AIDS Now a Migrant to Mexico

The migrant workers leave their Mexican villages with hopes of sending home fat money orders, but some are returning with a deadly U.S. export: the AIDS virus.

Once a stranger in many parts of rural Mexico, HIV has infected between 4,300 and 16,000 villagers, and the number is rising rapidly. Mexican health officials believe that at least 30% of those infected got the disease in the United States--then spread it to many others back in the Mexican countryside.

Away from their families, immigrants get infected when they experiment with hard drugs or have sex with prostitutes or multiple partners.

“The whole time I was in Santa Ana, I felt very unbalanced. I wanted to escape,” said Alejandro Villegas Olivares, who, at age 22, made the trek north to Orange County from his village of San Blas, in Mexico’s west-central state of Nayarit.

Villegas secured a job as a construction worker and sent home what seemed like a fortune to his wife and three children. By day, he helped build luxury homes. By night, however, he began experimenting with marijuana, then cocaine and then heroin. He had an affair with an American woman who also used heroin. He said the woman infected him with HIV.

“Drugs were so easy to get,” he said.

When men like Villegas return to Mexico, it’s to a culture where frank talk of sex is uncommon. They infect wives and girlfriends who usually don’t know they’ve contracted the virus until their mates become gravely ill.

Fernando Hernandez Plata, 38, never got an HIV test when he returned to Tacario, in Michoacan state, after working for several years in Chicago and Atlanta. One day, he became so sick he could no longer tend to his fields or animals.

Home remedies did not cure him, and his town’s doctor could not find what was wrong. Only after extensive testing did doctors diagnose him with AIDS.

For a year, he kept the secret from his wife, Maria Guadalupe Plata. He would have his cousin accompany him to medical appointments in Morelia, the state capital. Six months before he died, he finally told Maria Guadalupe the truth.

“He told me he had gotten it from a girlfriend nine years before, but I couldn’t believe it,” she said. “I didn’t know what to think. I felt so confused.”

To her, the situation seemed hopeless, and she treated it as God’s will. Maria Guadalupe eventually realized she needed to get an AIDS test. It came back positive--and her thoughts immediately turned to her four children.

How would she be able to keep them clothed and fed with her husband dying and herself sick? What would her neighbors think? What would her kids think?

And the most pressing question: Was her 5-year-old son infected from birth? It’s a question she still can’t answer because the family can’t afford a test. In any case, she and Fernando wondered whether they could live with the answer.

“His main thing was that he didn’t want the boy tested,” she said. “We can’t afford it now anyway. But what he knew he couldn’t live with was knowing that the boy was infected too. I don’t know if I can live with that either.”

Migrants Urged to Get Tested

Health officials in Michoacan are so concerned about the emergence of the cross-border AIDS route that they now give returning migrants cards asking, “Did you have sex with someone you met on the other side?” and urge them to get HIV tests.

But effective AIDS treatment is rare in most rural hamlets, and those who go public about their affliction risk discrimination.

Maria Guadalupe Plata said she struggles to keep the secret of her illness from neighbors. Not even her doctors know she has HIV. When she needs treatment for opportunistic infections such as skin rashes, she goes to a hospital two hours away from the village and hopes that doctors won’t discover she has the virus. A year ago, one doctor found out her real condition, she said, and refused to treat her.

And among some neighbors, a subtle stigma exists as well.

“The adults say to other kids, ‘Don’t play, don’t touch those kids, because they have something,’ ” she said. “I have a hard time sleeping because I don’t know what will happen to my kids.”

Miguel Angel Leyva, 33, and his family shared a similar experience. While working on and off in San Diego in the late 1990s, he had sex with several women. But he didn’t know he had contracted HIV until five months ago.

Even then, Leyva said, he was afraid and embarrassed to tell his family that he had AIDS. So he kept his illness secret until he couldn’t walk. That’s when he ended up in Las Memorias, a barrack-like AIDS shelter at the end of a dirt road in Tijuana. It was there that he lost his sight.

“I could deal with HIV, but I do not know how I will deal with blindness. I feel that my life is over. . . . I’m asking God to take me now,” Leyva said.

Villagers Mocked the Family

Froylan Ramirez of Jaripeo, a town of 300 families in Michoacan, had to sell his vegetable shop 18 months ago once neighbors found out that he was HIV-positive because they would no longer buy his products. His brothers engaged in fistfights with villagers who mocked the family.

Ramirez, who spent three years as a factory worker in Santa Ana and Atlanta and contracted the virus in one of the cities, said his treatment by the medical establishment was not much better.

One doctor, for example, told him to wash his underwear in bleach and eat from plates that only he could use, he said.

“I became the rare bird of the town, and I felt I couldn’t live in peace anymore,” Ramirez said. “It got so bad I tried to commit suicide.”

Ramirez once lived in a spacious house with his wife and two children. But since they left him, he lives alone in a tiny dirt-floored adobe that he built himself. To make money, he secretly helps his aunt prepare chickens for sale. He worries, however, that if the villagers find out about his work, they will refuse to buy the poultry.

He tries to get information from the Internet and from members of an HIV support group. He wants a prescription for Crixivan, a protease inhibitor and a key drug in the fight against AIDS.

On his worn kitchen table are pamphlets from the pharmaceutical company that makes Crixivan. He wonders how he will get the medication. Some days, he dreams about going to Atlanta or Los Angeles for better treatment.

But for now, he uses herbs and teas that he thinks strengthen his immune system.

