Prevalence and correlates of ‘agua celeste’ use among female sex workers who inject drugs in Ciudad Juarez, Mexico

BackgroundAgua celeste, or “heavenly water”, is the street name for a sky-blue colored solvent reportedly inhaled or ingested to produce an intoxicating effect. Study aims were to (1) describe prevalence of agua celestse (AC) use, and (2) identify correlates of lifetime and recent use of AC use among female sex workers who also inject drugs (FSW-IDUs) in northern Mexico.MethodsBetween 2008 and 2010, baseline data from FSW-IDUs ≥ 18 years old living in Tijuana or Ciudad Juarez participating in a longitudinal behavioral intervention were analyzed using logistic regression.ResultsAmong 623 FSW-IDUs (307 from Tijuana and 316 from Ciudad Juarez (CJ)), 166 (26%) reported ever using AC, all of whom lived in CJ. Among the CJ sample, lifetime prevalence of AC use was 53%, median age of first use was 16 years (IQR: 14–23), and 10% reported it as their first abused substance. Ever using AC was independently associated with ever being physically abused and younger age, and was marginally associated with initiating injection drug use and regular sex work at age eighteen or younger. Among those ever using AC, 70/166 (42.2%) reported using it within the last 6 months, which was independently associated with using drugs with clients before or during sex, being on the street more than 8 h per day, and younger age.DiscussionWe observed considerable geographic variation in the use of AC in northern Mexico. Future studies exploring factors influencing use, its precise formulation(s), and its potential health effects are needed to guide prevention and treatment.