San Francisco Chronicle - Sunday, March 17, 2002
David Perlman, Chronicle Science Editor

New field surveys of Latino men in Tijuana and San Diego show that rates of infection from HIV, the AIDS virus, are as much as four times higher there than they are in other California cities, according to George F. Lemp, director of the University of California's systemwide AIDS Research Program.

"Those numbers are alarming and shocking, and they come as a real surprise, " Lemp said. "While the AIDS epidemic exists so far only in pockets in Mexico, there's a danger that it will explode, so we need to look closely at the behaviors and the centers of infection in both border regions."

Spurred by the survey results, he said, health officials in both countries have speeded an unprecedented joint assault on the problem.

Lemp and a delegation of state experts on the epidemic have just returned from Mexico City, where they met with Mexican health officials to plan collaborative efforts to pin down the nature and causes of the rise in cross- border infection rates and to increase prevention and treatment services in communities on both sides of the border.

HIGH INFECTION RATES IN SAN DIEGO

More than 35 percent of young gay and bisexual Latino men are infected with HIV in San Diego, while in Tijuana the infection rate is nearly 19 percent, according to Dr. Juan D. Ruiz of the California Health Department's AIDS office, who disclosed the numbers at a recent meeting of UC AIDS researchers in Sacramento.

Previous studies have found infection rates of about 8 to 9 percent among comparable populations in cities such as San Francisco, Sacramento, Long Beach and Riverside, Lemp said in an interview. In Los Angeles County, however, the rate runs about 16 percent.

The study involved nearly 400 men, all volunteers recruited in San Diego gay bars and dance clubs, and in a Tijuana public park known as a cruising spot and center for prostitution. The researchers were members of the Bi- National AIDS Advocacy Project, known as PROCABI in Spanish, which has offices in both border cities.

Detailed results from the new survey were released last week, showing that in Tijuana only 56 percent of the men had ever received any information on preventing HIV infection, compared with 77 percent in San Diego. In Tijuana, 46 percent of the young men had been tested for HIV, vs. 63 percent in San Diego.

Tijuana men were more likely to report that they had engaged in "risky" sex with women and also to have engaged in "risky" drug use -- unprotected sex, in other words, while high on drugs.

In San Diego, however, the men in the survey were more likely to engage in "risky" sex only with other men. Men in both cities reported that their sex with both men and women often occurred on opposite sides of the border, the survey showed.

CROSS-BORDER HIV PLAN

Gov. Gray Davis and Mexico's President Vicente Fox discussed cross-border AIDS problems during visits last year and earlier, and a year ago Lemp and his colleagues began planning joint efforts with Mexican health officials.

The new upsurge in HIV infection rates among Latino men on both sides of the California border spurred the latest visit to Mexico City by Lemp and his colleagues, he said.

The two groups of AIDS experts decided to select two cities in Mexico noted for sending large numbers of men to work in California farm fields and cities, and to pick two California counties heavily populated by Mexican migrants, Lemp said.

In all four locations, AIDS researchers will conduct urgent and detailed surveys of the prevalence of risky sexual behaviors, rates of HIV infection as well as other sexually transmitted diseases, and trends in the emergence of AIDS itself and the availability of prevention and treatment services. The epidemiological study and the effort to increase services for the migrants will take at least five years of effort, Lemp said.

"The problem is particularly difficult," Lemp said, "because so many of these young men are arriving in a new culture and among people they don't know, and even if they're not gay, they have left girlfriends or wives back in Mexico and may turn to risky sex with other men -- or to women sex workers -- just because they have no one else to turn to."

E-mail David Perlman at dperlman@sfchronicle.com.
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