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Instituto Nacional de Salud Pública XVII International AIDS Conference Oaxacalifornia: indigenous migration and vulnerability to HIV/AIDS René Leyva-Flores, Frida Quintino, Xochilth Castañeda, George Lemp, Juan Ruiz, Carlos Magis México, D.F 4 de agosto 2008

Background Oaxacalifornia: Mexico-US migration: there are important cultural, social, ethnic, class differences between mobile groups. Zapotecas from Oaxaca: have been migrating to the US (California) for more than 50 years. Oaxacalifornia: Transnational space: 4,000 Kms separate Oaxaca from California There are social and cultural differences and similarities 150,000 Zapotecos live in California Continuous exchange of material and symbolic means.

Objetive Analyze how the Zapotec’s perceive and respond to the HIV/AIDS epidemic in both Oaxaca and California

Methods Qualitative study (2004) 53 in depth interviews: County of Fresno, California (EU) Municipalities of de San Pablo Huixtepec, Ciénega de Zimatlán y Teotitlán, Oaxaca 53 in depth interviews: Male Zapotec migrants (19) Zapotec women: spouses of migrants in Oaxaca(12) Health care providers (12) NGOs representatives (10)

HIV/AIDS among Zapotecs: information and behaviours Men In California: “..There is AIDS” Increase condom use. Return to Oaxaca: “Free of AIDS” Sexual behaviours: “machistas” Migrants do not use condom with their wife Women (Oaxaca) “Husband: is the only sexual partner “fulfil their traditional role as women” Sexual, reproductive health related to partner migration Risk to STIs related to partner return from the US

Health care providers and ethnicity: HIV prevention? Oaxaca Prevention strategies focus on women “Men do not agree to be tested for HIV and do not want to use condoms” Condoms are mainly used for family planning Health care providers do not speak Zapoteco and do not register data regarding ethnicity. California Information on HIV prevention directed to men (in spanish) Mexican consulate provide basic information on HIV/AIDS. Mexican consulate do not registers ethnicity data Binational health week “they return to die of AIDS…” “Access to scientific information”

Zapotec organizations and HIV/AIDS California Frente Indígena Oaxaqueño Binacional (FIOB): Guelaguetza and HIV Ethnic identity Human Rights approach Bilingual Oaxacan Radio: “AIDS is an important problem…the most affected are those men that arrive alone to work in the fields” Oaxaca Casa de la Mujer Rosario Castellanos: Sexual and reproductive health with indigenous women. HIV prevention: Intercultural health perspective Gender approach Focus on men

50 years of migration: ethnic identity, migration, sexuality and AIDS Health care system Differentiated sexual behaviours Ethnic identity “with AIDS” OAXACALIFORNIA Social networks “free of AIDS” Differentiated management of risks Zapotec Organizations MIGRATION Fuente: Leyva R et Al., Oaxacalifornia, 2008