An Ethnographic Assessment of Covid-19‒Related Changes to the Risk Environment for People Who Use Drugs in Tijuana, Mexico

Dados Bibliográficos

ID11022752
AutoresJoseph Friedman (0000-0002-5225-3267, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Alhelí Calderon-Villarreal (0000-0003-1064-7097, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Rebeca Cazares Adame (Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Daniela Abramovitz (0000-0002-2969-7193, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Claudia Rafful (0000-0003-0083-7276, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Gudelia Rangel (0000-0003-3376-152X, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Alicia Vera (0000-0001-5865-1621, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), Alicia Harvey-Vera (0000-0002-8708-8169, UCLA Health), Steffanie A Strathdee (0000-0002-7724-691X, Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhelí Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Autónoma de...), P Bourgois (0000-0002-1600-233X, UCLA Health)
Ano2022
Volume112
FascículoS2
PáginasS199-S205
Data de publicação2022-04-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAmerican Journal of Public Health (JOURNAL)
Identificadores do periódicoISSN: 0090-0036 • E-ISSN: 1541-0048
EditoraAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2022.306796
PMID35349326
OpenAlexW4220742055
IdiomaEN
Citações recebidas2
Referências citadas22

Objectives. To characterize the effects of the onset of the COVID-19 pandemic on the risk environment of people who use drugs (PWUD) in Tijuana, Mexico. Methods. We used intensive participant-observation ethnography among street-based PWUD and key informants, such as frontline physicians and harm reductionists. Results. PWUD described an unprecedented cessation of police violence and extortion during the initial pandemic-related lockdown, though this quickly reversed and police violence worsened. Government-provided housing and medical treatment with methadone were temporarily provided to PWUD in a dedicated clinic, yet only for PWUD with COVID-19 symptoms. Concurrently, non‒COVID-19‒related hospital care became virtually inaccessible, and many PWUD died of untreated, chronic illnesses, such as hepatitis C, and soft-tissue infections. Border closures, decreases in social interaction, and reduced drug and sex tourism resulted in worsening food, income, and housing insecurity for many PWUD. By contrast, potent illicit drugs remained easily accessible in open-air drug markets. Conclusions. The pandemic exacerbated health risks for PWUD but also offered profound glimpses of beneficial structural changes. Efforts are needed in Tijuana and elsewhere to institutionalize positive pandemic-related shifts and ameliorate novel harms for PWUD. (Am J Public Health. 2022;112(S2):S199–S202. https://doi.org/10.2105/AJPH.2022.306796 )

Ethnography · Extortion · Harm · Harm reduction · Health care · Overcrowding · Pandemic · Public health · Suicide prevention · Vulnerability (computing) · Forensic Toxicology and Drug Analysis · HIV, Drug Use, Sexual Risk · Opioid Use Disorder Treatment