My American Dream

Diagnosis: HIV positive. This is always a hard situation to deal with. Imagine now if you were to deal with it in a different country, with different laws and a different culture. My experience is not different from the hundreds of immigrants from Mexico and South America that come looking for the American dream. The question is whether to stay and try to make the best of it or to come back to die with loved ones. Ten years ago, the idea of dying rapidly from HIV/AIDS was more probable than today, but still applies. The prospect of going back sick and dying is not a nice one, especially when it includes disclosure and rejection in most cases.

Having HIV requires new skills to learn, not only to start trusting the medical system (something that is not done in my culture) but also learning medical terminology in English. Although the American HIV community is very supportive, US immigration laws are not friendly to HIV-positive people: we are not welcome here. However, compassion is plentiful, and illegal immigrants always seem to find the care and support they need. The estimated numbers of immigrants with HIV/AIDS are not always accurate, many move around or use fake names. We know there are more infected people than reported. Some wait to seek care until they are very sick, and that is why immigrants have higher numbers of AIDS diagnoses in emergency rooms.

Many HIV-positive immigrants risk their health every year by going back to their countries to visit their families. This usually results in missed doses of medications and a lack of primary care and social services. However, the HIV/AIDS services in our countries seem to be increasing, and there was a rumor 2 years ago of "universal access" for HIV-positive people in Mexico. People were planning to return to Mexico in groups: finally, we get to go back and be healthy. Rumor had it that free medications were being given out everywhere.

Information presented at the North American AIDS Treatment Action Forum (NATAF) in Mexico (November 27-30, 2005) indicates that only 17 antiretroviral drugs are approved in Mexico. Not all of them are provided by the government, and most medications for opportunistic infections and HIV-related diseases are not included. Social services and case management are non-existent, and patients seem to be grateful just to get their much-needed meds. The eligibility process is long and very detailed.

When I asked a group of Mexicans what I should report back to the HIV-positive Mexican Nationals in the US, they said, "Don't come; stay in the US if you have services." In the last 10 years, there have been many changes. While we have HIV medication in several countries such as Mexico, the prevention programs that were supposed to start 10 years ago are late, and the numbers of people infected are increasing, particularly among women. The perinatal transmission that is almost nonexistent in the US is still happening in our countries. Our families are crying for the many AIDS deaths now, much like was done in the US 10 years ago. It is my hope that we won't wait 10 years to create support and advocacy networks to change the system.

I am an HIV-positive, Mexican, gay male receiving treatment and services in the US: I guess I am living my American dream.

Bernie Vázquez is Education and Outreach Manager for The Center for AIDS Information & Advocacy.