Knowledge, perceptions, discrimination, health self-efficacy, and risky behaviors for HIV/AIDS and its association with migration time among Mixtec and Zapotec men who migrate, 2012
BACKGROUND AND SIGNIFICANCE: Historically, there has been a transnational migration flow from Mexico to the United States. There are many reasons for which people make the decision to migrate; the most common ones are unemployment and economic hardship. Currently, Oaxaca is considered one of the states with the highest poverty levels in Mexico. As a result of extreme poverty groups of indigenous people, such as Zapotec and Mixtec, are forced to migrate out of their communities in order to find jobs. Migration has been associated with various health outcomes, including diabetes, high blood pressure, and heart disease as well as negative effects on mental health. Evidence shows that upon their arrival to the U.S., Mexican immigrants tend to practice healthier behaviors than the Anglo-American population. However, acculturation has a negative impact on their lifestyle and consequently on their health. This situation puts them at risk for many chronic and infectious diseases, including HIV/AIDS. STUDY AIMS: The aims of this study are to (1) describe total migration time away; (2) describe sexual partners and condom use; (3) describe perceptions and discrimination towards HIV/AIDS, and health self-efficacy for HIV/AIDS; and (4) determine the association between migration time away from their community and knowledge, perceptions, discrimination, and health efficacy towards HIV/AIDS among adult Mixtec and Zapotec men who migrate within Mexico and to the United States. METHODS: This study is a secondary data analysis from a cross-sectional study completed in 2012 among Mixtec and Zapotec men who had migrated and now living in Oaxaca, OAX, Chihuahua, CHIH, or Vista, CA. Participants were interviewed using a structured questionnaire to assess the following measures: demographic characteristics, migration, sexual behaviors, access to goods and services, access to health care, risk perceptions knowledge, perceptions, discrimination, and health self-efficacy for HIV/AIDS. RESULTS: A total of 106 participants were interviewed. Participants' median total migration time away, the outcome of this study, was 8 years (range 5 months to 53 years). Of these, 70.8% identified as Mixtec with median age of 35 (range 19 to 79) years old. Most (71.7%) participants reported having no or elementary education. The primary reason reported for migration was for work (87.7%) and more than half (55.7%) reported currently working in activities involving agriculture. There were significant associations in time spent away by ethnicity (p-value=0.001), schooling (p-value=0.029), and marginally for work activities in the field (p-value=0.051). A vast majority of participants (90.0%) reported having sex with their stable partner in the last six months, among those, 76.1% reported never using a condom with their stable partner. No significant associations were detected between migration time and measures for sexual partners and condom use. The majority of participants (81.0%) believed that people who have HIV/AIDS have the right to be loved and cared by his/her family; have the same rights as those that do not have it (80.0%); and have the right to work (78.1%). There were significant associations between migration time away and participants' views on whether people with HIV are entitled to work (p-value=0.033) and children of people living with HIV/AIDS are entitled to attend school (p-value=0.006). There were no significant associations between migration time away and measures for HIV/AIDS and sexually transmitted infections (STI) knowledge. Most participants felt they had personal control over contracting HIV by agreeing to the following statements: it's up to you if you get HIV/AIDS (81.9%); if you adopt appropriate measures, you can avoid getting the HIV/AIDS virus (81.7%); and they agreed to in order for you to get infected with HIV/AIDS, it depends on your own actions (84.6%). DISCUSSION: Future studies should not only focus on the individual but instead should focus on contextual factors (e.g., social networks, policy, physical and social environment, etc.) as well as structural factors (e.g., poverty, economic crisis, etc.) beyond migration time away because alone it does not explain variability in independent variables. The main strength of the study is that this study is specific to Mixtec and Zapotec men as opposed to all Mexican migrants. Study limitations include: Interviewers were different per site; migration status was based on their current location; and, the analysis for migration time was not stratified in age group nor was it was not adjusted for age.
GLBT Studies|Public health|Health education|Gender studies|Epidemiology
Bejarano, Sandra I, "Knowledge, perceptions, discrimination, health self-efficacy, and risky behaviors for HIV/AIDS and its association with migration time among Mixtec and Zapotec men who migrate, 2012" (2013). ETD Collection for University of Texas, El Paso. AAI1551216.