“The situation for HIV-positive people [in rural areas] is critical. Not only can’t they get the medicines they need, but they face the prejudices from the society and from the doctors,” said Hugo Palma, director of the group Michoacan Residents for Health.

As recently as three years ago, only three of the 32 states in Mexico had AIDS education and prevention programs, said Patricia Uribe, Mexico’s top AIDS official. Even today, she said, many resources for AIDS prevention remain in the capitals of the states and are not shared with rural areas.

This disparity worries health workers on the front lines, who say a lack of knowledge about the disease jeopardizes both men who migrate to the United States without basic safe-sex education and village women who don’t protect themselves.

A 1997 survey of 501 Mexican migrants from Jalisco state found that only 21% of respondents used condoms during intercourse and that 30% thought they could tell from a person’s appearance whether he or she was infected.

“We need more rural education and testing,” said Porcia Mendoza, an infectious diseases specialist who handles AIDS policy for Michoacan. “Each year, more and more people are coming back from the United States infected.”

Even top Mexican health officials acknowledge some of these shortcomings but maintain that treatment for AIDS patients is improving. Uribe said some medical facilities, particularly in rural areas, did not have specialists to handle AIDS until recently. She also acknowledges that some doctors remain uneasy about treating HIV patients, even though increasing training is changing perceptions.

Mexico’s AIDS problem is far less severe than is the case in other developing regions such as Africa and parts of South America. But Mexico’s AIDS cases are more closely linked to the United States because of migration patterns.

Government statistics say there are roughly 43,000 HIV and AIDS cases in Mexico. But government officials acknowledge that their counting procedures are imprecise and dated, and say there could be as many as 160,000 cases.

AIDS cases in remote areas are estimated to account for about 10% of the total. But a recent government study suggested that the disease is spreading much faster in rural areas than in cities--with a more than 80% rise in cases in some outlying provinces since 1994.

“Migrant labor plays a major role in the geographic spread of HIV,” said Kurt Organista, a UC Berkeley professor who has extensively studied the Mexican AIDS problem. “It’s what’s bringing HIV to small towns where people never heard of AIDS. There’s no other way the women could be infected.”

In the United States, migrant workers find themselves at greater risk for contracting HIV than other groups because they often lack basic knowledge about disease prevention.

“It presents real challenges for us to prevent the HIV spread,” said Peter Kerndt, head of the Los Angeles County Office on AIDS. “We have a couple of million undocumented Mexican and Central American immigrants, many of whom are not educated [about AIDS] and [don’t] have strong language skills in English. Our work is cut out for us.”

Even when people take HIV tests, it is often difficult to get them to come back for the results, said Manuel Palacio, an outreach worker at Bienestar, a nonprofit AIDS organization in Los Angeles.

Cultural barriers also exist. Penny Weismuller, manager for disease control at the Orange County Health Care Agency, said her office commonly works with Latino men who are in sexual relationships.

“They are not frequenting places with gay men, so there are no [educational] messages targeted to them,” she said. “Even if the message was available, they might not get it because they don’t think it applies to them.”

Immigrants who have openly gay relationships in the United States hide their homosexuality when they return to Mexico, making it more difficult for health officials to target AIDS prevention education.

Ulises Vargas didn’t expect the secret of his illness to get out when he returned from work in Los Angeles to his hometown of Uruapan in 1997. Rather, his illness would eventually become known to all, throwing his family’s life into chaos and making him an unwitting symbol for the struggles of Mexicans with AIDS.

Even though he knew he was infected, Vargas had unprotected sex with his wife. When she tested positive--and pregnant--the couple began a nine-month odyssey through Mexico’s medical system.

His wife saw more than 17 gynecologists during her pregnancy. The neighbors gossiped. Nurses told her the baby would never survive. Uruapan hospital workers said that if she wanted to give birth there, she would need to supply gloves and sheets to protect them. In frustration, the couple eventually sought another option by hitchhiking 75 miles to a hospital in a larger city.

The baby was born June 9, 1998, in Morelia. The boy weighed a hefty 8 pounds and 12 ounces.

The anesthesiologist “stroked my head and told me, ‘It’s a boy and he is strong and beautiful,’ ” the wife wrote in a document filed with the Mexican government.

Hours later, without either parent’s consent, the baby was transferred to a children’s hospital, Vargas said. When the couple arrived to see the boy, doctors said the baby had died of an infection, he said. He and his wife never found out anything more, he said. Authorities eventually produced two death certificates, one saying the baby had AIDS, another listing the cause of death as an “infection.”

The couple’s experience eventually made newspaper headlines in Mexico, focusing attention on the treatment AIDS sufferers receive in the health care system. It also prompted a government investigation that is still underway.

Government health officials now agree that the medical community made errors that contributed to the newborn’s death. “There’s something to the complaint. We need to look at it and improve our care,” Uribe said.

After the baby’s death, Vargas and his wife left Uruapan for Tijuana. They eventually split up.

He now works at a Tijuana AIDS clinic. He lives a spartan life, with all his belongings in a backpack.

Often, his thoughts drift back to his wife and his baby and all they went through. But then he pulls himself out of the past and tries to focus on staying healthy. Still, one dream remains: eventually going back to his hometown one last time and visiting family.

“Before, I didn’t think I could go back. I didn’t want to,” he said. “Now, I do. I want to go to my son’s grave to remember him and to close things, to go on.”

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Rising Numbers

Latinos in Los Angeles and Orange counties have become a significantly larger percentage of AIDS cases.