{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:11:31Z","timestamp":1768252291992,"version":"3.49.0"},"reference-count":25,"publisher":"American Public Health Association","issue":"S2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p> Objectives. To characterize the effects of the onset of the COVID-19 pandemic on the risk environment of people who use drugs (PWUD) in Tijuana, Mexico. <\/jats:p><jats:p> Methods. We used intensive participant-observation ethnography among street-based PWUD and key informants, such as frontline physicians and harm reductionists. <\/jats:p><jats:p> Results. PWUD described an unprecedented cessation of police violence and extortion during the initial pandemic-related lockdown, though this quickly reversed and police violence worsened. Government-provided housing and medical treatment with methadone were temporarily provided to PWUD in a dedicated clinic, yet only for PWUD with COVID-19 symptoms. Concurrently, non\u2012COVID-19\u2012related hospital care became virtually inaccessible, and many PWUD died of untreated, chronic illnesses, such as hepatitis C, and soft-tissue infections. Border closures, decreases in social interaction, and reduced drug and sex tourism resulted in worsening food, income, and housing insecurity for many PWUD. By contrast, potent illicit drugs remained easily accessible in open-air drug markets. <\/jats:p><jats:p> Conclusions. The pandemic exacerbated health risks for PWUD but also offered profound glimpses of beneficial structural changes. Efforts are needed in Tijuana and elsewhere to institutionalize positive pandemic-related shifts and ameliorate novel harms for PWUD. (Am J Public Health. 2022;112(S2):S199\u2013S202. https:\/\/doi.org\/10.2105\/AJPH.2022.306796 ) <\/jats:p>","DOI":"10.2105\/ajph.2022.306796","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T20:07:21Z","timestamp":1648584441000},"page":"S199-S205","source":"Crossref","is-referenced-by-count":17,"title":["An Ethnographic Assessment of COVID-19\u2012Related Changes to the Risk Environment for People Who Use Drugs in Tijuana, Mexico"],"prefix":"10.2105","volume":"112","author":[{"given":"Joseph","family":"Friedman","sequence":"first","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alhel\u00ed","family":"Calder\u00f3n-Villarreal","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebeca Cazares","family":"Adame","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Abramovitz","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Rafful","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gudelia","family":"Rangel","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Vera","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffanie A.","family":"Strathdee","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. Claudia Rafful is with the Department of Psychology, Universidad Nacional Aut\u00f3noma de..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Bourgois","sequence":"additional","affiliation":[{"name":"Joseph Friedman and Philippe Bourgois are with the Center for Social Medicine at the University of California, Los Angeles (UCLA). Alhel\u00ed Calderon-Villarreal is with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD). Rebeca Cazares Adame is with Prevencasa, A.C., in Tijuana, Mexico. Daniela Abramovitz is with the Division of Infectious Diseases and Global Public Health, UCSD. 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