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Deportation and AIDS

1 August 2008

With the International AIDS conference in Mexico City,  scientistsand health-care workers have a rare chance to be heard by the public at large.  Whether policy makers listen is another story.

This was published in  U.S. News and World Report:

The odds of HIV infection increase fourfold for male injection drug users who were deported to Tijuana from the United States compared to non-deportees in the Mexican border city, a new study reports.

The findings, expected to be presented Aug. 5 at the International AIDS Conference in Mexico City, suggest further investigation is necessary into the risk factors of displacement and the need for programs that offer support to displaced persons on either side of the U.S./Mexico border….

“Deportation was significantly associated with HIV infection in males,” Steffanie A. Strathdee, chief of the division of international health and cross-cultural medicine at UC San Diego’s School of Medicine, said in news release issued by the university. “In addition, the prevalence of HIV infection and potential risk factors differed by gender. But a finding we didn’t anticipate is that living in Tijuana for longer periods was associated with lower HIV prevalence in men, which is the opposite of what we found in women. Among women, longer-term residents in Tijuana actually had a higher risk of HIV infection.”

While the researchers admit such causal implications are unclear, their paper suggests deportation might be indicative of higher risk-taking. This may suggest that mobility rather than deportation itself creates unstable social conditions leading a person to pursue risky behaviors that lead to HIV acquisition, Strathdee said.

It’s been noted for years that HIV/AIDS infections are highest among Mexicans who have lived and worked in the United States. The assumption has always been that living in the “decadent north” exposes one to more risks — both unprotected sex and intravenous drug use. Something I hadn’t thought about — but makes sense — is that the normal social controls in Mexico (your grandmother, your cousins and Jesus are all watching what you do) are absent when the workers go north.    Emigrants are on their own, and are more likely to take stupid risks.

That might account for the drop in men’s infection rates the longer they live in Tijuana, but the women’s rate increase suggests something else is at work here.  The implication in the article seems to be that women in Tijuana take more risks than others (which could be true… a lot of the women in Tijuana intended to cross the border, or are deportees also), or the State of Baja California isn’t doing a good job in early detection.  My sense is that the women’s increase is among commercial sex workers, who run a much higher risk of infection in border communities (for several reasons) than others.

However, being stuck in a crappy job with no access to medical care, or information, may have a lot to do with it.

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