Mexico and Central America.

Abstract

This article covers migrants from Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua and Panama. While their main destination is the US, Mexico is also a destination for Central Americans and a transit place on their way to the US.Central America’s migrant population comprises mainly illiterate and unqualified men, rural in origin and of economically active age. Many are heads of families and significant numbers are from marginal groups, including indigenous peoples. Mexican migrants are similar in age, but most come from urban zones. Whether Central American or Mexican, the majority are undocumented. Many return home after having lived in the US for a time.The little data that are available on HIV/AIDS in the region relate more to Mexico than to Central America. Honduras is the most affected country in Central America, with more than a half all reported cases. Currently, rural cases make a small but rapidly growing percentage of the total in both Mexico and Central America, an indicator of the growing impact of migra‐tion on epidemiological trends.Available data on HIV/AIDS in the migrant populations of Central America mostly concern migrants in their places of destination (i.e., Mexico and the US). In contrast, a number of research projects on migratory conditions in Mexico shed some light on HIV diffusion, particularly research on Mexican migration towards the US. Among current AIDS cases in Mexico, 10 per cent have a history of residence in the US. This group is clearly differentiated from the rest of People Living With HIV/AIDS’s (PLWHA) recorded in the country, with a demographic profile similar to that of temporary migrants.Studies assessing risk behaviours and levels of knowledge of HIV/AIDS among migrants to the US show a descending gradient: almost everyone has heard of condoms, few know about its preventive possibilities, fewer still have appropriate information about its correct use, only a minority use it, and even fewer do so correctly. Widespread risk and vulnerability factors among migrants include highly stressful living environments, high rates of alcohol use and sexual intercourse, and sex with sex workers and/or multiple sexual partners.Migration in Mexico and Central America is profoundly related to economic and political conditions. Police and restrictive measures in the US have resulted in high levels of undocumented migration which has had significant and broadly documented consequences for the spread of HIV, while restricting migrants’ use of services.Two priorities are suggested. First, more research on Central American migrant flows to Mexico and the US. Second, reducing illegal migration will require intense political and technical work to convince decision makers of the risks that restrictive measures generate for the public health.