Exploring Intersectional Risks Of Substance Use Disorder, Mental Health, Hiv/aids, And Hepatitis C Among Hispanic Adults On The TX-MX Border: A Mixed-Methods Study

Purpose: The purpose of this study was to explore intersectional risks of substance use disorders, mental health, HIV/AIDS, and HCV among Mexican-origin Hispanic adults on the Texas-Mexico border. Methods: The study employed an exploratory sequential mixed-methods approach, which involved collecting and analyzing qualitative data first, followed by quantitative data collection. Selected purposively, 15 in-depth interviews were conducted among the target population. Using convenient sampling, 106 cross-sectional surveys were conducted. Qualitative interview data were analyzed manually using thematic analysis. Quantitative data analyses included univariate descriptive analysis, bivariate, and multivariable penalized logistic regression, negative binomial, and zero-inflated negative binomial regression. Results: The majority of participants in both interviews and surveys were in their mid-thirties, and more than two-thirds of survey participants were females. Five themes emerged from the interviews and revealed rising polysubstance use across socioeconomic groups, increased intersectional risks of substance use, mental health disorders, and HIV/HCV, and social determinants shaping health disparities along the Texas-Mexico border. Interview participants emphasized the need to expand community-based treatment and outreach. Survey findings demonstrated high risks of substance use (Substance use positive 64.2%) and mental health issues (Anxiety/Depression positive 36%) and their intersection, but low risk of HIV/HCV. Across both phases, 50-67% of participants were uninsured, and 42-56% postponed or skipped care due to cost, with females disproportionately affected. The quantitative analysis also identified demographic and social determinants shaping health and health-related quality of life in the borderland. Conclusion: Findings underscore the interconnected risks of substance use, mental health disorders, and infectious diseases among Mexican-origin Hispanic adults on the Texas-Mexico border, emphasizing the need for early prevention through school- and community-based education and the expansion of safe, supportive community spaces to reduce risk and promote healthier behaviors.