A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico

Philbin, Lozada Remedios, Zúñiga María, Mantsios Andrea, Case Patricia, Magis-Rodriguez Carlos, Latkin, Strathdee

Description

The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. Methods We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes. Results Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies. Conclusion Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2008
• Nombre de lectures: 8
• Langue: English

Extrait

Harm Reduction Journal

BioMedCentral

Open Access Research A qualitative assessment of stakeholder perceptions and sociocultural influences on the acceptability of harm reduction programs in Tijuana, Mexico 1 2 1 Morgan M Philbin , Remedios Lozada , María Luisa Zúñiga , 1 3 4 5 Andrea Mantsios , Patricia Case , Carlos MagisRodriguez , Carl A Latkin 1 and Steffanie A Strathdee*

1 2 Address: Division of International Health, School of Medicine, University of California San Diego, La Jolla, California, USA, ProCOMUSIDA, 3 4 Tijuana, Mexico, The Fenway Institute, Fenway Community Health, Boston, MA, USA, Centro Nacional para la Prevención del VIH/SIDA 5 (CENSIDA), Ministry of Health, Mexico and The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Email: Morgan M Philbin  [e-mail]; Remedios Lozada  [e-mail]; María Luisa Zúñiga  [e-mail]; Andrea Mantsios  [e-mail]; Patricia Case  [e-mail]; Carlos MagisRodriguez  [e-mail]; Carl A Latkin  [e-mail]; Steffanie A Strathdee*  [e-mail] * Corresponding author

Published: 20 November 2008 Received: 24 September 2008 Accepted: 20 November 2008 Harm Reduction Journal2008,5:36 doi:10.1186/14777517536 This article is available from: http://www.harmreductionjournal.com/content/5/1/36 © 2008 Philbin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background:The MexicoU.S. border region is experiencing rising rates of bloodborne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. Methods:We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. Indepth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societalrelated themes. Results:Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and sociocultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies.

Conclusion:Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.

Introduction Tijuana's rate of illegal drug use is the highest in Mexico, with 14.7% of the city's population reporting a lifetime

prevalence of ever having used an illegal drug (including marijuana), three times that of the national average (5.3%) [1]. Tijuana is situated on a major international

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