Research

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

Morgan M Philbin¹ , Remedios Lozada² , María Luisa Zúñiga¹ , Andrea Mantsios¹ , Patricia Case³ , Carlos Magis-Rodriguez⁴ , Carl A Latkin⁵ and Steffanie A Strathdee¹

¹  Division of International Health, School of Medicine, University of California San Diego, La Jolla, California, USA

²  Pro-COMUSIDA, Tijuana, Mexico

³  The Fenway Institute, Fenway Community Health, Boston, MA, USA

⁴  Centro Nacional Para la Prevención del VIH/SIDA (CENSIDA), Ministry of Health, Mexico

⁵  The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

author email corresponding author email

Harm Reduction Journal 2008, 5:36doi:10.1186/1477-7517-5-36

Published:	20 November 2008

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.