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Prostitutes in Tijuana Forced to Pay More for Testing

Health authorities in Tijuana now charge more for the medical tests required for sex workers. The price increase may keep many away from the doctor.
 
 
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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.

Gathered in a small room they rent not far from the red light district, representatives of the Mary Magdalene Vanguard Organization of Free Women, which represents 80 sex workers, expressed their disagreement over the sharp increase in the cost of health cards.

Most of the "Magdalenas," as they are known, are from the Southern Mexican states of Tlaxcala, Puebla, Guerrero, Hidalgo and Veracruz, where economic misery forced them to migrate to northern Mexico.

These women are part of the sector of street prostitution. They congregate around several hotels in the red light district, also known as "La Coahuila."

Maribel Ramirez, who used to work in a maquiladora in her hometown of Puebla, said that all members of the "Magdalenas" have a health card.

However, the 30-year-old said she knows several street sex workers who "have no 'card' because of their economic situation." Most of these women are single mothers like her who work to support their children.

After the price increase was announced, the "Magdalenas" negotiated a deal with DMS Director Dr. Osuna Millan. They demanded additional optometric and gynecological services. And although they came to an agreement signed "under protest," they said the new fee they have to pay still seems unfair.

The "Magdalenas" and the dancers at Hong Kong represent just a fraction of the estimated 9,000 sex workers who work in this border town, according to Steffanie A. Strathdee, a researcher with the University of California at San Diego (UCSD).

The low number of women registered with the Health Department - only 1,700 - is a sign that the program is "a failure," Clark Alfaro believes.

Instead of implementing pragmatic policies that encourage more sex workers to get tested, the new increase has had the opposite effect: "You are pushing people into a sector of prostitution that has no guarantees, and where they could fall into the hands of the mafia and unscrupulous customers," said Alonso Meneses.

"The people who approved these increases are idiots," he said. "In Mexico, policies are made by people who don't have their feet on the ground, or don't understand that a fee hike in a time of crisis could disrupt the entire health control program."

The names of the sex workers interviewed in this article were changed for their protection. This report was conducted through a workshop offered by the Institute of the Americas in La Jolla, Calif.

 
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