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Examining the Health and Drug Use Behaviors of Mexican American Injection Heroin Users: A Mixed Methods Approach
Sunday, January 20, 2013: 8:45 AM-10:30 AM
Nautilus 2 (Sheraton San Diego Hotel & Marina)
Cluster: Substance Misuse and Addictive Behaviors
Symposium Organizer:
Luis R. Torres, PhD, University of Houston
Background and Purpose. Research on the health consequences of long-term injection drug use (IDU) among Mexican Americans is limited. Drug abuse and addiction are complex phenomena, which require multiple perspectives to better understand the drug abuse behaviors of the Mexican American population. This complexity is reflected in the collection of five papers featured in this symposium. These five papers are centered on three major themes: 1) The role of culture, in this case, Mexican American cultural values, on drug addiction and its health consequences; 2) The spatial nature of drug abuse; and 3) Co-occurring substance abuse and mental health conditions. These studies also take advantage of the rich quantitative and qualitative information on a "hidden" population (Mexican American heroin users) and provide a rare glimpse into their lives and the role that drug addiction has played.
Methods. The overall study that all five papers draw from is a prospective cohort study design consisting of face-to-face interviews with a structured questionnaire. Using field-intensive outreach methods we recruited 227 Mexican-American men 45 and older (M age=55.15, SD=8.27) with a history of injection drug use (IDU) for at least three years (Mean Duration IDU=31.15 Years, SD=11.54) and who were either current injectors, former injectors not in treatment, or former injectors enrolled in Methadone Treatment. Respondents were interviewed with a semi-structured instrument that collected demographic data and detailed information on substance use trajectory, family history, mental health measures, treatment history, acculturation and cultural values, and comprehensive medical and sexual histories. Additionally, 61 respondents were selected for in-depth ethnographic interviews centered around thematic areas covered or elicited by the quantitative survey (i.e., drug use trajectory, health, cultural values, etc.)
Results. Paper 1 examines the relationship between the presence of disease and self-rated health, specifically how this relationship is moderated by cultural values prevalent in Mexican American communities. Paper 2 is a qualitative study that discusses major themes related to heroin relapse in this population. Paper 3 uses Logistic Geographically Weighted Regression (GWR) models to examine the non-spatial and spatial effects of locus of control (LOC) and perceived concerns about injecting heroin in the near future. Paper 4 examines the role of familismo or family-centeredness in initiation of injection, treatment, and cessation of IDU. Lastly, Paper 5 describes the prevalence and correlates of co-occurring substance use and mental health conditions.
Conclusions and Implications. Taken together, these five papers provide a rich and nuanced description of the health and mental health consequences of injection heroin use in Mexican American men. Considering that Hispanics are disproportionately impacted by multiple health disparities, the collective findings of these five papers can provide much-needed ammunition in the struggle to eliminate such disparities, especially those related to drug use.
* noted as presenting author
Cultural Values, Disease, and Self-Rated Health Among Mexican American Injection Heroin Users
Luis R. Torres, PhD, University of Houston;
David V. Flores, PhDc, MPH, MSW, University of Houston;
Yi Ren, MA, MA, University of Houston;
Dennis T. Kao, PhD, University of Houston;
Patrick S. Bordnick, MPH, MSW, PhD, University of Houston
Determinants of Heroin Relapse in Older Mexican American Heroin Users- Implications for Culturally Responsive Treatment Modalities
Steven Applewhite, PhD, University of Houston;
Ashleigh Scinta, MSW, University of California, Los Angeles;
Yolanda Villarreal, MSW, University of Houston;
Patrick S. Bordnick, MPH, MSW, PhD, University of Houston
Exploring the Non-Spatial and Spatial Role of Locus of Control Among Heroin-Injecting Mexican American Men
Dennis T. Kao, PhD, University of Houston;
Luis R. Torres, PhD, University of Houston;
Sheila Singh, MA, University of Houston;
Patrick S. Bordnick, MPH, MSW, PhD, University of Houston
Sangre Mala, Sangre Buena/Good Blood, Bad Blood: The Role of Familismo As Risk and Protective Factor in Heroin-Injecting Mexican American
David V. Flores, PhD, LMSW, MPH, CPH, The University of Texas Health Science Center at Houston;
Luis R. Torres, PhD, University of Houston;
Melissa Torres, MSW, University of Houston;
Yi Ren, MA, MA, University of Houston;
Irene Pericot-Valverde, MA, University of Houston;
Tenee Lopez, University of Houston;
Dennis T. Kao, PhD, University of Houston;
Patrick S. Bordnick, MPH, MSW, PhD, University of Houston
Prevalence and Correlates of Co-Occurring Substance Use and Mental Health Conditions Among Aging Mexican American Injecting Heroin Users
Yolanda Villarreal, MSW, University of Houston;
Luis R. Torres, PhD, University of Houston;
Patrick S. Bordnick, MPH, MSW, PhD, University of Houston;
Adriana A. Alcantara, PhD, University of Houston;
Ali Haider, University of Houston