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The United States may be infecting Mexico with H.I.V., not the other way around. According to 2006 United Nations' statistics, Mexico's AIDS rate is about half of the U.S.'s, and a high percentage of new HIV infections in Mexico are traced back to migrant workers returning home from America. Twenty-two percent of patients with HIV at Puebla General Hospital (Puebla, Mexico) can trace their infections back to the U.S.
The news may come as a shock to many in the border regions of Texas, where illegal immigrants are often blamed for the state's growing healthcare crisis. Texas' healthcare system is overloaded with uninsured patients commuting from rural areas to the larger cities of Dallas, Houston, and Austin to seek care. As a result of these, and other, unreimbursed costs for the uninsured, most private, family health insurance premiums in Texas are higher than the rest of the nation's.
In the thirty-two counties comprising Texas' border region, 85% of the population was Hispanic in 2003, but only 9.8 in 100,000 were infected with HIV. In contrast, more than twice -- 22 in 100,000 -- on average, in the same year were infected statewide. In fact, Harris County accounts for the highest rate of HIV infections in the state.
Between 41% and 79% of Mexicans infected with HIV lived in the U.S., according to statistics collected from 1983 to the early '90s. Mexico has not reported comprehensive studies since then, however, and it seems up to joint initiatives, such as studies conducted by the California-Mexico AIDS Initiative, to gather information that reflects the current state of affairs.
Mexico's AIDS epidemic is still mostly confined to prostitutes and their clients, gay men, and IV drug users. Infected individuals between the ages of 15 and 49 account for only 0.3% of the population, as opposed to 0.6% in the U.S. Rural migrant workers, however, are slowly becoming a high-risk category on their own. Rural areas, where there is the least access to healthcare and testing, also boast the highest migration rates due to the poor economy. Combined, such factors create a near-perfect atmosphere in which the virus can explode. In fact, for most Mexican women, their greatest risk of contracting the disease is from having unprotected sex with their migrant-worker husbands.
"Migration leads to conditions and experiences that increase risks," said George Lemp, an epidemiologist and director of the University of California's AIDS research program. He and colleagues are studying the spread of HIV/AIDS among migrants, and says that isolation, different sexual practices, language barriers (including to health services), depression, loneliness, and abuse all contribute to the growing rate of infection. Migrants tend to have more sexual partners than those who stay at home, and there is a considerable lack of condom usage among this population, due, in part, to cultural factors. Migrant women may also be particularly vulnerable, as their risks of sexual abuse and rape are much greater.
Jennifer S. Hirsch, professor of public health at Columbia University, published an article earlier this month in the American Journal of Public Health citing evidence supporting the notion that part of the problem may actually be the emotional fidelity of many Mexican migrant-worker husbands. Rather than forming long-lasting relationships with women in the U.S., they instead seek sexual outlet with high-risk individuals providing short-term interaction, such as prostitutes.
But the subject is often taboo among couples, and routine HIV screenings are still not common. Many women, in fact, only discover they are infected after giving birth to an HIV-positive child. Mexico does provide antiretroviral drugs to even the poorest of migrant workers once diagnosed, but sacrificing the time and finances to travel to cities where they are distributed is a major obstacle. Lack of testing and treatment, in turn, increase the risk of transmitting the disease, especially in a culture in which condom usage is limited, infidelity not discussed, and screenings not routine.
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