| In 1990, 30 years after Edward
R. Murrow’s “Harvest of Shame,” Frontline correspondent David Marash looked at the continuing plight of migrant
farm workers and explored the forces that
keep their lives so desperate. He did this
in a documentary titled “Old Harvest, New
Shame” aired by CBS’ 60 Minutes. Fifteen
years later not much has changed. The
reality revealed in the titles of books and
documentaries is often shocking: “Dark
Harvest, With these Hands… Invisible
Neighbors, Voices from the Fields, Harvest
of Hope.” Factors such as poverty,
malnutrition, infectious and parasitic
diseases, poor education, and poor
housing reflect Third World conditions in
the world’s wealthiest nation.
HIV/AIDS disproportionately impacts
migrants and their communities compared
to others. Language and cultural barriers,
combined with a low perception of risk
lead to a population highly vulnerable to
HIV/AIDS. A disproportionately high
number of individuals with HIV/AIDS are
black or Hispanic. Recent Center for
Disease Control surveillance data indicate
that AIDS is spreading at much higher
rates among blacks and Hispanics than
among whites. Hispanics, who represent
the majority of migrant workers, are
disproportionately affected by HIV/AIDS
as they represent 13 percent of the
population and 19 percent of new cases,
which are increasing at three times that of
whites. HIV is on the verge of significantly
increasing in Mexican migrant workers
who comprise the majority of migrant
workers in South Florida (Kaiser 2004).
Estimated HIV rates range from a low in
California of two percent (Lopez & Ruiz,
1995) to a high of 13 percent among
Florida drug users (Weatherby et al.,
1999), underscoring the need to address
the risks in this population.
Migration and mobility increase HIV
incidence and vulnerability in a variety of
contexts and places. These
vulnerabilities are especially evident in a
large and growing population of an
estimated 125 million people living and
often working outside of their country of
citizenship, while between two and four
million migrate permanently each year.
First, migrant populations have a greater
risk for poor health in general and HIV
infection in particular due to many
circumstances, including their economic
transitions, decreased accessibility of
health services, and the complication of
the host country health systems to
address the needs of migrants. Second,
the uniqueness of migrants often fosters
racial or cultural intolerance and hostility
by the host community. Intolerance is
likely exacerbated for HIV-positive
migrants, resulting in stigmatization and
discrimination. As a consequence,
migrants may tend to hide their HIV
status as long as possible, thus making
health care and support services
unavailable for them. Third, even if health
care providers were prepared to assist
migrant populations, they would likely
encounter great difficulties in reaching
out to them. Many migrants live in ‘A personal, historical perspective’ constant fear of deportation, having no
stay or work permit. Therefore, any
contact with official government
agencies increases fear and suspicion.
Compared to migrant-worker populations
in other areas of the United States,
workers in the southeastern United
States are more likely to live away from
their families while doing farm work (64
percent) and travel in small groups of
men (Roka and Cook, 1998; Larson,
2000; Gadon et al., 2001). Alcohol and
other drugs are used to cope with the
isolation from family members and
mainstream society (Chi and McClain,
1992; Hovey, 2001; Watson et al., 1985;
Watson, 1997; Aldarete et al., 2000; Kail
et al., 2000). Other stressors, such as
acculturation and employment frustration
(Alderete et al., 2000), also increase the
risks for alcohol and drug use. Alcohol
use is more common among male
migrant workers (Watson et al., 1985; Chi
and McClain, 1992; Finch, et al., 2003),
which follows the national pattern of
Hispanic alcohol use (Treno et al., 1999).
Clearly, the plight of the migrant farm
worker population and their risks for
HIV/AIDS is convincing.
HIV/AIDS prevention research
among migrant farm workers is limited.
Our research in Immokalee, FL indicates
that when migrant farm workers
participate in an intervention targeted to
their culture, they were likely to increase
their knowledge of HIV/AIDS and adopt
risk-reducing behaviors, such as using
condoms more often when having sex.
In a community whose name means “My Home” in the Seminole language,
the influx of migrant farm workers almost
double the population during September
to June each year.
REFERENCES
Alderete, E., Vega, W.A., Kolody, B., and Aguilar-
Gaxiola. (2000). Lifetime prevalence of and risk
factors for psychiatric disorders among Mexican
farmworkers in California. American Journal of
Public Health. 90(4), 608-614.
Chi, P.S., and McClain, J. (1992). Drinking, farm,
and camp life: A study of drinking behavior in
migrant camps in New York state. The Journal of
Rural Health. 8(1), 41-51.
Gadon, M., Chierici R.M., and Rios, P. (2001).
Afro-American migrant farmworkers: a culture in
isolation. AIDS Care 13(6):789-801.
Finch, B.K., Catalano, R.C., Novaco, R.W., and
Vega,W. (2003). Employment frustration and
alcohol abuse/dependence among labor
migrants in California. Journal of Immigrant
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Hovey, J.D. (2001). Mental health and substance
abuse. National Center for Farmworker Health,
Inc., Migrant Health Issues, Monograph Series.
19-26.
Kail, B. Zayas, L.H., and Malgady, R.G. (2000).
Depression, acculturation, and motivations for
alcohol use among young Colombian, Dominican,
and Puerto Rican men. Hispanic Journal of
Behavioral Sciences. 22(1), 64-77.
Kaiser Network (2004). HIV Prevalence Among
Mexican Migrant Workers Three Times as High
as General U.S., Mexican Populations, Studies
Show. Accessed on 3/16/05 from the World Wide
Web. http://www.kaisernetwork.org/daily_reports
/rep_index.cfm?hint=1&DR_ID=26521
Larson, Alice C. (2000). Migrant and Seasonal
Farmworkers Enumeration Profiles Study, Florida
report, prepared for the Office of Migrant Health,
Bureau of Primary Health Care, U.S. Department
of Health and Human Services, Bethesda, MD.
Larson, Alice C. (2000). Migrant and Seasonal
Farmworkers Enumeration Profiles Study, Florida
report, prepared for the Office of Migrant Health,
Bureau of Primary Health Care, U.S. Department
of Health and Human Services, Bethesda, MD.
Lopez, R., and Ruiz, J.D. (1995). Seroprevalence
of human immunodeficiency virus type I and
syphilis and assessment of risk behaviors
among migrant and seasonal farmworkers in
Northern California. Manuscript prepared for
Office of AIDS. California Department of Health
Services.
Roka, F., and Cook, D. (1998). Farmworkers in
Southwest Florida Final Report. Immokalee,
Florida: Southwest Florida Research and
Education Center, University of Florida.
Treno, A.J., Alaniz, M.L., and Gruenewald, P.
(1999). Drinking among U.S. Hispanics: A
multivariate analysis of alcohol consumption patterns. Hispanic Journal of Behavioral Sciences. 21(4), 405-419
Weatherby, N.L., McCoy, H.V., Metsch, L.R.,
Bletzer, K.V., McCoy, C.B., and DeLaRosa, M.R.
(1999). Crack cocaine use in rural migrant
populations: Living arrangements and social
support. Substance Use and Misuse, 34(4&5),
685-706.
Watson, J., Mattera, G., Morales, R., Kunitz, S.J.,
and Lynch R. (1985). Alcohol use among migrant
laborers in western New York. Journal of Studies
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Watson, James M. (1997)Alcohol and Drug Use
by Migrant Workers: Past Research and Future
Priorities. NIDA Monograph 168, (pp.443-558)
Rural Substance Abuse: State of Knowledge
and Issues.
Virginia McCoy, Ph.D., is a professor
of public health in the College of Health
and Urban Affairs at Florida International
University.
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