among migrants in shelters in Tijuana, Mexico. METHODS: Cross-sectional survey conducted …
The social structural production of HIV risk among injecting drug users
Evaluating effectiveness of syringe exchange programmes
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers
Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estim…
Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments
Objectives. We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. Methods. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All intervi…
Over here, it's just drugs, women and all the madness
Respondent-Driven Sampling of Injection Drug Users in Two U.S.–Mexico Border Cities
Respondent-driven sampling (RDS), a chain referral sampling approach, is increasingly used to recruit participants from hard-to-reach populations, such as injection drug users (IDUs). Using RDS, we recruited IDUs in Tijuana and Ciudad (Cd.) Juárez, two Mexican cities bordering San Diego, CA and El Paso, TX, respectively, and compared recruitment dynamics, reported network size, and estimates of HIV and syphilis prevalence. Between February and Ap…
Estimated Numbers of Men and Women Infected with HIV/Aids in Tijuana, Mexico
The prevalence of homelessness among injection drug users with and without HIV infection
Can't Buy My Love
Female sex workers (FSWs) experience elevated risk for HIV and sexually transmitted infections (STIs) through unprotected sex with male clients, yet the complexity of these commercial relationships remains understudied. From 2010 to 2011, we explored FSWs' conceptualizations of various client types and related risk behavior patterns using semistructured interviews with 46 FSWs in Tijuana and Ciudad Juarez, Mexico, where FSWs' HIV/STI prevalence i…
Eyes that don't see, heart that doesn't feel
Effects of Race, Neighborhood, and Social Network on Age at Initiation of Injection Drug Use
Objectives. We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use. Methods. Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses. Results. Adolescent-initiating IDUs were less likely than adult-initiating IDUs to r…
Vivo para consumirla y la consumo para vivir" ["I live to inject and inject to live"]
Deported, homeless, and into the canal
Human rights to drinking water, sanitation and hygiene are routinely violated among El Bordo inhabitants. This is exacerbated by violent policing practices that force unhoused deportees to seek refuge in waterways, and drive water contacts. Furthermore, US-Mexico 'free-trade' agreements drive rapid growth in Tijuana, restrict Mexican environmental regulation enforcement, and drive underinvestment in sewage systems and infrastructure
Right Here is the Gateway”
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…
A Qualitative View of Drug Use Behaviors of Mexican Male Injection Drug Users Deported from the United States
Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the substance use and deportation experiences of Mexicans deported from the United States. This pilot qualitative study describes illicit drug use behaviors among 24 Mexico-born male injection drug users (IDUs), ≥ 18 years old, residing in Tijuana, Mexico who self-identified as deportees from the United States. In-person interviews were c…
A tale of two cities
Needle-exchange attendance and health care utilization promote entry into detoxification
Somebody Is Gonna Be Hurt
Involuntary drug treatment (IDT) is ineffective in decreasing drug use, yet it is a common practice. In Mexico, there are not enough professional residential drug treatment programs, and both voluntary and involuntary drug treatment is often provided by non-evidence based, non-professional programs. We studied the experiences of people who inject drugs (PWID) in Tijuana who were taken involuntarily to drug centers under the auspices of a federall…
The Influence of Perceived Risk to Health and Immigration-Related Characteristics on Substance Use Among Latino and Other Immigrants
Objectives. We examined whether immigration-related characteristics and perceptions of risk surrounding substance use were independently associated with lifetime use of cigarettes and various illicit substances among immigrant and native-born Latino and non-Latino White adults in the United States. Methods. Data were from the 2002 National Survey on Drug Use and Health. Analyses were limited to Latinos and non-Latino Whites 18 years and older. We…
Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland
Implementing Mexico’s “Narcomenudeo” Drug Law Reform
In 2009, Mexico decriminalized small-scale drug possession, instituting drug treatment diversion in lieu of incarceration. To assess initial reform impact, our mixed methods study integrated a structured questionnaire with in-depth interviews assessing legal knowledge, police encounters, and risk behaviors among people who inject drugs (PWID) in Tijuana. Between 2010 and 2013, we recruited 737 adults; 32 participated in qualitative interviews. On…
Exploring the Context of Trafficking and Adolescent Sex Industry Involvement in Tijuana, Mexico
Coerced and adolescent sex industry involvement are linked to serious health and social consequences, including enhanced risk of HIV infection. Using ethnographic fieldwork, including interviews with 30 female sex workers with a history of coerced or adolescent sex industry involvement, we describe contextual factors influencing vulnerability to coerced and adolescent sex industry entry and their impacts on HIV risk and prevention. Early gender-b…
Syringe Confiscation as an HIV Risk Factor
Childbearing Intentions of HIV-Positive Women of Reproductive Age in Soweto, South Africa
Objectives. We investigated whether the intention to have children varied according to HIV status and use of highly active antiretroviral therapy (HAART) among women in Soweto, South Africa. Methods. We used survey data from 674 women aged 18 to 44 years recruited from the Perinatal HIV Research Unit in Soweto (May through December 2007); 217 were HIV-positive HAART users (median duration of use = 31 months; interquartile range = 28, 33), 215 wer…
The social determinants of emergency department and hospital use by injection drug users in Canada
Needle exchange is not enough
Despite having the largest NEP in North America, Vancouver has been experiencing an ongoing HIV epidemic. Whereas NEP are crucial for sterile syringe provision, they should be considered one component of a comprehensive programme including counselling, support and education.
