Prostitutes in Tijuana Forced to Pay More for Testing

Editor's Note: The price of health cards required for sex workers in Tijuana has increased in what observers say is a "scandalous" and "immoral" setback in the fight against HIV.

TIJUANA, Mexico -- Like thousands of women, Veronica Lizarraga, 18, migrated from the interior of Mexico to Tijuana, where she joined the ranks of the city's prostitutes. She picks up customers as an erotic dancer at Hong Kong, one of the more sophisticated strip clubs in the border town's red light district. Her average weekly earnings: $2,000.

With modern architecture and neon lights, this business employs more than 300 dancers. Most of its customers are foreigners, men from southern California looking for fun and sex that's cheaper than in their country.

In order to work at Hong Kong, Veronica and her colleagues are required to have a health ID card that the local government issues to sex workers. Each month they undergo a series of medical tests for sexually transmitted infections and every four months, for Human Immunodeficiency Virus (HIV). If all goes well, the city's Department of Health Control renews their cards.

"Without it (the health card) you can't work here," said Veronica, originally from Mazatlan, Sinaloa.

Earlier this year, health authorities in Tijuana announced a price increase in the medical tests required for sex workers. The annual fee rose from $300 to $500.

This news doesn't worry high-income sex workers like Veronica. But the price increase has had a much greater impact on street sex workers who earn much less, according to Victor Clark Alfaro, director of Tijuana's Binational Human Rights Center.

Clark Alfaro called the price increase "immoral and scandalous." One of its serious consequences, he said, is that "many [sex workers] are going to choose not to go to the doctor."

Health advocates believe that the move is a setback in the fight against the spread of sexually transmitted diseases, particularly HIV and the epidemic of Acquired Immunodeficiency Syndrome (AIDS) that has reached alarming numbers in Tijuana.

It is estimated that one in 125 people between the ages of 15 and 49 is living with HIV in this border town, according to a study by Kimberly C. Brouwer from the University of California in San Diego (USCD).

Guillermo Alonso Meneses, director of the cultural studies department at Tijuana's Colegio de la Frontera Norte (Northern Border School) called Tijuana a "hotbed for a very serious potential public health crisis."

He insisted that these medical tests should be free. "Charging such a vulnerable population for this kind of test is another example of the injustice of the Mexican state," he said, "which already taxes the rich so that it can invest in this kind of thing, not only because of the threat of AIDS but also of other diseases."

The price increase is also worrisome because it coincides with an economic crisis: According to Clark Alfaro, sex workers here have seen a 70 percent decrease in customers.

Earlier this year, before Tijuana increased the price of medical tests for sex workers, the Directorate of Municipal Health (DMS) reported that Tijuana had 1,700 registered sex workers. This number is expected to decrease as a result of the fee hike.

ProstitutesThe fee hike for medical tests required for sex workers has had the greatest effect on those who work in the street. The real figure is a mystery. Ana Cristina Nisifore, of DMS's Department of Health Control, said that the current number of registered sex workers in the city is "confidential." Several employees of the DMS indicated that the only person authorized to discuss the topic of sex workers was the director of the unit, Dr. Miguel Antonio Osuna Millan. However, he did not respond to multiple requests for an interview made by this newspaper.