Dr. John explains the danger of HIV transmission to young teen couple in Tlaquepaque market
Dr. John walks and works in Guadalajara in Jalisco state.
A year ago, Dr. John was set to work with street youth in Mexico City and Belize City (Belize) but had to cancel due to an emergency with his elderly mother (see Barbara). When informed by his travel agent Dorothy that he would lose the entire value of his earlier purchase if not used by early July 2006, Dr. John made an impromptu visit to central Mexico at the end of June. (There was also enough money left over for him to buy a round trip ticket to attend the upcoming International AIDS Conference in Toronto in August where he is presenting his new research on the growing youth..
Dr. John explains the danger of HIV transmission to young teen couple in Tlaquepaque market
Dr. John walks and works in Guadalajara in Jalisco state.
A year ago, Dr. John was set to work with street youth in Mexico City and Belize City (Belize) but had to cancel due to an emergency with his elderly mother (see Barbara). When informed by his travel agent Dorothy that he would lose the entire value of his earlier purchase if not used by early July 2006, Dr. John made an impromptu visit to central Mexico at the end of June. (There was also enough money left over for him to buy a round trip ticket to attend the upcoming International AIDS Conference in Toronto in August where he is presenting his new research on the growing youth pandemic due to globalization).
He changed his mind about going to Mexico City because he wanted to work with TeenAIDS Global Board member Julio Cesar Nakamura Matus who is now working in Guadalajara. The two originally worked together in Oaxaca, Mexico in 2000 when students associated with the city's Casa de Muheres organization volunteered to be outreach workers and translators. Dr. John is very impressed with 29 year-old Julio because he is now become a doctor who has worked among the Zapatec Indians in remote, rural areas. Presently, he is an ER doctor for two hospitals in Guadalajara. Julio is now training to be a surgeon at this moment. His friend, Gabriela Jiminez is also a doctor in Guadalupe (training to specialize in anesthesiology) who was part of the original PeerCorps group in Oaxaca. She is now 27.
Dr. John wrote:
"Julio met me at the hotel when I first arrived. We had a lot of catching up to do.
He is deeply committed to his medical work among the indigent. After dinner, he dropped me off at Plaza del Sol Mall where I talked with youth until rain sent me home. He had to be in the ER by midnight. Later meeting with Gabriela, she thanked me for remembering her when I sent a photo postcard from my travels. She told me that she respected the work I did with teens as a volunteer and said she talks with youth still about AIDS. You can see their photos in this section.
"Two days later, Julio took me to the two hospitals where he worked (one public and one private). Afterwards, he brought me to the 'country' to the artisan town of Tlaquepaque, now a built-up suburb. If you like arts and crafts, this is the place (about 15 miles from Guadalajara). After a brief bout with Montezuma's Revenge, we hit the streets and spoke to many youth and some adults in the town square where a Saint's Day was being celebrated with music and fireworks. Julio remembered well the AIDS Attacks from before in Oaxaca. I would start talking in my Spanish (rudimentary but sufficient), pass out my Spanish language cards and he would do the follow-up in more detail. We made a great team.
"[Some observations: there is no longer any secret among teens about sex despite what well-meaning parents might wish. In every country I visit, youth tell me that sex is spoken about liberally - among peers, that is. Very little sense of modesty exists. Upon questioning, teens say they believe this raw openness comes from media influences (television, music and the internet). Talking about sex (and doing it) comes as naturally as most other subjects. Where parents talk about politics, taxes and religion, young people concentrate on love, dating, sex and fun. As I remember my childhood, we were much more naïve about the birds and the bees.]
"We met about 100 youth in the course of three hours. We were able to talk about the seriousness of the AIDS pandemic to young people of mixed backgrounds gathered at the festival. One young man of 21 named Amado wanted me to visit his class at music school on Saturday (I couldn't). He was concerned that youth do not pay attention to adult messages that are judgmental. He said he liked our earnest but low key approach adding, the info cards are "cool" and easy for teens to pocket. In front of a stand, an older sister (21) was at first suspicious of why we were talking to her brother 14, but was soon enthusiastic about the content as she said she is worried about how her brother's friends think. In another group, an 18 year-old girl asked where SIDA came from. Across the square, an older brother 21 was very laid back about his 17 year-old brother's interest in everything dealing with sex saying that's natural - but understood that sex without a condom was always problematic. Among youth encountered in Tlaquepaque and Guadalajara, not one Mexican teen was shy about the topic and most seemed to welcome the invasion of our attacks (a marked contrast from street outreach in Korea where girls are very shy, or act it at least). One couple had red eyes and sorrowful looks, and we only gave them our cards in passing, not wishing to interrupt an obvious break-up. Another was so locked in each other's arms that distributing a card would have been impossible.