HIV-positive Women Living in the Metropolitan Toronto Area
Determinants of HIV-related High Risk Behaviours Among Young Offenders
Barriers to Use of Free Antiretroviral Therapy in Injection Drug Users
CONTEXT: In British Columbia, human immunodeficiency virus (HIV)-infected persons eligible for antiretroviral therapy may receive it free but the extent to which HIV-infected injection drug users access it is unknown. OBJECTIVE: To identify patient and physician characteristics associated with antiretroviral therapy utilization in HIV-infected injection drug users. DESIGN: Prospective cohort study with record linkage between survey data and data …
A qualitative investigation into an HIV outbreak among injection drug users in Vancouver, British Columbia
The proportion of injection drug users (IDUs) testing positive for Human Immunodeficiency Virus (HIV) in British Columbia has increased from 3 to 7% since January 1993 (Patrick et al., 1997). We conducted a qualitative study as a first step in a case control investigation aimed at identifying risk factors associated with HIV seroconversion. Sixteen subjects participated in in-depth interviews which were transcribed and analysed using grounded the…
The social determinants of emergency department and hospital use by injection drug users in Canada
Needle-exchange attendance and health care utilization promote entry into detoxification
Non-Nominal HIV Surveillance
Factors Associated with Willingness to Participate in HIV Vaccine Trials Among HIV-Negative Injection Drug Users and Young Gay and Bisexual Men
Decline in Self-Reported High-Risk Injection-Related Behaviors Among HIV-Seropositive Participants in the Baltimore Needle Exchange Program
Characteristics and utilization patterns of needle-exchange attendees in Chicago
The prevalence of homelessness among injection drug users with and without HIV infection
Evaluating effectiveness of syringe exchange programmes
Sex Differences in Risk Factors for HIV Seroconversion Among Injection Drug Users
BACKGROUND: Injection drug use directly or indirectly accounts for nearly half the annual human immunodeficiency virus (HIV) infections in the United States. Prospective studies that investigate both sexual and parenteral HIV risks among injection drug users (IDUs) are needed. We studied factors for HIV seroconversion among male and female IDUs in Baltimore, Md. METHODS: The HIV-negative IDUs (1447 male and 427 female) were recruited into a prosp…
Social Factors Related to Antiretroviral Therapy Use in Injection Drug Users
Impact of Needle Exchange Programs on Adolescent Perceptions About Illicit Drug Use
Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men
OBJECTIVE: To determine whether attitudes towards highly active antiretroviral therapy (HAART) are associated with unprotected anal sex among sexually active homosexual men. DESIGN: Cross-sectional study nested within an ongoing prospective cohort study. SETTING: Multicenter AIDS Cohort Study, from April through September 1999. PARTICIPANTS: Five-hundred and forty-seven homosexual men reporting anal sex (218 HIV-negative and 329 HIV-positive) dur…
Risk Behaviors by Audio Computer-Assisted Self-Interviews among HIV-Seropositive and HIV-Seronegative Injection Drug Users
Audio computer assisted self-interview (ACASI) has been shown to elicit significantly higher reports of sensitive HIV risk behaviors compared with interviewer-administered questionnaires (IAQ). Injection drug users were randomized to either ACASI (n = 556) or IAQ (n = 586) in order to evaluate reporting differences. A significant interaction was found between mode of administration (ACASI/IAQ) and HIV status. HIV-seropositive respondents on ACASI…
From risk environments to safe havens
Social influences on the transition to injection drug use among young heroin sniffers
Correlates of Suicide Attempts in an Open Cohort of Young Men Who Have Sex with Men
The Role of Sexual Transmission of HIV Infection Among Injection and Non-Injection Drug Users
Public opinion about syringe exchange programmes in the USA
Sterile syringe access for injection drug users in the 21st century
Sexual HIV transmission in the context of injection drug use
Medicine (247 works) · HIV, Drug Use, Sexual Risk (218 works) · Environmental health (153 works) · HIV/AIDS Research and Interventions (147 works) · Psychiatry (127 works) · Demography (123 works) · Psychology (114 works) · Sex work and related issues (108 works) · Family medicine (100 works) · Public health (94 works)