Problem: La Zona Roja located in Tijuana, Mexico, encompasses commercialized sex work and drug trafficking. Female sex workers (FSWs) are exposed to high-risk work factors (i.e. engaging in intravenous drug use) that increase the risk for human immunodeficiency virus (HIV) contraction and HIV+ serostatus. While there are many reasons FSWs forego HIV testing, a combination of their burdensome lifestyles and learning about this serostatus lead to depression. Therefore, an understanding of how these factors shape depression concerns for FSWs is needed to identify mental healthcare gaps.

Methods: A literary review of various research articles through multiple academic databases was conducted to focus on HIV transmission high-risk factors within FSW environment that lead to HIV+ serostatus, reasons why FSWs were not getting tested, and how the syndemic nature of these factors lead to an increase in depression.

Results: The evidence within the literature review emphasizes that the combined interaction of FSW background, exposure to HIV contraction through intravenous drug use and learning about HIV+ serostatus leads to increased rates of depression among FSWs. Research shows that low socioeconomic status among other factors drives women to sex work. Once recruited, FSWs that utilize injection drugs have higher rates of HIV prevalence than FSWs who do not engage in this behavior. Additionally, if FSWs do get tested for HIV for job security and lack of knowledge, learning about their HIV+ serostatus adds stress to their already existing mental health issues.

Interpretations: Further research of depression effects on FSWs living with HIV+ serostatus and drug use in Tijuana must be done for understanding their correlation. Increased HIV+ serostatus surveillance is needed to appropriately identify HIV rates among FSWs. Mental health and depression awareness/education are required to help decrease negative Mexican cultural stigma and encourage better FSW health behaviors with the availability of more mental health resources.

Implications: Without proper research on depression among this population and increased interventions for HIV and mental health, the effects of depression on these women will remain irremediable.

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