8. México

Recen[ Titles in A World View of Social Issues Series

HIV and AIDS

Child Abuse: A Global View Beth M. Schmartz-Kenney, Michelle McCaulg and Midxllc A Epsteia, editan Crime and Crime Control: A Global View Gremí Barak, editar Teen Violence: A Global Vicw Alían M. Hollinan and Randa! IV. Sun: 711 erS, cditors Teonage Pregnancy: A Global View Andrew L. ClICT5 Aida», E. Dalton, and Douglas Ruftb, editan Women's Righrs: A Global Vicw Lino Walter, editar

A GLOBAL VIEW Edited by Karen McElrath

A World View of Social Issues Andrew L. Cherry, Series Aduiser

Greenwood Press Westport, Connecticut • London

CONTENTS Library of Congress Catalogingin-Publication Data HIV and AIDS : a global viese edited by Karen p. cm.—(A world view of social issues, ISSN 1526-9442) Indudes bibliographical references and index. ISBN 0-313-31403-9 (alk. papal 1. AIDS (Distase)—Cross-cultural studies. I. MeElrath, Kanm, 1959- 11. Series. RA643.8 .H58 2002 362.1'969792-1:21

2001023886

British Library Cataloguing in Publication Data is arad able.

SERIES FOREWORD Andreu' L. Chem,

Copyright C 2002 by liaren McElrath All rights resemcd. No portion of this hook may be reproduce d, by any procesa or technique. without the exprcss written con sone of the publisher. Library of Congress Catalog Card Number 2001023886 ISBN: 0-313-31403-9 ISSN: 1526-9442

INTRODUCTION 1. AUSTRALIA Susan Goode and Toni Makkai 2.

First published in 2002 Greenwood Press, 88 Post Road AVent. Westport, GT 06881 An imprint of Greeimood Publishing Group, Inc. www.greenwood.com

BRAZAL Karcn Gtffin and Leticia Legal, Vertnelbo

vü

ix 1

17

3 CENTRAL AND EASTERN EUROPE Jean-Pan/ C. Grand

41

4.

CHINA Clvdc 13. McCoy, Douglas Feldman, Lisa R. Maui.), Robert S. Auno'!, Shenghan Lai, asid Xue-ren Wang

69

5.

HAITI Maly Conterford

87

6.

IRELAND Karen McElrath

97

Printed in the United Sta res of America

The paper used in this hook complies sylth the Permanent Paper Standard issued he the Nacional Information Standards Organization , 7,39.48-19841. 10 9 8 7 6 5 4 3 3 1 Leen- reasonabla effort has buen madi: ti troce the owners oí right niatcrials in Mis book, but in some insunces this has primen imputad-4R 'l'he editor and publisher Will be alad to receive information leading era more complete acknowledgments ubsequent printings of the hook and in the mean time- extend their a pail =r" c.

1/40

o

o N

re-

'cl-

2

N Vi

o. o ro 00 N I-- 0, O CO ó VI t.-1 -N

7.

Homosexuals and

History of HIV/AIDS

c

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En" -=o Tiw ó :., ":° -ó 3 c ■ ._ :) o. o -1°

03 :2 > a. - Fr t

140

Hn. AND .AIDS: A GLOBAL VIEW

Map 8.1 Distribution of AIDS in Mexico, Cumulativo Incidente Ratea, 1983-1999

141

MEXICO Figure 8.1 Trends in AIDS Mortality Proportionally Worncn/Men, by Place of Residence, 1988-1997 35

Interval Rates 30 • 12 n 20

25 -

a

20.

—*— Rural

40

—a— Urban

129 rv

15• ID • 5

o 88

89

90

91

92

93

94

95

96

97

Years Sobrio Si:acracia de Salud 1998. Rato per 100,000 inhabitants.

