Wednesday, February 23, 2011
Migrant men who make their living as farm workers are at higher risk of HIV infection, and increasingly, they have fewer resources to control it.
SAN DIEGO Angel is afraid to use his full name. He’s a 27 year old man from Nayarit, Mexico, who picks grapes in the fields of Southern California. He never thought he’d get HIV, but one day, five years ago, he started getting some of the typical symptoms.
“I found out I was infected because I had a fever, my joints hurt and my appetite was suddenly gone," said Angel. "My family took me to clinics in Mexicali, Mexico, but they didn’t diagnose me with anything serious.”
He's one of a growing number of farm workers who’ve become infected with HIV. According to the Centers for Disease Control and Prevention, prevalence of HIV infection for the general population in the U.S. and Mexico is less than 1 percent, but among migrant farm workers in Imperial County, it's between 6 and 13 percent -- one of the highest for any population in the country.
“They’re migrant seasonal workers, they travel,” said Lalita Hermosillo, HIV case manager for Clinicas de Salud del Pueblo in Brawley, a small agricultural town about two and a half hours east of San Diego. “The economy is so bad right now, that I’ve had people even travel all the way to Arizona, but I make sure that they’re taking their medication, keeping in contact with them.”
Hermosillo said these farmers are at risk for several reasons: they live a transient lifestyle, they’re separated from family and friends, and they sometimes engage in risky sexual behavior when they’re far away from home. This population is generally uninsured and their initial symptoms often go undiagnosed.
Take Angel, for instance. He was misdiagnosed a few times before he was found to be HIV positive, even though he was at high risk for infection because he’d been having sexual relationships with other men. Among migrant farm workers, men having sex with other men or with sex workers are the top reasons for HIV transmission.
The problem, is that Angel’s options for treatment are increasingly limited.
“Over half of our budget was cut and we lost a lot of personnel,” said Dr. Jon Persichino, a clinic specialist, and a national authority on HIV in the migrant farm worker community. He explained that a lack of state funding for promotoras, or community health workers, has been slashed in half in the last two years, making his and his colleagues’ jobs more difficult.
“We used to use a lot of promotoras and a lot of funding for the rapid tests so you could go out to the fields, go out to the clubs—the funding has decreased for that.”
But Clinicas del Pueblo is finding ways to continue caring for its 140 patients who rely on HIV treatment. It’s partnering with human rights organizations, and starting next month, administrators will reinstate a program to get farm workers tested out in the fields, where they spend most of their time.