I will be looking at how the different cultural, political, social, and economic factors on both sides of the Tijuana-San Ysidro border contribute to the public health issue of injection drug use in both Tijuana and San Diego. These factors of living are extremely different on both sides of the border, however we see a binational effect on injection drug users. The issue of injection drug use needs to be addressed by both border cities together because the factors of living are so different on both sides of the border. Which makes it difficult to address this issue because Injection drug users can simply travel across the border for a day, inject drugs on that side of the border, and then return back. This is more likely to be the case for injection drug users who live in the United States because Tijuana has more lenient drug use policies and easier access to drugs for cheaper. This is a binational issue, so it must be addressed as such. Tijuana has a higher prevalence of injection drug use than in San Diego which leads to other negative health outcomes like high HIV prevalence. This is due to the different social, cultural, political, and economic factors Tijuana has. They have more lenient drug policies, easier access to cheaper drugs, more societal stigma of drug use which leads to less access to clean syringes, and have less resources for safe syringe use education. While San Diego has stricter drug policies, more resources for drug use safety, better access to clean syringes, and it can be more difficult to constantly acquire cheap drugs. Because of the differing factors of living injection drug users travel back and forth across the border in order to access cheaper drugs in Mexico. Because most injection drug users are able to go back and forth across the border whenever they choose, it becomes a binational issue. In order for the prevalence of injection drug use to decrease on both sides of the border, both cities on either side of the border need to come together and come up with a comprehensive solution that takes into account the differing social, cultural, political, and economic factors of both cities. This may not be the easiest thing to do due to conflicting interests of either side and because of different limitations like funding, societal opinion, and political interventions. But the prevalence of injection drug use is continuing to rise, even more so in Tijuana. In order for this to be decreased then it must be viewed as a binational issue and be addressed as such.

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