Source: CONASIDA 2000.

in there thrce states in the period benveen 1983 and 1999 (see Map 8.1) oven though only 28% of the total popu lation lives diere; it is important to note that the main cirios in Islexico are in diese three stares. With respect ro the regional distribution, until 1994 only 3.7% of the cases \s'ere regisrercd as residente of rural arcas (arcas with less than 2,500 inhabitants); the majority of cases "ere concentrated in the major cides in Mexico and in the northern border with the United Surtes, with a higher percentage of cases among men. In the sout he rn part of the country, which is largcly rural, the epidemic has a higher proportion of cases among \minen (21%) than in urban arcas 114%). In 201116 states in Mexico, up to 25% of the cases in rural arcas involve prior temporary immigration ( Magis, del Río, and Valdespino 1995). In IsIexico, 80% of the AIDS cases registered in the beginning of the ydar 2000 are among persons betwcen 15 and 4-4 years old, persons undcr 15 sears old represent less rizan 2% of the total cases. Locking at risk facrors, 80% of the cases result from sexual transinission, 18% list the method of transmission as unknown, and perinatal and blood transmissions account for 2.5% of the cases (CONAS1DA 2000). Gradually, AIDS has become one orthe major healdi problcms in Mexico. In 1997, Islcxieo seas thirtecnth in the world in total number of AIDS cases

and third in the conti nent; however, when using the cumulative incidente rato Mexico occupics the sixtrointh place in the world and rwentyminth place in Lado America and the Caribbean. Mexico is considered among the countries with a ven' lote incidente rate (Magis et al. 19981. It is estimated that since 1996 the AIDS epidemic in Mexico has stabilized, vith an average of 4,000 new cases oven' year. Mortality due to AIDS in Mexico Undl 1992, AIDS was not reponed among the most frequenr causes of death in Mexico; however, it has increasingly occupied an important place among certain age groups and by scx (Izazola et al. 1995). Figure 8.1 indicates the mortality raes for A1DS proportionally for men and 'comen according to their place of residente (rural and urban arcas). This figure shows that the proportion of women who die from AIOS issmallcr in urban arcas than in rural arcas. On average, in urban arcas 14.5 women dicd from AIDS for oven' 100 men, and In rural arcas, 20 women dicd for cvery 100 men during the period analvzed. Neverthcless, tic distribution of dcaths due ro AJOS according ro place of residente 311d scx has not ehanged for the period under ineestigation ("rabie 8.2). In rural arcas (localitics with less than 2,500 inhabitants), women who die from Al OS represent approxi. =tele 1%, whercas men in urban arcas (localities with greater than 15,000

142

HIV AND AIDS: A GLOBAL VIE1V

Table 8.2 AIDS Mortality in Mexico, by Sex and Place of Residence, 1988-1997 Year

Urban

Rural

Figure 8.2 Percentage Distribution of AIDS Mortaliry in Mexico, by Age Group, 1988-1997

TOTAL

100%

Men (%)

Women (%)

Men (%)

Women (%)

1988

71.9

11.9

6.2

1.1

562

1989

69.0

10.9

4.0

1.3

1,093

1990

68.3

12.3

5.7

1.5

1.500

1991

68.7

11.7

5.3

1.3

2,017

1992

86.5

13.5

5.5

0.9

2,118

1993

73.2

11.6

5. 1

0.7

3,162

o 35-44 ■ 20-34

(n)

1994

71.8

9.8

5.4

1.2

3.514

1995

74.1

9.3

5.8

0.9

4,029

1996

71.0

9.5

6.0

1.5

4,369

1997

69.4

9.8

6.8

1.3

4,200

80%

Age Group • 65 >

60%

O 45-64

40%

❑ 1-19

20%

'Urban: Included ateas with more [han 15,000 inhabitants. 'Rural, Included arcas with leas rhan 2,900 inhabitants.

0%

Source: Secretaria de Salud 1998. Source. Sea [aria de Salud 998.

inhabitants) represent 65% of the total deaths due to AIDS in the period studied. Looking at age as a factor, deaths due to AIDS predominare in persons in the age groups 20-34 and 35-44, which togethcr represent 80% of the deaths due co AIDS in Mexico (set Figure 8.2). During the period 19881997, schen looking at sea and marital status as factors in deaths due to AIDS, the resulta show that mos[ of the men who die from AIDS are single. Married women exhiba the highest mortality cates, though chis tendeney is declining; at che same time, among widowed ■vonien the percentage of deaths due to AIDS is increasing (scc Figure 8.3).

Figure 8.3 Trends in AIDS Mortalirv Lates in Mexico, by Marital Status, 1988-1997 80

70

60 -

The Social Context for AIDS in Mexico Since ira appcarance in Mcxico, various rescarchcrs hace warned about the social nature of the epidemic. It was obvious from the ver), begi nning that chis disease mas mobilizing processes of discriminati