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The XVII International AIDS Conference (AIDS 2008)
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Newsmaker Interviews: Ceci Connolly

August 1, 2008

Jacki Judd: Ceci Connolly of the Washington Post. Welcome.

Ceci Connolly: Thank you for having me.

Jacki Judd: Thanks for joining us. You spent a month reporting on AIDS, principally in Mexico, and of course in the United States among Latinos. As you have mentioned part of it was done by way of a Kaiser Family Foundation Fellowship. What did you set out to find?

Ceci Connolly: We had several questions going into this project. I don't know that we answered them all, but we very much wanted to shine some light on what's happening in Mexico because it is in fact hosting this International Conference. It is the first time it is in Latin America. It happens to be the United States' neighbor and yet, there's not a lot known about HIV/AIDS in Mexico, especially among people in the United States. That of course led to many questions about migrant populations, border communities and that also tied in quite naturally with the HIV epidemic in the Latino population in the United States.

Jacki Judd: The piece that ran most recently was focused on Tijuana, the border community of Tijuana. What did you find there about the epidemic?

Ceci Connolly: Well, that is where I got to see first hand what academics had been saying to me about borders and about migrant populations and the way in which you have many factors combining in one fairly small contained area to really increase the risk there. In the case of Tijuana, you have 1.5 million people that we know about; many, many more truly spending time there. Many people do not live in one country. They live in both countries really. They may go to school in the United States and go to church in Tijuana. They may have a job on one side of the border, but have a house on the other side of the border and what you discover are, with this very transient populations, quite often poor, quite often individuals who are being deported, you see that that leads to more high risk behavior. It can lead to more drug use. It can lead to spending time with prostitutes and unprotected sex and all of these vulnerabilities really kind of add up to an epidemic in Tijuana that is three times higher than the rest of Mexico.

Jacki Judd: And the principal means of transmission is the drug use, unprotected sex? [Interposing]

Ceci Connolly: [Interposing] And prostitution. Yes, absolutely. And again, that was something that was intriguing from a reporting point of view because it is very different from the rest of Mexico. In Mexico as a whole, the primary means of transmission is men who have sex with men and that is an interesting subject for the third story in this project that has to do with stigma and homophobia and elements that are driving the epidemic and the rest of Mexico, but in Tijuana, much as you see in Ciudad Juarez, another border city, is very much injection drug use and prostitution that are transmitting the illness.

Jacki Judd: And in Tijuana, you found Angel, who seems almost single-handedly wanting to protect people, what was he doing?

Ceci Connolly: He is an incredible story and we we're blessed to spend so much time with him. This is a person who did just about every horrible thing you can imagine for about 22 years of his life. Every drug imaginable, prostituting himself, even stealing from a family who took him in off of the street and yet, he has now been clean for eight years and is really dedicated in Tijuana to spreading what is known as harm reduction and it essentially is giving out condoms and clean needles to almost anyone that he can find in that city and trying to convince them that if in fact you are going to do some of these things, at least please take some protective steps to ensure that we are not spreading HIV.

Jacki Judd: In the time that you spent with him, how many times did people walk away from him and how many times were people receptive?

Ceci Connolly: Oh, people are incredibly receptive to him. It is amazing. I mean I think part of it is so many people there now know him and trust him and it struck me one of the things that he said over and over again in conversations, in filthy alleyways and in these damp, pitch black tunnels from the canal, he would keep saying in Spanish to them, "Somos iguales," which is "We are the same." And he would say, "I am an addict just like you. I've been there." And that seemed to have a real impact, but I can tell you that [laughter] when they would see him pull up, especially with the condoms, with the clean needles as well, they went right for him.

Jacki Judd: Tell me for a moment or two about the impact on the other side of the border, on the US side. You interviewed a researcher who described it as the uninvited hitchhiker.

Ceci Connolly: Absolutely. And to be clear, she was really pointing out that it is an uninvited hitchhiker going both ways across that bridge very much so. And I encountered that some people in the United States may kind of jump to the conclusion that, well, foreigners are bringing HIV into our country. There is not hard data on this, but there is certainly anecdotal evidence to suggest that a fair number of migrants actually are becoming infected in the United States returning to home countries, but the important point here that the researchers and activists are pointing out is that while we may think of a border as having a wall and security guards and armed men, diseases don't pay attention to those borders. Those diseases are as Stephanie [inaudible] put it, they're just hitchhiking back and forth across those borders.

Jacki Judd: And what is her role in this? She's doing some research on the harm reduction aspect.

Ceci Connolly: Yes, that is right. She is a researcher at the University of California in San Diego. She and a large team have been doing a number of studies along the border, trying to examine transmission patterns. Her newest research that is come out just in time for this conference shows that there appears to be a spike in HIV incidents when deportation also goes up. And that is an intriguing notion when you think about the very lively debate going on in the United States right now around immigration and enforcement policies. The reason that she thinks there is that increase is that when an individual is deported, they are suddenly usually left without a home, without a job, without any kind of a support network, family, friends, et cetera, and that vulnerability appears to lead to more of the risky behaviors.

Jacki Judd: The story that you did before the piece on Tijuana was about Latinos more generally in the United States. What was the headline there? What did you find?

Ceci Connolly: Well, I suppose the headline came out of the Centers for Disease Control and Prevention which has new analysis suggesting that 22-percent of the new HIV/AIDS cases in the US are within the Latino population.

Jacki Judd: So, it is a community increasingly at risk [interposing].

Ceci Connolly: At risk, very much so. And it is at the time when it is a community that is also growing and so, for both of those reasons people in the public health field are saying we need to pay more attention to this community and how we can reach them. At the moment, there are not many programs specifically targeted to the Hispanic community and that is something people are starting to give some real thought to.

Jacki Judd: Okay. Final question, let us bring the interview back down to where we are talking which is Mexico City. Is there an expectation among officials here that the simple act of having the AIDS Conference in Mexico will have a real impact on the AIDS epidemic, not only in this country, but elsewhere in Latin America?

Ceci Connolly: Well, there is certainly an expectation that it is going to get a good bit more attention than it has in this region and probably ever.

Jacki Judd: A region that feels very much overlooked.

Ceci Connolly: A region that feels very much overlooked and as you are certainly well aware, has the highest incidence rates. Latin America and the Caribbean has the highest incidence rates after Africa.

Jacki Judd: The Caribbean.

Ceci Connolly: Exactly. But it is something that is not fully appreciated and so I think that the simple fact of shining a spotlight here on Latin America is a very important step in that direction. At the same time though, I think what you see here especially when you consider countries where the Catholic Church is in fact still so influential, where it is fairly conservative, where you do have very high stigma around homosexuality, it is still a high bar to clear to get people to really bring this out into the open.

Jacki Judd: Okay. Thanks so much, Ceci Connolly.

Ceci Connolly: My pleasure.

Jacki Judd: Great.

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