A Migrating Plague : The AIDS Virus Is Crossing the Border to Mexico via High-Risk, Hard-to-Educate Migrant Workers

THE SUN WAS SETTING ONE RECENT WEEKDAY AS MARIA Luisa Jimenez arrived at El Hoyo migrant labor camp in Fillmore, an agricultural town in Ventura County. During harvest season, El Hoyo holds up to 200 men who spend eight months a year picking citrus, avocados and other crops. The camp’s rows of drab, green bunkhouses sleep six to 10 men each. This evening, several were lounging outside on wooden benches, drinking beer. The older men wore tightly woven straw sombreros native to their southern Mexican villages. The younger ones, many still teen-agers, sported baseball caps, tight jeans and T-shirts. Inside the bunkhouses, other men lay on cots--hatless, shirtless and too tired to notice Jimenez’s arrival.

Jimenez parked her car and bounded out the door to introduce herself to the bench-sitters. “Buenas noches, senores, estoy aqui para darles informacion sobre el SIDA.” “Good evening,” she told them, “I’m here to tell you about AIDS.”

“El SIDA! “ a grave-looking man said, repeating the Spanish acronym for AIDS. He looked carefully at the short-haired woman in her conservative pantsuit and her sensible makeup. “Are you a doctor?” he asked.

“Uh, not exactly,” she said. Jimenez, a 47-year-old former nun turned AIDS educator, sometimes identifies herself as “the AIDS lady.” This day she simply repeated why she had come to the camp: “It’s real important for us all to learn about AIDS. Can you ask your companeros to come out?”

In a few minutes, several dozen men drifted into El Hoyo’s stuffy mess hall behind Jimenez. She stood at the front of the room and began to talk about the immune system, HIV and the number of people in this country sick and dead because of AIDS. Then, fishing into the kind of vinyl bag mothers pack with picnic lunches, she pulled out a strip of foil-wrapped condoms.

“Close your eyes and raise your hands if you’ve ever used one of these,” she said.

The men sat stock still, eyes squeezed shut. It was the response Jimenez expected.

“OK,” she said. “You can open your eyes now. Unfortunately, hardly anyone raised their hand. Why? Some of you will say sex doesn’t feel as good with a condom, but it’s a question of fantasy, of getting used to it.”

Jimenez smiled mischievously. She tore a condom from its wrapper, stuck her hand in it and extended her fingers. With the other hand she pulled upward, stretching the condom so high that it looked ready to snap. “You can see it’s very strong,” she said. “As for size--well, some men say they’re too long even for this.”

The men chuckled nervously.

But when Jimenez pulled out a dildo to show them how to put a condom on, they tittered and leered.

That’s when she got serious.

“You’re embarrassed?” Jimenez asked sharply. “Think of how I feel. Three years ago, I didn’t even know what a condom was. But I have to leave my shame at the door. Our raza is dying and this is a question of life.”

MARIA LUISA JIMENEZ IS ON THE front lines of a late-breaking battle in the war against AIDS. During the past few years in the United States, the number of cases among gay white men has proportionately declined. But among children and heterosexual adults, AIDS is on the increase, particularly among minorities. The disease has a changing demographic face.

Nationally, Latinos are more than three times as likely to contract AIDS as non-Latino whites. The statistics are even more alarming for Latinas, whose risk is nearly 10 times that of other white women in this country. Latinas with a Mexican or Central American heritage are more likely to get AIDS from having sex with men than from other transmission routes.

These trends are beginning to show up across the border as well; AIDS appears to be spreading from the United States to Mexico, and that spread is starting to affect families.

Pilar (not her real name) lives in a picture-postcard farming village in the Mexican state of Jalisco, 1,500 miles south of Ventura County. She is a widow with a 4-year-old son, and when she speaks of her husband, she glances over her shoulder to make sure that the local gossips aren’t listening.

“My husband had been going around California for years to work,” she says. “The last time, in 1983, he ended up washing dishes. After a few years he started getting sick and couldn’t shake it.”

By the time he returned to Mexico, Pilar remembers, her husband was vomiting blood and had diarrhea and fevers. “After we found out what he had, he just sat. We didn’t tell people what it really was; we said it was liver disease. He died here in the house. Then the kids were tested and came out negative. Me? I don’t even remember; I burned the papers with the results. Now I’m just waiting to see what will happen.”

