HIV on the Border

New data on HIV/AIDS in Cameron County reveals deadly inadequacies in the extent and frequency of local testing.

According to the Texas Department of State Health Services the county had 742 confirmed cases of HIV and AIDS at the close of 2006. About half of the cases had advanced to AIDS.

The data confirm that six times more Hispanics have HIV/AIDS than any other ethnic group in the county, where slightly more than 80 percent of the population is Hispanic, according to the U.S. Census Bureau’s latest figures.

State statistics also show that three times more males have reported cases of HIV/AIDS than females. These data reflect the national male-female ratio.

Most of the cases in Cameron County were a result of men having sex with men, or MSM. The practice of two men having sexual intercourse is referred to as MSM because not all men who have sex with other men identify as gay or bisexual.

The second most frequent mode of transmission was heterosexual contact. The third was intravenous drug use.

HIV/AIDS data is collected whenever a new case is reported. It is a legal requirement for testing facilities to report any positive test results, though patients are not identified in statistics.

According to the AIDS Education Training Center or AETC, which publishes information about HIV/AIDS in Texas, there are less reported cases of infection in Texas border counties than in the rest of the state.

This statistic does not conform to what is known about how the virus is commonly transmitted, potentially indicating an under-tested population.

“We almost discontinued the border report because the data is potentially inaccurate,” said Cynthia Taylor, an epidemiologist with the TDSHS.

‘RIPE TO EXPLODE’

Recent analysis of border communities from McAllen to El Paso by Farmworker Justice reveals that border residents are engaged in risky sexual behaviors, including sex without condoms, sex with multiple partners, or with sex workers.

“Given the prevalence of those kinds of behaviors, we may be at the cusp of an epidemic,” said Shelly Davis, deputy director of the Washington D.C.-based nonprofit.

“Maybe the statistics are inaccurate, or maybe HIV hasn’t entered this population yet, but if it does, conditions are ripe for it to explode.”

Hispanics face some of the most fatal risks of those with HIV/AIDS in the country, according to a new study conducted by the National Council of La Raza, or NCLR.

“Hispanics are the most likely to learn of their HIV status late in their disease progression, the least likely to gain access to quality HIV/AIDS-related health care, and the most likely to die within 18 months of an AIDS diagnosis,” the study shows.

Pedro Coronado of the Valley AIDS Council believes that if local residents were more aware of the virus, they would take more significant precautions to protect themselves.

“People don’t talk about it, so they don’t think it’s here,” Coronado said. “That’s the big issue the district isn’t really addressing.”

SOCIAL STIGMA

Brownsville resident Oscar Galvan learned of his AIDS status in 2004 when he was helping Coronado fill a quota for monthly testing.

Galvan says the support of his friends and family has helped him to feel comfortable living with AIDS, as he continues to practice activism.

He still finds the Valley less tolerant toward gays, lesbians and bisexuals than in larger metropolitan areas.

“I used to have a partner in San Antonio and we could walk down the street holding hands and stuff and no one would care,” Galvan said. “Here, that would be more difficult.”

For Galvan, 29, the biggest impediment to preventing the spread of HIV/AIDS is intolerance.

“Straight people who have a wife or something, if they’re afraid of being gay they might have sex with other men in secret,” he said.

This practice is responsible for many cases of HIV/AIDS among women, since men who feel uncomfortable discussing their sexual contact with men keep this information secret from their female partners.

“Sex itself is not so openly discussed in the Latino community,” said Dr. Henry Pacheco of the Texas/Oklahoma AIDS Education Teaching Center.

In Brownsville, abstinence-based education is taught in public schools. Contraception, which may prevent the spread of HIV/AIDS, is never demonstrated, according to Elizabeth Avitia, BISD health curriculum specialist

Additionally, Pachecho says machismo contributes to a homophobic environment. “Stigma and outright hostility are directed at people who choose certain lifestyles.”

According to Pacheco, cultural factors like homophobia may contribute to low rates of testing and high rates of transmission.

When fear of alienation causes men who have sex with men to keep their activities secret, the women they infect may not get tested because they are unaware their partner is engaging in risky sexual behavior.

TRANSIENT RESIDENTS

The transient nature of the border population may also alter county statistics.

The regions of Mexico with the highest rates of HIV also have the highest rates of migration, according to The New York Times.

A study in the Journal of Community Health reported that 44 percent of 342 migrant male laborers returning to Mexico had visited a sex worker while in the United States.

“The common way this plays out is you have a split family,” Davis said. “So let’s assume that the spouse stays back in the homeland community while the husband migrates. With other risks, the husband undergoes as a farm worker; the wife is not at risk — with heat risk for example. So she might assume that he’s at risk, but she isn’t, and then he passes HIV onto her when he comes back.”

In rural areas of Mexico, this is especially fatal, since life-saving treatment may not be available.

Davis says another barrier for migrant testing is fear of contact with law enforcement.

“People have a fear of any kind of contact with officialdom because of potential repercussions,” Davis said. “This makes them less likely to get tested.”

She adds that many migrants feel that the benefits of getting tested wouldn’t outweigh the risk. “People feel like, ‘why should I get tested, no one’s going to give me the drugs, so what’s the point?’”

According to Davis, even if the statistics were accurate, the risky conditions on the border are reason enough to take serious steps to change local attitudes about the virus.

“People aren’t going to get tested until they’re going to get help or they’re in acute distress,” she said. “Either way, it’s fatal.”

ENDURING CONFLICT

Fear and secrecy is often based on ignorance or misinformation about the science of contagious diseases, health experts have said. These roadblocks to awareness and treatment lie in cultural or religious beliefs about sexually transmitted diseases, such as HIV and AIDS.

Groups like Homosexuals Anonymous, with a branch in Brownsville, propagate the myth that HIV/AIDS is a moral, rather than medical condition, according to experts like Pacheco.

The group’s mission is to lead people away from homosexuality and toward a Christian, heterosexual life.

Counselors work with individuals for months and years to fully convince them that their homosexual feelings are not real, but a psychosis.

“I’m going to be honest with you,” said David Alvarado, who works at the group’s Laredo branch, “not everyone makes it.” Alvarado says he used to be gay, but is now married with two kids.

“When people worship false idols or live these lifestyles, God does not like that,” he said, adding that HIV/AIDS are punishment to African countries for improperly worshipping Christ. “That’s why people perish.”

Pacheco responds that a quick look at common causes of death discredits such a statement.

“Look, the principal causes of death in the U.S. are cardiovascular disease and cancer. The principal causes in African countries are malaria and diarrhea,” he said.

“Babies who die at birth or young children haven’t had to chance to commit religious indiscretions. How do you explain those deaths?”