San Diego-Tijuana Region

According to monthly HIV surveillance reports for 2003 by the California Office of AIDS, S an Diego County ranks second for the highest number of HIV cases in all the counties of the state of California . San Diego is an area of high drug consumption, which increases the risk of transmission, mostly due to the practice of sharing needles. While the typical profile of a person living with AIDS in San Diego is a white male between the ages of 30-49, Hispanics are the second leading group. Of the 11,529 AIDS cases reported in San Diego County as of October 2003, 21% were Hispanic, and 87 % of these were of Mexican origin.

Tijuana is ranked first place for the number of reported HIV cases in the state of Baja California and second in the whole of Mexico . Between 1995 and 2004, 1,209 AIDS cases were reported in Baja California : 59 percent in Tijuana , where the infrastructure for HIV/AIDS prevention and treatment services is very limited. There's a shortage of health services available to the affected population and preventive programs are scarce. The newest generations of youth have not been sufficiently informed on HIV/AIDS prevention

The Imperial-Mexicali-Valley

Imperial county registers low rate of HIV cases (. 038%, according to data reported by the Ca State Office of AIDS) , but it is still considered a high risk zone due to its proximity with the counties of San Diego and Riverside, which register some of the highest HIV rates in California. On the other hand, its shared border with Mexicali and the frequent transfer of field workers allows HIV to disseminate with relative ease.

The population of Mexicali relies on two programs that offer services to persons living with HIV/AIDS. One of these programs is privately operated and charges for HIV/AIDS exams and counseling. The other is a small program of the Universidad Autónoma de Baja California and has limited resources for its clientele. The variety of medicines needed by HIV/AIDS patients is not always available in Mexicali and already there are cases of patients that have become resistant to certain medicines because of this. Lack of these medicines leads some people from Mexicali to migrate to the United States to receive the adequate treatment.

BHI Interventions
The BHI provides support and technical assistance to the binational HIV committee s in the region that serve as a forum for networking and collaboration, and conduct outreach and awareness activities. The San Diego/Tijuana committee is well-established, while the Imperial/Mexicali coalition is relatively new, and BHI support was important to becoming a viable group.

The BHI also provides additional capacity building opportunities for organizations that work in HIV/AIDS through workshops, conferences and training to groups such as Christies Place in San Diego, BICEPS in Brawley, and Programa Amigo in Mexicali.

The San Diego/Tijuana Binational HIV/STD Committee organizes tours of HIV/AIDS service providers in the San Diego/Tijuana area which provide an opportunity for representatives from public agencies, businesses and community-based organizations to get a picture of the current HIV/AIDS situation.

The BHI staff has collaborated with the binational committees and other organizations to plan the following activities:

1. Annual Binational HIV/STI conference, “The Border that Unites Us”. The conference aims to update knowledge and increase awareness of HIV, AIDS, and STIs among health providers and community members in the area San Diego-Tijuana. It also promotes collaboration and the exchange of abilities and information across the border.
2. . The BHI provided a sub grant to International Health Programs (IHP) for technical assistance to NGOs that conduct HIV/AIDS prevention activities for street youth.
3. A conference entitled "Creating a Pathway for Our Future Along the Border" was held in Imperial County in December 1999. This conference presented health care providers in the El Centro/Mexicali area with the most recent developments in early detection of HIV and medical treatment protocol.
4. An advocacy campaign, based on a study carried out by the BHI to identify barriers that impede binational collaboration with local HIV/AIDS and TB organizations. The BHI and the San Diego-Tijuana Binational HIV Committee developed an educational video titled " HIV/AIDS and TB Do Not Have Borders ", which presents information on the state of the HIV/AIDS and TB in the border region, and emphasizes the changes needed to improve their prevention and control. In addition to the video, the BHI and its partners implemented a massive media campaign which included printed announcements and messages on radio and television in the counties of San Diego and Imperial and the cities of Tijuana and Mexicali .
5. MSM (Men who have Sex with Men) Project , at the Mexicali office of BHI, in collaboration with the California Department of Health Services and the local Health Departments in Imperial and Mexicali . The MSM project is a study that seeks to measure HIV prevalence among young Latin American MSM (men that have sex with other men) in the county of Imperial ( California ) and Mexicali ( Mexico ) and also to measure high risk behaviors and attitudes regarding sex amongst MSM.
6. During World AIDS Day (Dec 1 st . each year), the BHI collaborates with the San Diego Tijuana Binational HIV/STI Committee in the development of activities to create awareness in the San Diego-Tijuana border region. In 2004, along with bi-national committee members the BHI lead a World AIDS Day event at the Tijuana/San Ysidro International Port of Entry to increase awareness of the HIV pandemic in the border region. Over 5000 flyers were distributed to drivers and pedestrian crossers. And more than 20,000 individuals were reached with media campaign messages.
7. In March, 2005 the BHI organized and facilitated a Capacity Building workshop tailored specifically for the San Diego Tijuana Binational HIV/STI Committee . Using the I-STAR ( Integrated System for Transformation, Appreciation and Results ) process , the members identified the most relevant capacity building areas and indicators within a context of quality and sustainability appropriate for the committee. UCSD Mother, Child, and Adolescent HIV Program, Drug Free Border Coalition , Planned Parenthood, CASA, and the BHI from San Diego, and ALVIDA, AFABI, and PROSALUD from Tijuana were part of this event The benefit to participants was twofold; on one hand, the committee will improve its operation and on the other, each individual will take the learning experience for the benefit of their organization.
8. At the 2004 HIV Binational Conference, the BHI invited Prosperitas Consulting to present the San Diego-Tijuana Binational HIV/STI Committee Logic Map . The logic map is an efficient and powerful tool useful in understanding the depth of the committee's collective impact in the region. Each participating organization in the binational committee has the potential to be featured in the map and help develop the map by inputting information about their work. The logic map has the capacity to improve the binational HIV/ STI committee's internal and external collaboration and communication.

For more information contact Rosalinda Cano-Hays
( rcano-hays@projectconcern.org ) at (619) 791-2614 (San Diego) or Dr. Enrique Gomez ( enriquegomez@uabc.mx , egomez@projectconcern.org ) at (011-52-686) 582-3110 ( Mexicali ).