A hundred miles away, in a slum near the Guadalajara airport, what Pilar is waiting for has already happened to a mother of four school-age children. The woman requests the pseudonym Rosa. She doesn’t want her children to know what’s going on. In Mexico, she says, having AIDS makes one a pariah.

“Down here my husband was a house painter,” Rosa says. “He used to go to the other side undocumented and earn more there than in Mexico. Last time he left, in 1985, he went to Santa Barbara and worked in the fields. When he came back he was very sick with night sweats and diarrhea. It took three months to get a diagnosis. He lay in bed three more months, then died.”

Now Rosa is sick. Two years after receiving her first positive HIV test results, she still looks healthy, but a local medical counselor who’s helping her get treatment says she is ravaged internally by tuberculosis. He estimates she’ll be dead by 1992.

AIDS takes as long as 10 years to incubate, and while Mexican health authorities routinely question victims about their history of high-risk behaviors, it is seldom possible for them to pin down the time and place infection occurred. Officials are seeing more and more cases like Rosa’s and Pilar’s, however, where the evidence points north.

“We’ve seen men, women, kids, entire families with AIDS. Many of the men used to work in the United States,” says Raquel Gutierrez, a social worker at Guadalajara’s Civil Hospital. The hospital serves the poor of Jalisco, Michoacan and Zacatecas. Every year, these states send so many men to the United States that, during certain seasons, their villages are called pueblos de mujeres --women’s towns. These days, the hospital registers three or four new AIDS patients a day.

Mexico City sociologist Mario Bronfman, who studies AIDS and migration, points out that in his country only one of every 10 people with the disease has spent time abroad during the decade before their diagnosis. But in states such as Michoacan that export torrents of seasonal migrant workers, as many as 20% of the AIDS victims have lived north of the border. Also, an impressive percentage of those who are ill are poor laborers and farmers, the kind of people who tend to migrate. The United States has a much higher rate of AIDS cases than Mexico, Bronfman says, and when the two populations mix, it’s statistically logical to expect that Mexicans will get infected.

Migrant workers may be particularly at risk because of how they live in the United States. Isolated from families, wives and girlfriends, many earn enough to sample narcotics and prostitutes. While the use of intravenous drugs is highly stigmatized in the Mexican interior, “here it’s a lot easier,” says Rebeca Gilad, who does AIDS education for the American Red Cross in Washington. Drugs assuage loneliness, she says, and homesick migrants “get a family among the users.”

Ruth Lopez, who works with migrants in Watsonville, Calif., says that intravenous drug use in the area is “right up there with New York City. The Parjaro River levee is one of the first places the migrants hit when they arrive here,” Lopez explains. “They go there to sleep, but it’s also where addicts go to shoot up. So there’s an immediate connection between the two subcultures.”

Prostitutes are another risk factor for migrants. “In Mexico, it is very much accepted for men to use prostitutes,” Gilad says, and the practice continues in the United States. At El Hoyo labor camp, migrants say that prostitutes arrive by car on weekends. They charge $10 to $20 per man and conduct business in assembly-line fashion.

In Mexico, studies have shown that few prostitutes are intravenous drug users or are HIV-positive, but that is not the case in the United States. In Orange County, which absorbs many migrant workers, an estimated nine out of 10 prostitutes are IV drug users, and in California’s big cities the rate of HIV infection among them can run as high as 9%. Raul Magana, until recently the head of the Orange County Health Department’s AIDS Prevention Project, traced an outbreak of syphilis in migrants to their use of prostitutes. The same situation, Magana says, is fueling AIDS transmission among these men.

In crowded all-male labor camps such as El Hoyo, even prostitutes may be in short supply. Researcher David Hayes-Bautista says that although most migrants identify themselves as heterosexual, in situations like the one at El Hoyo, the men may engage in yet another high-risk activity--having sex with other men.

Hayes-Bautista directs UCLA’s Chicano Studies Research Center and teaches at the School of Medicine; currently he’s studying AIDS among Latinos in the L.A. area. During a recent visit to a labor camp in Oxnard, Hayes-Bautista says, “I was impressed by the consistency with which the migrant workers said: ‘Well, yeah, I haven’t seen my wife for six months, and I get horny. We’re not gay, but we have needs. And that’s what friends are for.’ If a Mexican male says, ‘I got so smashed last Saturday night that I don’t know what I did,’ I classify him in the man-to-man, high-risk sexual behavior category.”

