Today marks the last day of a month of activities in honor of Hispanic Heritage Month, which began on September 15. The end of this celebration is capped off by National Latino AIDS Awareness Day (NLAAD). This year’s theme is “Hispanics United to End AIDS.” Events commemorating this occasion, which started in 2003, were held today all around the country, from Laredo, Texas to Anchorage, Alaska. At present, there are more than 1 million people in the U.S. living with HIV/AIDS, including over 200,000 Latinos.
Latinos are disproportionately affected by HIV in the U.S. While they represented just 16 percent of the population in 2009, they made up 20 percent of all new HIV infections. It is unclear how many farmworkers live with HIV/AIDS—studies indicate the range of infected farmworkers is between 2.6 percent-13.5 percent. The National Centers for Farmworker Health has suggested that in 2001, HIV/AIDS was the third highest cause of death among Hispanic men aged 35 to 44.
Migrant farmworkers should be of particular concern as they travel around the country following the harvest, with some of those workers even traveling internationally. Mexican officials estimate 30 percent of their country’s HIV/AIDS cases are caused by migrant workers returning from the U.S. Many Mexican migrants live in the border areas since they travel back and forth between the two countries frequently, which can lead to bi-national infection patterns. One study that seems to substantiate this claim showed HIV diagnosis increased almost 8 percent between 2003 and 2006 on the US-Mexico border. This relationship becomes obvious when looking at the relationship between California, which has the highest HIV rates in the country, and Jalisco, where a very large percentage of farmworkers who work in California originate.
Why are the numbers so high among farmworkers? Poverty, language barriers, low health literacy, and limited access to care prevent awareness about risk and seriously limit opportunities for testing or treatment. These risk factors for HIV/AIDS are the same factors that result in other disproportionately high health problems experienced by farmworkers. Sub-standard housing, mobile lifestyles, and social isolation also play a large role.
The National Agricultural Workers Survey found the majority of migrant farmworkers who travel to the U.S. for work are male. Male farmworkers are sometimes exposed to the virus through unprotected sex with other men or through sex with sex workers. A study of migrant male farmworkers in San Diego, California found that 70 percent of sexually active farmworkers reported sex with a sex worker, while only 23 percent of those individuals reported using condoms. There are a variety of barriers to condom use among farmworkers, including lack of sex education, lack of resources, and prohibitive cultural and religious beliefs.
HIV has also been shown to spread through amateur tattooing and injections, which are all too familiar in farmworker communities. Self-medication and lay health injection of vitamins and antibiotics as a treatment for illness are quite common. A study done on the tattooing practices among farmworkers concluded that amateur tattooing is widespread and there is little understanding of the transmission of blood-borne illness through needle sharing. Some migrants also may use drugs and alcohol as a coping strategy for mental health problems related to poverty and isolation, which is another risk factor for contracting HIV.
Latinos in the U.S. are considered an at-risk population when it comes to HIV/AIDS due to significantly higher rates of the disease, when compared to the general population. They are also more likely to die due to delayed treatment. Farmworkers, who are predominantly Latino, are one of the most vulnerable subsets of the population. They typically have no health insurance and little knowledge about the disease and its transmission. Moreover, they have little to no access to linguistically and culturally sensitive prevention information, counseling, testing, and treatment programs. This year NLAAD is uniting communities at the federal, state, and local levels, together with public health agencies and non-profit organizations, to fight the effects of the AIDS epidemic on Latino people. Farmworkers should be included in that conversation, as they are part of the AIDS epidemic on a domestic and international level.