Table II.

Quantitative and Qualitative Findings Regarding U.S. Injection Initiation Among Deported Male IDUs in Tijuana, Mexico (2008 – 2010)

	QUANTITATIVE RESULTS		QUALITATIVE RESULTS
Context from Theoretical Framework	Variable	RDS-Adjusted AOR a (95% CI) b	Theme	Illustrative Quotes
1. Pre- Migration (Mexico) Context	Ever consumed any drugs in Mexico pre- migration	4.61 (2.36–9.00)	Limited drug use in Mexico pre-migration: Some exposure to illicit drugs by families, schools, communities Social pressure against drug use	There in Sonora, they’ve always had heroin. Since I was a kid, I saw tecatos [junkies; IDUs]; I saw drugs. I had an uncle who died of an overdose when I was just a kid. –first migrated at age 17 I started to smoke [marijuana], very hidden. I remember well that I was just a kid. […] I would hide it in my socks or other places so they wouldn’t find it in the house. –first migrated at age 14
2. Initial U.S. Migration Experiences	Age first migrated to U.S. (per year increase)	0.86 (0.82–0.89)	--	--
3. Post- Migration (U.S.) Context	Ever incarcerated in United States	6.00 (2.84–12.68)	U.S. criminal records were intertwined with drug abuse: Early delinquency related to drug use Crimes relating to drugs (possession, paraphernalia) Poor access to drug treatment (immigration status) Coping with guilt/emotions from criminal activities	Because sometimes I couldn’t earn enough money, well, I would go out to make mischief, rob or sell drugs. It wasn’t an honest way to live. Then, because I was selling drugs and doing bad things to survive, so that I wouldn’t run out of drugs, they caught me and … and sent me the first time to [juvenile hall] and then to prison. […] There were a lot of tecatos [junkies; IDUs] in there. –first migrated at age 12 I went to pick up some heroin, and that’s when they caught me. I had malilla [withdrawal], and I was going to find a syringe … A patrol car passed by and they saw me … I think someone must have pointed me out, because when I started running, they already had me … they caught me with the drugs. –first migrated at age 3 I did time [in] a [drug] rehabilitation center. I was in the program for like eight months, and my counselor found out that I got an immigration hold. So they told me that I can’t keep with the program because I got to be deported. And so they threw me out. –first migrated at age 17 I was initiated into a gang over there with my cousins. […] Using drugs, I wouldn’t have a guilty conscience if I hit someone, hurt someone, that is, it wouldn’t bother me who it was. That’s the reason why I started using more drugs: to believe myself to be superior to the others. –first migrated at age 8
	--	--	Importance of U.S. social context: Social networks facilitated first injection; friends, family, neighbors helped inject Girlfriends/sex partners helped initiate; inject to impress women Social networks reduced barriers to injecting (e.g., fear of syringes, low knowledge) Drug abuse, injection, selling were pervasive in social networks Social pressure to inject; blaming of friends for negatively influencing drug abuse trajectories	I started because of my neighbors who were already injecting. I didn’t know that it was heroin. I just saw that they were mixing something with cocaine and they offered me some … They told me, “Think about it, because this is strong.” […] That’s how I started injecting, and I liked it. –first migrated at age 12 There were several of us there, and I liked this girl … one time she suddenly asked me, “Do you want some [heroin]?” And in order to look good, I said, “Sure,” and she said, “Put out your arm,” and she injected me, and that was the first time I tried heroin. […] I started to vomit, sweat, and after all of that passed, well, I liked it… I told her that I would like more… and that’s how I started using. –first migrated at age 19 I was with some friends of mine, and they doctored me up, you know, a few times. I was kind of scared by the needle, but after they helped me get used to seeing it, I started using every three or four days. –first migrated at age 17 When I was there, [cocaine] was all I was seeing all day, you know what I mean? I saw everyone doing it. I just kept using it, and after a little while, I got addicted. […] My friends were kind of drug dealers and I didn’t have to pay for it, so it was easy for me to get it. Sometimes they’d just tell me, “Go ahead, use it if you want to.” “I don’t have a pipe.” “So just slam [inject] it,” you know what I mean? –first migrated at age 11 I didn’t want to inject because … I had my job, I had my apartment. I was doing well … the thing that did me the most harm was my friends … My friends really derailed me. –first migrated at age 24

^aAdjusted odds ratios from multivariable logistic regression model; adjusted for RDS sampling method.

^bConfidence Interval; all variables significant at P ≤ 0.001.