Hayes-Bautista’s findings echo studies by U.S. anthropologist Joseph Carrier and Mexico City researcher Maria Luisa Liquori that reveal that some Latino men who consider themselves heterosexual occasionally have relations with men. Their culture strongly condemns homosexuality; but unlike Anglos, Latinos don’t label these men gay as long as they play the “dominant” role during sex. The dominant partner penetrates the mouth or anus of the other man, who is usually a self-identified homosexual.

According to Carrier and Liquori, a man considered heterosexual may adopt the dominant role with another man for various reasons. He may be engaged to a woman who refuses to have sex until after the wedding. He may feel that proving his machismo means showing he can have sex with anyone, regardless of gender. Or, like migrants at labor camps, he may be far from his community and cut off from female companionship.

Regardless of the specific route of transmission, the spread of AIDS into Latino communities and across the border with Mexico is generating mounting concern among health educators and officials. They have found that while prevention programs and materials proliferate in the United States, few of them speak the cultural language of Spanish-speaking immigrants or of the migrants who can carry the disease south.

In Ventura County, where Pilar’s and Rosa’s husbands may well have lived, the county health department knows of two men--one HIV-positive and the other already ill--who have returned to Mexico. Clinicas Camino Real, a group of public clinics in the county, has diagnosed 16 HIV-positive immigrants since 1988. Last year, in an effort to keep those figures from skyrocketing, Camino Real hired Maria Luisa Jimenez to give lectures about AIDS to the area’s Spanish-speaking migrants and immigrants, and to urge those at risk to come in for HIV testing.

SHE IS ON A MISSION THAT BORDERS on the religious. When Maria Luisa Jimenez began giving AIDS-prevention classes, the expectation was that she would speak to a few hundred people a year. Now she sometimes talks to that many in a week.

After 10-hour workdays, with back-to-back presentations in labor camps and night schools, she returns, exhausted, to her apartment in Santa Paula. Home for Jimenez is a small converted garage on an upscale street with gracious yards and trees that practically rain avocados. Some nights she scuttles about in the dark gathering them up, worrying all the while that the neighbors will have her cited for theft.

“I don’t even know what to do with all of these,” she says. “But I can’t stand wasting food. I’ve seen too many people starving.”

Jimenez has always been fiercely independent and fiercely eager to do the right thing. Born in a small town outside of Quito, Ecuador, she was the youngest of four daughters. “My parents were expecting a son,” she says, “so my father treated me like a little boy. He was the town mayor, and he always took me out with him on his duties. I did things the average Latina never gets to. After I got a teaching degree in 1964, I ended up at a rural school and started teaching the children catechism because I didn’t want them going to hell. But it was a Protestant community”--Jimenez chuckles--”and when the parents got mad, I thought, ‘If I become a nun, no one will be able to stop me.’ ”

She made an impulsive decision to enter the Los Angeles-based Society Devoted to the Sacred Heart. By the late 1970s, she was increasingly disenchanted with her insulation from the world. Along with many other Latin American nuns and priests, Jimenez had developed a passion for liberation theology and its emphasis on empowering the poor through communal political action. “I thought about the church,” she remembers, “and how we were concerned about saving souls. But what about bodies? Liberation theology meant thinking about the here and now, not just the afterlife.”

In 1980, Jimenez returned to rural Ecuador. Almost single-handedly, she founded a liberation theology-based religious order made up mostly of lay people. She is still haunted by her experiences with the group.

“I came to know what it was to live in utter misery,” Jimenez recalls. “Children were dying from diarrhea and malnutrition. Every week I helped bury someone’s son or daughter. I remember trying to swish the parasites out of my own glass of water and never being able to keep all of them out of my mouth. Yet the people didn’t have money to buy fuel to boil the water. If they couldn’t, I wasn’t going to boil it for myself.”

Ultimately, Jimenez was unable to reconcile her understanding of God with the suffering she saw; and when the area bishop decided to disband lay orders, friends in California helped her get into the master’s program at UC Berkeley’s School of Applied Theology. Today she is no longer a nun, but as an AIDS educator among often devoutly religious Latino immigrants, Jimenez sees ample opportunity to put the tenets of liberation theology into secular practice.

Here as in Central America, she says, it’s a matter of battling passivity and silence. “In Ecuador,” she says, remembering her days as a nun, “I used to love to make the workers scream. Anything--calls, yells, jokes--it was great fun out there in the jungle. But it was more than fun. We Latinos have been taught in so many ways not to make noise. It’s said that we took the (Spanish) Conquest on ourselves, that we are melancholy. Religion brought us good things, but it also brought repression. The people can’t verbalize their complaints; they can’t argue. They just bear things, and for so long the church has said their suffering is God’s will. So I would get them to scream. So they could feel that hearing themselves is OK, coming out of themselves is good.”

