Thread: Mobile population targeted in outreach movement

http://www.dallasnews.com

Mobile population targeted in outreach movement

05:37 PM CST on Monday, December 26, 2005
By ERNESTO LONDOÑO / The Dallas Morning News


TECÚN UMAN, Guatemala – The guests at the Hotel California seldom venture out into this bustling, stifling town that has become a coveted gateway into Mexico.

Most are immigrants en route to the United States and their smugglers like to keep them indoors, fearing they might find a cheaper deal or attract undesired attention from the drug runners who control this tense border town.

Nelson Gramajo, an HIV outreach worker with a local non-profit who targets migrants among other at-risk groups, frequently visits Hotel California and others like it, a condom-filled bag in hand.

"This is an adventure-filled trip, right guys?" he said jovially on a recent morning, shortly after inviting himself into a room where five men sat idly as a slow ceiling fan stirred warm air. "And, you never know, that could always mean a little sex."

Mr. Gramajo is on the front lines of a growing movement among social workers and healthcare providers in the HIV field to reach out to mobile populations who are at-risk of contracting HIV and those who already have the disease.

When HIV emerged as a global public concern nearly 25 years ago, this was a sleepy town kept afloat by coffee plantations. People knew their neighbors and foreigners passed by only sporadically.

But the drug trade and the influx of Central Americans wishing to immigrate to the United States have made the area's transient population grow exponentially. Those factors have put Tecún Uman – and the southwestern trade corridor that links Central America and Mexico – on the map of HIV hotspots.

"The whole context of migration creates a pretty flammable situation as far as HIV is concerned," said Michael Bartos, program coordinator in Guatemala City for UNAIDS, a United Nations division that coordinates HIV prevention and services programs. "You have a situation where there are a lot of people going through with a certain amount of spare time. They are areas where security is dubious and areas with a high degree of sex work."

Mr. Gramajo said male migrants – many of whom travel in groups without families – often engage in risky behavior when they're away from home. He's stumbled upon migrants having sex in hotel rooms with open doors. He's met others who opted to sell their bodies after being deported. And he's spoken to women who were coerced to have sex with their smugglers as a requisite to continue their trip north.

"They arrive with the dream of getting to the United States only to run out of money here," he said. "People who find themselves penniless stop worrying about AIDS, sexually transmitted diseases – sex in general, whether it be with a man or a woman."

The risky behavior doesn't stop at the border. A joint study published earlier this year by the University of California and the Mexican government showed that 1.1 percent adults who had previously migrated to the United States, surveyed in Mexico, were HIV positive.

That's more than three times higher than the Mexican prevalence rate.

It's a phenomenon that hasn't dodged North Texas. Fernie Sanchez, director of intake at AIDS Arms, a local non-profit agency in Dallas, has seen the number of first-generation immigrants diagnosed with HIV increase through the years.

Mr. Sanchez said his agency receives anywhere from 12 to 15 new first-generation immigrants each month as clients. Most get diagnosed when their symptoms become unbearable.

"Many of the Latinos we serve, their idea of going to the doctor is going to the emergency room when they're in a real emergency," Mr. Sanchez said.

One such patient arrived at the agency last spring, after collapsing at a construction site in Corsicana.

"He worked until he couldn't work anymore and ended up in a hospital in Corsicana," he said. "These guys work until their bones fall off."

The disease cripples more than individual lives.

"It is manifesting itself in the disintegration of families and cultural values that were in place before but no longer exist," said Sister Dee Smith, a Catholic nun who runs Proyecto Vida, a non-profit agency that provides social services to people with AIDS in Coatepeque, a town near Tecún Uman.

"It is affecting the productive sector in Guatemala. If you're reducing the number of people able to work in their country, you're fomenting their dependence on relatives in the United States."

E-mail londonoernesto@yahoo.com

oh sure - illegals coming to the united states always use condoms when they rape american women-