Migrant Workers and HIV/AIDS and the Lack of Health Care

migrant workers and HIV

It may come as a surprise to know that of the roughly 11 million Mexican-born migrant workers currently living in the United States, recent immigrants — though poorer — are healthier in several ways than the average American. But the longer they “acculturate” here, the worse their health gets. For migrant workers who have a chronic disease, this is a particular problem. Not only are they unlikely to get the regular checkups and basic care needed to stay healthy, they often fail to get proper treatment for life-threatening illnesses, including HIV/AIDS.

Perhaps more than any other illness, HIV/AIDS exposes the shortfall of health care for migrant workers, says Vivian Levy, MD, an adjunct clinical instructor of infectious diseases and geographic medicine at Stanford University School of Medicine. Levy and her colleagues recently studied a group of 391 HIV patients at a Northern California clinic. Seventy-four of those patients were Hispanic immigrants, including migrant workers. Remarkably, they were six times more likely than U.S.-born Hispanics to have the disease reach an advanced state before getting medical care. Early treatment for HIV is crucial, Levy says, and such delays can be deadly for both the patient and others in the community. “Prompt treatment with antiretroviral drugs can control the disease and reduce the chance of spreading the virus to others,” she says.

Risky Lives

There’s no way to know exactly how many migrant workers in the United States are infected with HIV, says George Lemp, DrPH, director of the Universitywide AIDS Research Program (UARP) at the University of California at Berkeley. However, a 2008 pilot study of the sex habits of 458 male Mexican migrant workers in California hints at the potential for widespread HIV infection. The researchers found that risky behavior such as sex with prostitutes or sex while under the influence of alcohol increased by 11.3 percent and 16.7 percent respectively after arriving in the United States. With the rise in these high-risk sex behaviors, researchers see the makings of a possible calamity.

What’s more, the living conditions and overall quality of life for migrant workers is degrading and can destroy their sense of self-worth, says Lemp. “I’ve seen workers in Northern San Diego County living in boxes or sleeping in the hills above the fields. Or there could easily be 15 to 20 guys living in one place,” he says. “Faced with such dismal living conditions, many workers get involved in drugs and engage in unprotected and [otherwise] risky sexual behavior.” Lack of jobs and poverty may be pushing others toward unprotected sex for hire. Some migrant workers in Northern California have told employers that day laborers are regularly solicited for sex by North American men and women as they wait for jobs in construction.

Social isolation may be the main thing that has protected Mexican migrant workers, Lemp says. Because they tend to stick together — and because HIV isn’t especially common in the country that they once called home — they don’t have many chances to get infected. However, says Lemp, if they’re going outside of their community to bars or brothels where HIV may be more common and easier to pick up, the disease could quickly explode. “If we can’t reduce risky behavior, we could have an epidemic,” he says.

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