AT A NIGHT-SCHOOL ENGLISH CLASS in Oxnard, Jimenez is talking to an audience of men and women, coaxing an entire classroom to “come out” of themselves. To break their uneasy silence, she invites the students to add to a laundry list of Spanish vulgarisms for the word penis . For every word added, she hands out a prize.

The students are nonplussed as Jimenez starts reading the list. Soon, though, the men are adding to it.

“Sausage,” one says in Spanish.

“You get a condom,” Jimenez says. The winner holds it aloft while his friends hoot.

“Whistle,” says another.

“Here’s an AIDS comic book for you.”

“Squash.” “Electric chair.” These men also get condoms and pamphlets.

Four young Mexican women in the class are all but dumbstruck by the game. One covers her eyes and quakes so hard with silent laughter that tears run down her face.

Jimenez gets serious again. “What do all these names tell us? Are they respectful of this part of man?”

“No,” several men say in unison.

“And yet, if you had to choose whether you were going to lose your eye or your penis, which would you keep?”

“My penis,” says one.

Jimenez hands him a pamphlet. “But men insult themselves with their lack of respect for their bodies. We need to treat ourselves with dignity.”

“We have to educate ourselves,” says another man.

The women nod in agreement.

“That’s right,” Jimenez says. “It’s time to change. And now AIDS gives us the chance.”

This sort of give-and-take has become Jimenez’s stock in trade as an AIDS educator. She is adamant about getting the students involved. “Many workers end their presentations by giving out condoms to everyone in the class. That’s not education,” she says. Jimenez offers them only to people who ask questions, answer them or express opinions. “They get a prize for speaking up. It encourages them to come out of themselves.”

At an all-male vocational training class in Oxnard, for instance, she pushes the dialectic into delicate territory. “What is a homosexual?” she asks.

“Someone from San Francisco!” yells the class joker.

Amid the laughter, a slender, intense-looking young man sits with his eyes averted.

Jimenez quiets everyone, turns off the lights and shows “Mi Hermano”--”My Brother”--a video produced by the American Red Cross, a soap opera about a Mexican family torn apart by the death of a handsome young man who was son, brother and husband. The beautiful widow is now HIV-positive and pregnant. She is totally mystified about how her husband got AIDS, and the tear-jerking drama never reveals the answer. But all the possibilities are suggested, including a flashback of the husband at a party, hugging a bottle of tequila with one arm and a man with the other.

During the discussion that follows, Jimenez plays the word game again. This time she asks for names for homosexuals. The resulting glossary seems endless: Leandro. Joto. Puto. Marica. Pulgon. Cachagranismos. The thin young man adds a word. He wins a condom.

“All these words are put-downs,” Jimenez says. “If I ask all you fine gentlemen who is homosexual here, who is going to raise their hand? Our raza wants marriage, children and grandchildren. So a man who’s attracted to another can’t say he’s homosexual. In this country, perhaps, you can go around with your boyfriend on your arm. But what will happen if you decide to go back to your village?”

“They’ll shoot you in the head,” says the joker. He seems serious.

“So in our culture, men with these tendencies are forced to get married and have kids. Then they can put their families at risk.”

“What causes homosexuality?” one man asks. “Is it heredity?”

“Or hormones?” asks another. “Or psychological?”

“They’re born that way,” Jimenez answers. “And if they’re born that way, do we have the right to insult them? To marginalize them?”

“No!” yells the student sitting behind the thin, intense young man.

The latter suddenly comes alive, turns around, smiles radiantly and offers a prize--his condom.

Such scenes please Jimenez. “A lot of times when we first start the discussion, people will jeeringly point to someone in the class, someone who they know is homosexual. Then when we work through it, the men will give the one they were pointing to a hug or a Mexican handshake. It’s very spontaneous and beautiful. For a moment, at least, they’ve been freed inside themselves.”

She also tries to open up the discussion on female sexuality. She blames Latinas’ aversion to condoms on the Catholic Church’s longstanding prohibition of condoms as a means of birth control. But even when an immigrant woman wants to use them, her male partner may take offense. “Some women tell me that when they bring one home from class, their husbands say, ‘Don’t talk to me about this filth!’ A Latina isn’t supposed to think about such things, and if she suggests it, he may get angry and abuse her.”

