HIV Prevalence Among Mexican Migrant Workers Three Times as High as General U.S., Mexican Populations, Studies Show
HIV prevalence among Mexican migrant workers in California is rising at a "significant" rate and is on the "threshold of rapid increase" in the population, according to two studies conducted by the University of California's Universitywide AIDS Research Program, the Los Angeles Times reports (Bernstein, Los Angeles Times, 11/2). Last year, government researchers from Mexico and California announced plans for a joint study to explore the spread of HIV among migrant workers and their families. The study focused on seasonal farm workers, day laborers and urban workers in Fresno and San Diego counties, as well as similar groups and their relatives in the Mexican states of Oaxaca and Michoacan (Kaiser Daily HIV/AIDS Report, 2/7/03). The first study of 600 migrant workers in Fresno and San Diego counties showed that as many as 1% of workers -- or 20,000 people -- are HIV-positive. That prevalence rate is more than three times as high as the rate in the general U.S. and Mexican populations, according to researchers. The second study, which was published in the Nov. 1 issue of the Journal of AIDS, found that HIV prevalence among pregnant women at Tijuana General Hospital in Mexico is more than four times as high as the rate among the general populations in both Mexico and the United States. According to Dr. George Lemp, head of the Universitywide Program who worked on both studies, previous research had "suggested that the epidemic was remaining stable in Mexico and that it was a fairly minimal problem among migrants," Lemp said.
However, the two studies indicate that "HIV infection is potentially on the threshold of rapid increase in this population," Lemp said, adding, "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 that if public health officials do not "devote considerable resources" to tracking infections and educating the Mexican public about HIV/AIDS, Mexico could "rapidly become the next India or China," where the pandemic is "raging out of control," according to the Times. In addition, the increase in HIV prevalence among migrant workers "echo[es] the skyrocketing [prevalence] rates among Latinos overall," the Times reports. According to the study published in the Journal of AIDS, 34.2% of AIDS cases in California in 2002 were among Latinos, who make up 30.8% of the population. Latinos currently account for 40% of AIDS cases in the United States, compared with 39% for whites and 21% for African Americans, according to Gunther Freehill, spokesperson for the Office of AIDS Programs and Policy in the Los Angeles County Department of Health Services, the Times reports.
Previous research has shown that migrants engage in high-risk behaviors -- such as sharing needles -- while in the United States, but there was "little evidence" of HIV infection to "go along with that risk," Lemp said, the Times reports. Male migrant workers typically contract HIV in the United States through sexual contact with other men, as well as through the widespread use of shared needles to inject antibiotics and vitamins. Although it is "common" to inject antibiotics in Mexico, and syringes are available without a prescription, migrants often share needles in the United States because clean needles are not easily accessible, according to the Times. Moreover, most workers do not know how HIV is spread or that their female sexual partners can contract the virus from them, the Times reports. Currently, at least 33% of migrants living with HIV/AIDS reside in the Mexican states that "export the most workers to the United States," according to the Times. "We've known it's just a matter of time before we started seeing these kinds of numbers coming from Mexico," Terry Cunningham, director of the Office of AIDS Coordination at San Diego's Health and Human Services Agency, said, adding, "It's alarming."
According to Lemp, it is "particularly difficult" to find and treat rural migrant workers living with HIV/AIDS because outreach workers must "win the trust of people whose lives are essentially hidden from the mainstream," the Times reports. In addition, outreach workers must "persuade them to talk about something as sensitive as sex," according to the Times. Even when patients are brought to local clinics for treatment, ongoing care is "nearly impossible" because these largely uninsured workers move every few weeks, the Times reports. In urban areas, such as Los Angeles, health care workers have begun using mobile testing vans to reach workers employed in construction and other trades. However, it is "really hard to get a handle on the situation," Freehill said, adding, "It's hard to go back to them time after time" (Los Angeles Times, 11/2).