Study: Mexican Migrants See Spike in HIV

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ALEX CHADWICK, host:

This is DAY TO DAY. I'm Alex Chadwick.

Officials estimate more than one million illegal migrants cross into this country over the Mexican border each year looking for jobs. Now studies by the University of California researchers suggest that a growing number of them become infected with HIV, the virus that causes AIDS, while they're working here in the US. Experts worry about a rapid spread of AIDS among people without much access to health care. Here's KQED Scott Shafer.

SCOTT SHAFER reporting:

It's 11 AM on a weekday morning in the San Diego County city of San Ysidro, just minutes north of the Mexican border.

(Soundbite of traffic)

SHAFER: At a busy intersection, Rosana Scolari stands on a sidewalk chatting with three men sitting along a concrete wall in front of a Bank of America building. The men are here looking for work. She's here to talk to them about AIDS.

Ms. ROSANA SCOLARI: (Spanish spoken)

We have to gauge where people are and how approachable they are in talking about HIV-AIDS.

SHAFER: Scolari runs the AIDS outreach program at the San Ysidro Health Center. She's here with a boxful of pamphlets and condoms. At first the men seem amused and only mildly interested in what Scolari has to say, but they keep listening. Then they start asking questions.

Unidentified Man: (Spanish spoken)

SHAFER: One is worried about the needles used for the tattoos on his arms. Another asks if the police can find out HIV test results. Scolari's offering the men free HIV tests and other incentives, like $10 food coupons, as encouragement to come back for their test results. If these men test positive, she says it will be easier to get the help they need in California than in Mexico.

Ms. SCOLARI: I've often said that a 10-minute drive down south takes you back at least 10 years in terms of HIV-AIDS. On one side you have services. We have prevention services. We have information. We have free tests for HIV and we have medical care and medications. On the other side you can't even get a free HIV test.

SHAFER: After years of relatively few HIV infections among migrant workers from Mexico, the rate of infections is rising. Since 2001, the University of California and the Mexican government have been cooperating to determine the size of the problem. For years, researchers found high levels of risky behaviors among migrants but very little HIV infection. But in a study presented this summer, they describe new data showing that .6 percent of migrant workers in San Diego and Fresno counties are infected with HIV. That may seem like a small number to some, but it's considerably higher than previous surveys.

Dr. George Lemp of the University of California's AIDS Research Program says the data concern him and his Mexican counterparts.

Dr. GEORGE LEMP (University of California): Our worry is that if HIV begins to take hold and move rapidly to a new epidemic level, that that could result in a significant increase in the epidemic, particularly in Mexico and among migrants in this country.

SHAFER: Lemp says that once infection rates within a community reach a certain threshold, risky behavior like sharing needles and having unprotected sex can lead to faster spread of a virus. He added that migrant workers are far from home and away from family for months on end, making them especially vulnerable to conditions that foster unsafe sex or drug use.

Dr. LEMP: Including depression or isolation, loneliness, discrimination, a lack of education or resources, and all of these factors play into people taking risks or being victims of risky behaviors.

SHAFER: The problem of reaching migrants for education, testing or health care is complicated by legal issues here in the United States. According to Terry Cunningham, chief of HIV-AIDS Services for San Diego County, workers here illegally are often afraid to seek help.

Mr. TERRY CUNNINGHAM (HIV-AIDS Services, San Diego County): This is a population that doesn't want to be found. You know, they are fearful of being extradited at any time. They are fearful, some of them, for their lives.

SHAFER: Another barrier, health-care workers doing outreach to migrants say that Latinos do not see a doctor until they're really sick. Since the AIDS virus can destroy immune systems silently for months or years, it can be difficult to convince infected migrants to practice safe sex, see a doctor or take medication until they have full-blown AIDS. In Tijuana, Jorge Bedoya is a board member of a clinic that's providing care to needy AIDS patients living in Mexico. Bedoya says Mexico faces major hurdles in tackling AIDS, including ignorance about the virus, discrimination against those who are infected, and a lack of government funding. When asked what he thinks California's obligation is to people with HIV and AIDS who cross the border, Bedoya answers emphatically.

Dr. JORGE BEDOYA: (Through Translator) AIDS is everyone's problem, not just Mexico's problem or California's problem. We always say that AIDS has no borders. We can't just have a California-only program or a Tijuana-only program. It has to be a binational program.

SHAFER: And it may be more of a binational problem than some realize. The days when migrant workers were isolated in the fields far away from US cities is long gone. Today an estimated three million migrants in California are working on farms but also in hotels, restaurants, construction sites and in homes doing child care and yard work. An AIDS epidemic in that community would be felt by a loss of workers in critical segments of the economy and in health-care costs at public clinics and hospitals treating migrants. Again, San Diego County's HIV Services director Terry Cunningham.

Mr. CUNNINGHAM: I think it's a powder keg and no one knows how long the fuse is.

SHAFER: Another fear is that infected migrants in California will take the virus back with them to Mexico, where HIV infection rates are still lower than in the US. There's evidence that is already happening, with rising infection rates among women living in rural Mexico. For NPR News, I'm Scott Shafer.

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