Mexico, the United States, and HIV: It’s Complicated

from my last semester of college, I took an Introduction to Chicana Studies class in which I read a lot about HIV transmission between the United States and Mexico. In the book we used, Latina Activists Across Borders, activists in Michoacán argue that women are infected with HIV by men who migrate to the United States and then bring it back to Mexico. While there is a lot of truth to that, the way our two countries interact on this issue is a little bit more complicated.

We need to have a more complex conversation about migration and HIV/AIDS than the one we’re having.

Often, HIV is constructed as something that is spread between “immoral” people. When it comes to transnational transmission, the country the disease comes from is seen as “immoral” or “dirty.” In the United States, we have just as many beliefs about HIV coming into the country from Mexico as the other way around. But who is right?

The answer — both/neither. Less than 1 percent of the adult Mexican population is HIV positive — that’s half the rate in the United States. According to USAID, population mobility is a big factor in HIV transmission. In Tijuana and Juarez, where HIV/AIDS rates are the highest, a large part of the population comes from South America and southern parts of Mexico. In Zacatecas and Michoacán, more than 1 in 5 people who has AIDS had lived in the United States prior to infection.

It’s also true, according to studies, that male migrants are more likely than non-migrants to have sex with other men and to pay for sex with men and women, which, considering unprotected sex between sex workers and clients is one of the ways HIV is spread, supports the idea that men become infected while working in the United States and then bring the virus back to their partners in Mexico.

Clearly, the problem with the Michoacán activists’ argument is not that it’s wrong. The problem is that this type of argument ignores other factors that contribute to migration and HIV transmission. The reason population mobility is such a large factor in HIV/AIDS rates is not because the places people migrate from are “immoral” or “dirty,” but because people who migrate often do so because of violence or poverty — factors that influence a person’s access to education and health care and the likelihood they will engage in high-risk behavior (sharing needles, unprotected sex, etc.). HIV/AIDS is concentrated in what are considered vulnerable communities — places like Juarez where poverty and violence rates are high.

Another factor that is crucial to the understanding of HIV transmission is isolation. George Lemp, director of the University of California’s HIV/AIDS research program, said it best when he told the New York Times, “Migrants are vulnerable. They are isolated. They are exposed to different sexual practices. They have language barriers to services and there is a lot of depression and loneliness and abuse.”

I think we need to have a more complex conversation about migration and HIV/AIDS than the one that is currently going on. We can’t ignore the population mobility factor, but we can’t act like it’s the only force at work here.

A lot of great work is being done to address HIV/AIDS in Mexico. See some of it here, here, and here.

Madelaine Archie wrote for Border Health Care, a blog focusing on health care issues in the U.S.-Mexico border region.