Peer Effects on Condom Use and Sexual Risk Behavior Among Mexican Migrants, Returning Migrants and Non-Migrants Open Access

Abstract

Migration from Mexico to the U.S. is the largest sustained flow of immigrants
anywhere in the world with 11% of Mexican-born people living as migrants in the U.S. International
migrants have been identified as a vulnerable population for HIV and the migration process has been
cited as a factor for HIV infection. Higher rates of HIV in Mexico have been linked to Mexican returning-
migrants from the U.S. Although condom use among migrants has been identified at higher levels of use
when compared with non-migrants, the determinants for greater condom use among migrants are not
well defined. Social networks and peer effects have been shown to significantly improve health-related
behaviors. The aim of this study was to understand the association between peer influences
and condom use among Mexican migrants to the US, migrants who had returned to Mexico from the US
and men who had never migrated. The data for this study were obtained from a mixed
methods data collection study looking at different aspects of Mexican-migrant and non-migrant health
and sexual risk behaviors. Bivariate logistic regression analysis was conducted to identify factors of
interest associated with condom use. Multivariate logistic regression analysis was used to create two
models that included peer effects as predictors of condom use.The study sample included 224
male Mexican migrants, 318 returning migrants and 336 non-migrants. Age, migrant status, marital
status, duration of peer's friendship, peer's condom use and peer's advise about condom use were
potential independent predictors of condom use during last sex. This study did not show a significant
difference between migrant group and condom use as previously shown by other studies. Multivariate
logistic modeling showed that peer's condom use (OR= 7.52, 95% CI= 3.00, 18.87), and peer's advise
about condom use (OR= 3.57, CI= 1.46, 8.72) were significant predictors of condom use during last sex.
This study suggests that peer influences may impact condom use and that this may partially
explain the differences previously reported in condom use between Mexican migrant and non-migrant
populations. Understanding the role of social networks among migrant and Mexican non-migrant
populations may allow the design of novel effective and comprehensive HIV/AIDS prevention
interventions.

Table of Contents

Table of Contents

Chapter 1. Introduction................................................................................................................1
1.1 Rationale.............................................................................................................................................1
1.2 Problem Statement............................................................................................................................1
1.2. Purpose Statement............................................................................................................................2
1.3 Research Questions:..........................................................................................................................2
2.1. Importance of Comprehensive-Evidence-Based HIV/AIDS Prevention.................................1
2.2. The Magnitude and Intensity of Migration between Mexico and the U.S...............................3
2.3. Migration and Risk of HIV/AIDS:.................................................................................................5
2.4. Condom Use in Mexican Migrants................................................................................................6
2.5. Justification for Studying Individual and Environmental Determinants of Condom Use in
Mexican Migrants....................................................................................................................................8
2.6. Migrant's Peer Effects and Health-Related Behavior................................................................10

CHAPTER 3. Methods and Results.........................................................................................13

3.1 Methods:...........................................................................................................................................13
Study Population:..............................................................................................................................13
Sampling Methodology:...................................................................................................................14
First Stage Data Sampling:...............................................................................................................15
Second Stage Data Sampling:..........................................................................................................16
Sample Size:........................................................................................................................................16
Data Collection:.................................................................................................................................17
Recruitment and Study Interviews:................................................................................................18
Human Subject Research Approval:...............................................................................................19
Data Analysis:....................................................................................................................................19
Overall Descriptive Statistics:..........................................................................................................19

3.2. Results:.............................................................................................................................................21
Overall Descriptive Statistics:..........................................................................................................21
Descriptive Statistics by Migrant Status:.......................................................................................21
Bivariate Logistic Regression Modeling- Research Question 1:.................................................22
Model 1- Research Question 2:........................................................................................................22
Model 2- Research Question 3:........................................................................................................23

CHAPTER 4. Discussion, Conclusions and Recommendations........................................25
4.1. Discussion:......................................................................................................................................25
4.2. Conclusions and Recommendations..........................................................................................28
Conclusions:.......................................................................................................................................28
Recommendations:............................................................................................................................28
APPENDIX A...............................................................................................................................30
APPENDIX B...............................................................................................................................37
References....................................................................................................................................38

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Mexican Migrant health, sexual risk behavior, HIV/AIDS, peer effects, condom use
Committee Chair / Thesis Advisor	Del Rio, Carlos, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs University, college or educational institution (other than Emory)

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