HIV/AIDS Infection: HIV Among Pregnant Women at Mexican Hospital Much Higher Than Reported Earlier
March 23, 2004
HIV infection among women in labor at Tijuana General Hospital is 14 times higher than previously reported by CONASIDA, the Mexican organization that tracks AIDS cases, according to a University of California-San Diego School of Medicine study. Among 947 pregnant Mexican women in labor tested June-September 2003, the study found a 1.26 percent HIV-infection rate, compared to CONASIDA's estimated HIV-prevalence rate of 0.09 percent.
Input assumptions for total population and HIV prevalence for Tijuana population ages 15–49 years, by scenario and group
Model parameters
Variable Population* HIV prevalence
Total population
Males 347,300 –
Females 339,300 –
Total 686,600 –
Transmission groups
Gay and bisexual men 10,400–17,400 11–19%16,22,23
Injection drug users 6,400–10,000 2.3–6.5%20
Sex trade workers 4,850–9,000
4.8% 21[/COLOR]
High-risk pregnant women 2,900 5.6–11.6%3
Low risk women 15–49 years 326,000–330,600 0.01–0.10%16,25
Low-risk men 15–49 years 321,400–331,400 0.01–0.10%16,25
A qualitative study conducted in 2004 found that FSWs in Tijuana seldom negotiated the use of condoms, had a low knowledge regarding the proper use of condoms, and did not like to use condoms with clients because they were perceived as uncomfortable.29An ongoing quantitative study among FSWs in Tijuana recently found that injection of vitamins and illicit drugs (e.g. methamphetamine, cocaine) was common among FSWs in Tijuana.21 The link between drug use and HIV in pregnant women in Tijuana further suggests that HIV could soon become more generalized in Tijuana unless immediate preventive actions are taken.3 Since the latter study was conducted, HIV antibody screening of pregnant women in Tijuana is now becoming routine, and provisions have been made for administering antiretrovirals to HIV-positive pregnant women.
Our model provides a snapshot of the current HIV situation in Tijuana; however, comparison with earlier figures suggests the situation is dynamic. While studies conducted in 1987 and 1988 found that HIV prevalence was 0.5–1% in
FSWs,23,30
more recent surveys of HIV in this sub-population found prevalence near 5%.21
Tijuana sex workers' male clients raise HIV risk
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Date: 2009-07-13
Contact: Debra Kain
Phone: (619) 543-6163
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A study by a bi-national team of global health researchers at the University of California, San Diego School of Medicine, examining HIV infection among male clients of female sex workers in Tijuana, has found that more than half of the male clients had recently had unprotected sex. They also reported a high prevalence of drug use.
"Targeted intervention among male clients is necessary to prevent the spread of HIV and other sexually transmitted infections -- intervention that doesn't solely place the onus on female sex workers," said lead author Thomas L. Patterson of UC San Diego's Department of Psychiatry and the Veterans Administration Health Care System, San Diego.
Tijuana, located in Baja California, directly across the border from San Diego, has a thriving sex industry and is a popular destination for U.S. and foreign sex tourists. While the city's health service does license female sex workers, on condition that they are regularly tested for HIV and other sexually transmitted diseases (STIs), only about half of them indeed are licensed. In addition, Baja California has the second highest cumulative AIDS incidence of any Mexican state and, in 2006, the HIV prevalence among female sex workers in Tijuana was 6 percent. It has been estimated that as many as one in 112 persons aged 15-49 living in Tijuana is HIV-infected.
"Male clients of female sex workers in the San Diego-Tijuana border region act as a bridge that can potentially transmit HIV and other STIs to sex partners, including their wives," said co-author Manual Gallardo, M.D, Patronato Pro-COMUSIDA in Tijuana. "However, given that only 59 percent of clients reported regularly using condoms with a female sex worker, there appears to be some level of complacency that urgently needs to be addressed."
The study, published in the current on-line issue of the journal AIDS, looked at 400 clients -- about half residents of San Diego and the remainder from Tijuana. Their average age was 36.6 years, with the majority Mexican or Hispanic (about 80 percent) and single, never married or divorced (57.5 percent). During the past year, clients had sex with an female sex worker an average of more than 25 times and over half of them reported having unprotected sex during the past four months.
While only half of clients reported having been tested for HIV, 14.2 percent tested positive for at least one STI (chlamydia, gonorrhea, syphilis or HIV). The prevalence of HIV infection among clients was similar to that of female sex workers in Tijuana. The risk of contracting HIV was highest for those who lived in Mexico, used methamphetamines or had tested positive for syphilis.
"Of those we interviewed, nearly nine out of 10 reported having used illicit drugs during their lifetime," said Patterson. Many were binge drinkers, and one-third said they were frequently high on drugs when with a female sex worker. This profile of substance abuse -- especially methamphetamine use -- likely contributes to high-risk sexual behavior."
Earlier reports by UCSD researchers suggested that interactions with clients can be a critical barrier to the adaptation of safe sex practices among female sex workers, who reported that some clients are willing to pay double for unprotected sex.
"Our new data suggests an urgent need to develop behavioral interventions to improve the clients' knowledge of the risk of HIV," said co-author Steffanie Strathdee, Ph.D., associate dean for Global Health Sciences at UC San Diego. "Intensified efforts to 'test and treat' should reach out to this high-risk group in ways that are culturally sensitive, recognizing that some men fail to reali