To counteract such attitudes, Jimenez has added basic female sexuality to her curriculum. “We women need to know our own bodies, about orgasms, so we’ll get satisfaction and not have to go running from partner to partner,” she says to the women, while looking pointedly at their husbands.

Do the people who hear Jimenez ultimately adopt safer sex practices? “I think some do,” she says. “Because if I come back and do a second or third class, when guys ask questions, there’s a different tone from the sarcasm or cynicism of the first time.”

Later, some also come to the Camino Real clinic for AIDS testing--like the large, baby-faced father of three who walked in recently with his 4-year-old son. While the little boy colored Ninja Turtle pictures, the man quietly told Jimenez that when he first came to the United States alone, he lived in a house with homosexuals and regularly had sex with them. He stopped when he found out that his wife and family were coming to join him; now he wanted an HIV test. He also asked for a copy of the Red Cross video to show his family and neighbors.

Another man sent his wife in, even though presumably he was the first member of the couple at risk. “She was straight from a little village,” Jimenez remembers, “and when I asked her if she knew what oral or anal sex was, she just cracked up giggling. I let her laugh as long as she needed to. She had no idea what I was talking about, or what her husband might have done to make him think he’d infected her. She tested negative. But he came home one day with a condom and said, ‘Let’s try it.’ ”

And Jimenez proudly if a little sheepishly tells one more story to show that her classes are indeed having an effect. After the sessions at El Hoyo camp, Jimenez had drafted two students to be her guides on a mission to visit a cantina in nearby Fillmore. The idea was to distribute matchbooks and condoms printed with AIDS prevention messages and to reconnoiter the bar scene in preparation for classes she was slated to conduct soon for the area’s prostitutes.

Jimenez’s guides were Senor P., a dark, handsome man in his late 20s, and Senor R., a still-spry 60-year-old. The cantina was typical: murky reddish light, bridge tables and chairs, a busy bar serving mostly beer, a loud band belting out Mexican rancheras and cumbias . A solid wall of men stood at one side of the room, staring at several heavily made-up women in tight dresses who huddled at the tables, smoking cigarettes.

“Prostitutes,” Senor R. said glumly. “For us farm workers, stuck in the fields all day and the camps all night, it’s impossible to find sincere women.”

Jimenez offered the barmaids matchbooks and condoms, and soon every table was set with the materials. Senor R. and Senor P. sat down stiffly at first, as though at a lecture. But soon they were taking turns inviting Jimenez to dance. After a few songs, both confided to her that they were recently divorced. When Jimenez said it was time for her to go, they wanted to stay and order more beers. She insisted; they finally shrugged and agreed to leave. Back at the camp, Senor P. made a final effort to extend the evening.

“Look what I have!” he said. “I bought it today.” He pulled a foil-wrapped square from his shirt pocket.

Jimenez gulped, and then remembered her mission. “That’s wonderful!” she said. “You bought a condom!” Senor P. beamed modestly. “Be sure to use it when you need it,” Jimenez added, as she firmly said good night. “It’s your lifesaver.”

BY THE END OF THIS year, health authorities in Mexico estimate, at least 21,000 people there will have gotten sick with AIDS. Many will be the wives and children of men who once sojourned “over there”--men who never grasped what they needed to think about, do or buy to protect themselves from a strange sickness in a strange land. Most probably never ran into an AIDS educator like Jimenez, who could communicate that need in their own cultural language. Officials here acknowledge the need to put more people like her to work but wonder when that will happen. “At what point in this crisis will people do things that haven’t been tried before?” asks Juan Ramos, deputy director of prevention and special projects at the National Institute for Mental Health.

“Unfortunately,” Ramos adds, “there’s no consensus that education for migrant farm workers is a priority, because compared, say, to American gays, migrants with AIDS are different. Once they get infected, they leave and go back home. United States communities don’t see the funerals. They don’t see the sick families. The problem doesn’t feel real.”

In Mexico, Pilar tends her chickens as an American Airlines flight passes high over her village. “My 4-year-old still thinks his daddy’s ‘over there,’ ” she says. “When a plane goes by he says, ‘ Adios, papa! You don’t love us anymore.’ ”

In Guadalajara, Rosa makes plans to die. “I think of the children and what’s going to happen to them. Today I went into a church and I was crying and crying. It calmed me down.

“I don’t know what my husband did that made him sick,” she says, staring into space. “He never would tell me, and I didn’t really ask.

“I only wish he’d known what AIDS was before he went north.”