Examining the Health and Drug Use Behaviors of Mexican American Injection Heroin Users: A Mixed Methods Approach
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.