Mobile Populations: HIV/AIDS in Central America, Mexico, and the US

Migration and AIDS: STIGMA AND Migration and AIDS: STIGMA AND DISCRIMINATIONDISCRIMINATION

INSTITUTO NACIONAL DE SALUD PÚBLICA

Guatemala City, 2004

METHODOLOGY STUDY DESIGNSTUDY DESIGN

PHPHASE IIIASE III

EvaluaEvaluatiotionn

PHPHASE IASE I

Basic DiagnosisBasic Diagnosis

PHPHASE IIASE II

IntervenInterventiotionn

January-February 2001

Design: Aug. 2002 - July 2003Implementation: May 2004

Accompaniment: Aug. 2002 - Sept. 2004

QUANTITATIVE METHODSQUANTITATIVE METHODS Population SurveyPopulation Survey

QUALITATIVE METHODSQUALITATIVE METHODS Ethnographic StudyEthnographic Study In-depth InterviewsIn-depth Interviews

Key Actors and Common ActorsKey Actors and Common Actors Sex WorkersSex Workers Mobile PopulationMobile Population

ELEVEN TRANSIT STATIONS:ELEVEN TRANSIT STATIONS:Tecún Umán, Guatemala - Ciudad Hidalgo, MexicoTecún Umán, Guatemala - Ciudad Hidalgo, Mexico

MOBILE POPULATIONS AND HIV/AIDS PROJECT

OBJECTIVE:

Analizing the social rejection of illegal migrants associated with HIV/AIDS

Dynamics of the Population Movement Across Borders Mexico-Guatemala

CENTRAL AMERICAOTHER COUNTRIES

MEXICO/ USA

EL CARMENVertedero de

indocumentados

TALISM ﾁN

DEPORTACI ﾓN

TEC ﾚN UM ﾁN Estancia Interacción Destino TSC PollerosContratistas

R I O S U C H I A T E

CD. HIDALGOPaso r疳 ido Poca interacción Destino TSC Persecución

PLANTATIONS

GUATEMALA

Migration

Detention

IllegalCrossing

Migrants

First Time Migration

Return migration

Chiapas

Caminos deExtravío

Attacks, violence

Voluntary return

PUENTE INTERNACIONAL

Paso Documentado

MEXICO/ u

EL CARMEN

“Dumping Site” of

Migrants without documents

TALISMAN

Deportation

TECUN UMAN Stay InteractionDestination TSC“Polleros”Contractors

S U C H I A T E RIVER

CD. HIDALGOFast transitLittle interactionDestination TSCPersecution

GUATEMALAMigrant agricultural workers

MigrationPosts

Returno ofMigrants

Chiapas

Shortcuts

INTERNATIONAL BRIDGE

Source: Leyva R, Dreser A, Bronfman M. Diseño propio, 2001.

- - - - - - - - - - -

Means of Mobilization at the Southern Border

0102030405060708090

Transmission Use ofpreservatives

TU

CH

Information on HIV/AIDS Transmission and Prevention

%

Source: Population Survey Migración y SIDA, 2001.

HIV/AIDS Risk Perceptionand Willingness to Use Preservatives

0

1 0

2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

1 0 0

W o u ld b e willin g tou s e a p re s e rv a tiv e

No p o s s ib ility to g e tin fe c te d

T U

C H

Fuente: Encuesta Poblacional Migración y SIDA, 2001.

%

01020

3040

506070

8090

Would NOT consult adoctor with AIDS

Would NOT employ aperson with AIDS to help

out at home

Would NOT allow theirchildren to play with thechildren of people with

AIDS

TU

CH

Attitudes of Rejection of PVS by the Population

%

Fuente: Encuesta Poblacional Migración y SIDA, 2001.

Migration Movement and HIV/AIDS

Migration and AIDS: ¿Why do you think that people get infected here in Tecún Umán? “Well, because there are a lot of foreignerwandering around”

(01INFCO, Tecún)

Prostitution, Migration and AIDS: “The bars, I thing that is theplace where that is transmitted, because many infected womengo there, and migrants go there. But also, the migrants whoarrive are infected.”

(13INFCO, Tecún)

Transactional Sex: “I tried to pass through customs, they told me that I had to have sex with them if I wanted to get a permit”

(08PM, Cd. Hidalgo)

What the Local Population Thinks of Migrants

0102030405060708090

100

They cause troub le They bring benefits

TU

CH

Source: Population Survey Migración y SIDA , 2001.

%

Migrants: Insecurity and Violation of Human Rights

Social Representation of AIDS Transmission Associated with the Mobility between Mexico and Guatemala

HIV/AIDS

INFORMATION

Localpopulation

AIDS

Migrants

Sex Workers

Truck Drivers

Homosex

Soldiers

Expressions of rejection

Dissemination of AIDS

Resistance to interact with PVVS

“Comes from abroad”

“POTENTIAL TRANSMITTER

”

Source: Leyva R, Infante C. 2002

Action Sphere of Local Organizations

Tapachula

SaludSalud Migración VIH/SIDA

Tecún UmánTS DDHH Migración

Ciudad HidalgoVIH/SIDA TS DDHH

Tapachula

HealthHealth Migration HIV/AIDS TS H Rights Migration

Ciudad HidalgoHIV/AIDS TS H Rights

Casa del Migrante

Casa de la Mujer

Human Rights Office

Clínica Parroquial

IGSS

Migration Office

Health Center

Ministry of Labor Office

Mexican Consulate

Municipal City Hall

Communication Media

Union Tricicleros

Municipal Health Dept.

Health Center

Grupo Beta Sur (INM)

UMF/ IMSS

Municipal City Hall

Casa del Migrante

Human Rights State Commission

COFAT

Mano Amiga

HIV/AIDS Program

Fray Matías de Córdoba

PHASE IIINTERVENTION DESIGN AND

IMPLEMENTATION

STRATEGY BETWEEN BORDERS Binational Action Local Action

Strategy between Borders: Local and Binational Action

Collaboration between

Borders:

Planning and implementing joint inter-institutional and inter-sectorial actions

Community Action: Reducing rejection and discrimination of HIV/AIDS and STIs in mobile populations.

Training, awareness raising and collaboration:

Training and awareness-raising for HIV/AIDS prevention in mobile groups.

Inter-institutional cooperation for HIV/AIDS and STI prevention and Human Rights promotion.

Working with specific

Groups:

Information on HIV/AIDS and STI for migrants

Information on HIV/AIDS and STI for TS

Inter-Institutional Work with Specific Groups

Community Response

Immediate Results

The topic of HIV/AIDS and population mobility has been made visible to local organizations.

It has been recognized that mobile groups (illegal migrants) are vulnerable to HIV/AIDS.

Network between borders for health actions.

Links with regional processes and projects.

PERSPECTIVE

Strengthening technical capacity for response

Binational cooperation for sustainability

Developing new binational proposals

Establishing links with other regional projects

Incorporating strategies into the PNS

Mobilization of financial resources