FW: HIV Lserv: HIV Prevention With Mexican Migrants: Review, Critique, and Recommendations

October 27, 2004

FYI, one paper and several abstracts from a special issue of JAIDS on

HIV/AIDS and HIV prevention among Mexican migrants, primarily in

California. The research articles are based on work done under the

Mexico-University of California initiative.

Best,

Tom

-----Original Message-----

From: Malow [mailto:rmalow@...]

Sent: Tuesday, October 26, 2004 10:24 PM

' Malow'

Subject: HIV Lserv: HIV Prevention With Mexican Migrants: Review,

Critique, and Recommendations

Attached is the article summarized immediately below (Organista et al)

from a special issue on " HIV/AIDS Among Mexican Migrants and Recent

Immigrants in California and Mexico " . Below this, is the text of

introductory article to the issue and abstracts for other articles in

the issue.

==============

HIV Prevention With Mexican Migrants: Review, Critique, and

Recommendations.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 37 Supplement

4:S227-S239, November 1, 2004.

Organista, Kurt C PHD *; Carrillo, DRPH +; Ayala, PSYD

++

Abstract:

Summary: Charged with the task of reviewing the research outcome

literature on HIV prevention with Mexican migrants in the United States,

the following broad observations and conclusion were made: (1) there is

little research on this specialized topic of concern; (2) the research

that exists reflects an overly individualistic behavioral science

approach designed to reduce individual risk factors, with little regard

for structural and environmental factors that influence HIV risk; and

(3) there is a compelling need to develop better theoretic frameworks

for understanding the complex and dynamic social and cultural processes

influencing sexual behavior among Mexican migrants so as to better

inform HIV prevention efforts with this unique and diverse Latino(a)

population.

=================

INTRODUCTION to Special Issue

HIV/AIDS Among Mexican Migrants and Recent Immigrants in California and

Mexico.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 37 Supplement

4:S203, November 1, 2004.

, MPH *; Lemp, F DRPH, MPH *;

Castaneda, Xochitl MPH +; , A MA *; Aoki, Bart K PHD *;

Tapia-Conyer, o MD, MPH, MSC ++; Drake, V MD *

This special issue contains original review articles by researchers from

the University of California and the Secretariat of Health of Mexico.

The articles on epidemiology, prevention, and health care services

review available published data and selected unpublished data on Mexican

migrants in California specifically and across the United States. These

articles identify research and intervention needs and, where available,

document effective methods of outreach and interventions with the

Mexican migrant population. An article addressing the issue within

Mexico outlines the emerging data on the vulnerability of Mexicans

migrating to the United States with regard to HIV, sexually transmitted

diseases, and associated behaviors. Lastly, a concluding article

presents an analysis of policies that serve as barriers or facilitators

of prevention and care for Mexican migrants in California. All the

articles offer compelling evidence for integrating tailored outreach,

prevention, and health care services for the Mexican migrant population

into the overall health care infrastructure of communities in California

and Mexico.

Patterns of transnational movement among Mexican citizens vary widely;

therefore, the term migrant extends to all those groups of persons whose

residence, work, and social patterns extend across the United

States-Mexico border. This population includes individuals at different

stages of migration, their families, and individuals who are part of

their social and economic networks in California and Mexico. Effective

prevention and care strategies for Mexican migrants must focus on these

populations as distinct migrant group who contribute economically to the

communities where they reside.

The California-Mexico AIDS Initiative was created by the University of

California, Office of the President, in collaboration with the

Secretariat of Health, Mexico, to address the epidemiology, prevention,

health care services, and public policy issues with regard to HIV/AIDS,

sexually transmitted diseases, and tuberculosis among Mexican migrant

communities in California and within their originating communities in

Mexico. This transnational collaboration is based on the premise that

Mexican migrants in the United States are particularly vulnerable to

infectious disease epidemics such as HIV, sexually transmitted diseases,

and tuberculosis. The body of data presented in these articles supports

this hypothesis and indicates that without intervention, these epidemics

may expand more aggressively in the future, representing an emerging

threat to Mexican migrants in California, along the California-Mexico

border, and within Mexico.

==================

The Epidemiology of HIV Among Mexican Migrants and Recent Immigrants

in California and Mexico.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 37 Supplement

4:S204-S214, November 1, 2004.

, A MA *; Lemp, F DRPH, MPH *;

Magis-, MD, MPH +; Bravo-, Enrique BA +; ,

JD *; Ruiz, D MD, DRPH ++

Abstract:

Summary: For Mexican migrants and recent immigrants, the impact of

migration from Mexico to California has the potential to lead to an

increased risk for HIV infection. Until recently, the prevalence of HIV

in Mexico and among Mexican migrants in California appeared to be stable

and relatively low. Recent studies have raised new concerns, however,

that the HIV epidemic may expand more aggressively among this population

in the coming years. Unfortunately, the insufficient amount of data

available within recent years makes it difficult to fully assess the

potential for rapid spread of the HIV epidemic among this population.

Consequently, there is a critical need for an ongoing binational

surveillance system to assess prevalence and trends in HIV/STD/TB

disease and related risk behaviors among this population both in

Calfornia and within this population's states of origin in Mexico. This

enhanced epidemiologic surveillance system should provide improved data

on the subpopulations at the highest risk for HIV/STD/TB, such as men

who have sex with men, and should provide the opportunity to evaluate

the impact of migration on the transmission dynamics, risk behaviors,

and determinants of behavior on each side of the border. It is essential

that this potential threat be assessed and that intervention programs

are developed and implemented to combat this possible escalation in the

HIV epidemic.

Migration and AIDS in Mexico: An Overview Based on Recent Evidence.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 37 Supplement

4:S215-S226, November 1, 2004.

Magis-, MD, MPH *; Gayet, Cecilia MHD, MSS *; Negroni,

Mirka MPA +; Leyva, Rene PHD +; Bravo-, Enrique BD *; Uribe,

MD *; Bronfman, PHD +

Abstract:

Objectives: Provide an overview of the relation between migration to the

United States and AIDS cases in Mexico. Characterize the sexual

behaviors of Mexican migrants. Describe HIV/AIDS prevention and clinical

attention actions developed.

Methods: The following were analyzed: AIDS cases databases, various

prevalence studies, the migrants survey, and information of the

Ministries of the Interior and of Health. A documental analysis was

undertaken of works published between 1992 and 2000 on migration and

AIDS.

Results: In terms of their sexual practices, migrants in the past year

had more sexual partners, tended to use a condom in their most recent

relation in greater proportion, and had greater use of injected

medicines and drugs. Two bi-national programs undertake epidemiological

surveillance activities, while several initiatives have used innovative

formats to provide prevention information to migrants. Imminent

universal coverage leaves the challenge to assure quality of attention

for migrants.

Conclusions: Studies to evaluate the impact of international migration

on distribution of infected persons will be indispensable to establish

priorities in prevention and attention among migrants. More information

is needed on bi-national health projects to understand the impact they

may have in prevention, while continuity of the prevention initiatives

must be guaranteed. Attention to migrants in bi-national contexts

requires information exchange agreements on migrants living with the

HIV/AIDS.

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