HIV on the Rise Among Migrants

HIV infections are rising at a significant rate among migrant Mexican workers after decades of being a minor problem along the border, according to two new studies by the University of California’s AIDS research program.

As many as 1% of migrant workers -- about 20,000 people -- are infected with HIV, according to the results of a study of 600 migrant workers in Fresno and San Diego counties. That’s more than three times the rate of HIV in the general U.S and Mexican populations, according to UC researchers who sponsored the field work.

The AIDS program’s second study, published Monday in the Journal of AIDS, showed that the rate of HIV infection among women giving birth at Tijuana General Hospital was four times higher than that in the general population of either country.

“Previous data was suggesting that the epidemic was remaining stable in Mexico, and that it was a fairly minimal problem among migrants,” said Dr. George Lemp, head of the Universitywide AIDS Research Program, who worked on both studies.

The new data, however, show that “HIV infection is potentially on the threshold of rapid increase in this population.... If behavior change doesn’t occur and there is no intervention, then we would expect some exponential growth in the number of people infected.”

Lemp said researchers have known for years that migrants were engaging in high-risk sexual behavior while in the U.S.

But earlier studies had shown little evidence of infection to go along with that risk.

Researchers say that male migrant workers, separated from spouses and adrift from the cultural mores of their native Mexico, typically contract the virus in the U.S. -- usually through sexual contact with other men.

Another source, Lemp said, is the widespread use of shared needles to inject antibiotics and vitamins. In Mexico, where injecting antibiotics is common, clean needles are available over the counter, but migrants here must share needles because syringes cannot be easily purchased.

Unaware of how the disease is spread or that they can pass it to their wives and girlfriends, these men return to Mexico, where a third of those with HIV and AIDS live in the states that export the most workers to the United States.

“We’ve known it’s just a matter of time before we started seeing these kinds of numbers coming from Mexico,” said Terry Cunningham, chief of the Office of AIDS Coordination for San Diego County. “It’s alarming.”

If public health officials don’t devote considerable resources to tracking the infections and educating the Mexican public about AIDS and HIV, Mexico could rapidly become the next India or China -- countries where the epidemic is raging out of control, Lemp said.

The rising HIV infections among migrant workers echo the skyrocketing infection rates among Latinos overall. According to the study in the Journal of AIDS, Latinos in 2000 accounted for 34.2% of AIDS cases diagnosed in California, where they make up 30.8% of the population.

Just last summer, Latinos became the largest group of people in Los Angeles County diagnosed with AIDS. They now account for 40% of the county’s AIDS cases, compared with 39% for whites and 21% for African Americans, according to Gunther Freehill, spokesman for the Los Angeles County AIDS office.

It is particularly difficult to find and treat rural workers who have HIV and AIDS, said Lemp and others. Outreach workers must go to the fields, win the trust of people whose lives are essentially hidden from the mainstream, and persuade them to talk about something as sensitive as sex.

Once patients are identified and brought to local clinics for treatment, ongoing care is nearly impossible. The patients, typically uninsured, move every few weeks, following the crops.

In urban areas like Los Angeles County, migrant workers tend to work in construction and other trades rather than on farms.

Public health officials have used mobile testing vans to reach these migrant workers at day labor sites.

“But it’s really hard to get a handle on the situation,” Freehill said. “It’s hard to go back to them time after time.”