HIV infection among women in labor at Tijuana General Hospital is 14 times higher than previously reported by CONASIDA, the Mexican organization that tracks AIDS cases, according to a University of California-San Diego School of Medicine study. Among 947 pregnant Mexican women in labor tested June-September 2003, the study found a 1.26 percent HIV-infection rate, compared to CONASIDA's estimated HIV-prevalence rate of 0.09 percent.

Dr. Rolando Viani, UCSD assistant professor of pediatrics, presented the findings at the 11th Conference on Retroviruses and Opportunistic Infections in February. The researchers found that the vast majority of women in labor (96.7 percent of those surveyed) were willing to undergo HIV rapid-result testing and counseling. Women in active labor who were found to be HIV- positive were given zidovudine intravenously, and were advised to refrain from breast-feeding. Newborns were tested for HIV within the first week of life, with repeat tests at 4 weeks, 2 months, and 4 months. The newborns were given zidovudine orally for 6 weeks.

"The key to preventing HIV infection in children is the identification and treatment of pregnant women who are HIV positive," said Viani. "Unfortunately, HIV testing during pregnancy is not routinely done at Tijuana General Hospital."

The UCSD study also found that compared to HIV-negative mothers, HIV-positive women were more likely to use IV drugs or other drugs (17 percent vs. 2 percent), have more sex partners (3.8 vs. 2.8), not seek prenatal care (53 percent vs. 23 percent), have a partner who uses IV drugs (25 percent vs. 5 percent), or a partner who uses other drugs (42 percent vs. 14 percent).

The HIV/AIDS problem in Tijuana extends beyond the Mexico-U.S. border, with San Diego being significantly impacted, said Dr. Stephen Spector, chair of the executive committee on the National Pediatric AIDS Clinical Trial Group, chief of the UCSD Division of Pediatric Infectious Disease, and director of UCSD's Mother, Child & Adolescent HIV Program, which oversaw the study. "Our maternal-child HIV clinic at UCSD is about 50 percent Latinas," noted Viani. "Of these women, 95 percent are of Mexican descent. This points to the problem that spills over on both sides of the border," Viani said.

In 2002, California's Department of Health Services released a study among high-risk men who have sex with men in San Diego and Tijuana. The 2-year study showed that 43 percent of Tijuana men reported having unprotected heterosexual intercourse, 25 percent reported sharing needles in the previous 4 months, and 39 percent reported having sexual partners from across the border.

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