Wednesday, May 31, 2006
There's a constant flow of traffic on the road that runs along the Mexican side of the border fence.
A canal lies next to the road. A man known as Tortas lives inside one of the canal's pipes, in the Tijuana neighborhood called Zona Norte.
Tortas has been shooting heroin since he was a teenager. Lately, the 25-year-old has added methamphetamine to the mix.
Tortas says he's pretty sure he knows how he got HIV.
I got infected from using dirty needles. Many times I was walking around with bad withdrawals, and I saw a used needle, so I took it. Or I borrowed one from someone else.
Tortas found out he was infected last year. At first he couldn't believe it.
Tortas: "I never imagined I would get infected. I didn't know anything about HIV. I didn't know that you could get the virus by using someone else's needles. I thought you could only get it from having sex with someone, like with another man.
Men who have sex with other men are at highest risk of getting HIV. But there also are an estimated 10,000 injection drug users in Tijuana. Their behavior, and that of the city's prostitutes, is helping fuel a steep increase in the region's HIV infection rate.
Steffanie : "We have seen HIV increase from very low, stable rates in Tijuana, to one that is quickly spiraling out of control."
Steffanie Strathdee heads up UCSD's division of international health. She says new research reveals since the 1990s, the HIV rate among injection drugs users in Tijuana has tripled. And among female sex workers, it's gone up nearly ten times.
Strathdee says the conditions in Tijuana are ripe for an explosion of HIV.
Strathdee: "We've got a situation where Tijuana is situated on a major drug trafficking route, prostitution is quasi-legal. We've got a very highly transient population that's very poor, that's marginalized, and many of whom are very desperate."
But some of those at risk in Tijuana are getting help. UCSD has donated a converted van that operates as a mobile HIV prevention clinic. It's open twice a week in Zona Norte, an area filled with prostitutes and drug addicts.
This clinic offers HIV testing and prevention materials. And clients can participate in a study, that researchers hope will provide a more complete picture of the H-I-V situation in Tijuana.
Next to the van, a couple of non-governmental organizations set up shop. These groups hand out clean syringes and condoms.
Local resident Veronica Rosas says she likes to stop by whenever the clinic is open.
Veronica Rosas: "Because they help me get tested. They help me to stop using drugs. And they help me try and stay straight."
There are other efforts underway to try and stem the rise of HIV in Tijuana.
For example, all pregnant women at the region's public hospitals and clinics are now tested for the virus.
Dr. Romedios Lozada is Tijuana's coordinator of sexually transmitted disease programs. She says the government is trying to do what it can with limited resources.
But Lozada says health officials shouldn't be the only ones trying to prevent the spread of HIV.
Lozada: "Because this information must begin at home. I mean, we at the health department are doing our part. But all of the responsibility shouldn't fall on health officials, or the government."
UCSD's Steffanie Strathdee believes the U.S. and Mexico need to launch a bi-national response to HIV treatment and prevention.
Strathdee says unfortunately, the U.S. may move in another direction.
Strathdee; "If we have a unilateral response that militarizes this border, what it will do, is it will create likely more high risk social networks, more desperation, more economic deprivation. And that will contribute, unfortunately, to an epidemic. And let's hope that my prediction doesn't come true."
Strathdee says if things aren't brought under control in Tijuana, the HIV infection rate could soon top one percent of the population. That would be more than triple the national HIV rate in Mexico. Kenny Goldberg, KPBS News.