"I often talk with adults but with this proviso: I rarely speak to a teen girl when with her mother, especially when she appears to be shepherding her daughter around. I have found that teens tend to feel intimidated by the topic of sex and AIDS with a parent present. My aim is not to embarrass any youth. However, I often go up to groups of mothers especially if they appear a bit suspicious of me. My message is this: 'I know you are good mothers who have done a great job of bringing up your children' [they then nod in unison]. But I hasten to add, 'The problem is that you do not know who they meet and talk with when they leave your home' and that's the rub for worried mothers in this day of open discussion of sex among youthful peers [here's where they glance at each other knowingly and audibly agree]. I explain that the threat of youth HIV/AIDS is very real. I see it everywhere and it's difficult to confront because many young people don't see it as a personal threat. After more discussion and answering questions, I close with, 'It's important that mothers talk with other mothers about this issue, and the information on my cards is a way to begin a meaningful discussion. The three grandmothers we encountered on a park bench kept saying 'thank you' and 'God Bless' as Julio and I walked away.
"Julio also took me to the hospitals where he works in the ER. Obviously, the services proffered are more modest than in hospitals in the States but I was struck by the care these doctors used in caring for the people with limited resources. Julio has been chosen by his fellow doctors to represent them in their fight to get medical coverage for themselves from the government (they get none now). Politics plays a big part in everything in Mexico involving public services and contracts. As a sign of the times, he showed me his newly purchased medical malpractice policy ($300 for $100,000 coverage). He has devoted a few years of his life deep in rural pockets of poverty as the sole physician providing medical care to indigent folk who have had none before.
"Since I was in Mexico after regular school was out for the summer, I concentrated on street outreach along sidewalks and in the many parks. Teens aren't often found out and about in the mornings unless they are working. Whether unloading food supplies or manning a market booth, any youth is a target of my AIDS Attacks. In this rushed trip to Guadalajara (unlike other places where my trips are pre-planned) I mostly walked and talked alone. I can't recall one teen who didn't stop when I approached them with a smile and my hand extended. Youth are always curious about me.
"The afternoons and early evenings are when Mexican youth are out of the house. When I asked them what they knew about AIDS from schools, they said it was very little or not at all (it's pretty much the same response I get in many countries with some notable exceptions). They all say that I am the first and only person who has approached them directly on AIDS. I had four days of this kind of outreach and covered a large swath of the downtown area (taking a taxi back to my hotel in the old Colonial section when I petered out). Incidentally, taxi drivers are among the very best informants for a researcher like me.
"However, it was in the night that I was most busy. In many areas of Mexico, sex work (full or part-time) is a viable option for some youth who need money. I met a young couple, Miguel and his girlfriend "Vicky" who are both working in the trade. He was 20 and she 17. They have been together for 10 months. While Miguel has done orgies and gone with couples who swing both ways, he said he doesn't do anything with Vicky present. When questioned if this was modesty, he said no. He loved her and they kept their love making private. While we drank cokes, his cell phone rang. It was from a regular business client, a woman whose husband was out of town. He said he could be over in 45 minutes. I asked, how much? He said she paid $60 (I have found that pros often exaggerate what they get). Later, he had an appointment with a businessman (he said he was the active partner but again, I have found that sex workers will say one thing but do what they need to do to pay their rent and extra time on the cell phone). I was surprised however, that neither of them carried their own condoms. I gave him one but said it was his responsibility to buy and use them. He shrugged. She smiled and checked her cell phone's text messaging. She said she had to leave too. We said goodbye and they parted company - for a few hours."
Dr. John respects every teen he meets. He might not like what they do but he is not judgmental when it comes to delivering his message about AIDS and HIV prevention. He knows that keeping the lines of communication open are important. Does he like that kids are doing sex for money? No. He will tell hem that he wishes they could find other work because HIV transmission is like Russian Roulette. Sooner or later, they will get AIDS and die (it's important to note that only a small fraction of HIV infected people have access to any meaningful medicine). He has interacted with young sex workers in most countries that he has visited, often by accident or coincidence.
One young man, Carlos, 17, worked as a street vendor during the day and evening but earned money going with men at night. He had no cell phone and charged very little (he was not in Miguel's league). He also didn't carry condoms and complained they often broke so why bother? I asked if his clients had condoms and he said yes, if they wanted him to use one. However, upon further questioning, it became obvious that he did not understand that it was necessary to leave space for the sperm at the end of the condom. He didn't know why there was a reservoir tip on every condom. He explained that he had no longer had a mother (a father was never mentioned) and he lived with an older woman who kept house for a number of homeless teens and children. He knew he had to bring home money if they were to eat. Carlos asked if Dr. John could buy "lavandaria" detergent for the woman so she could wash their clothes. His favorite pastime: watching cartoons with his "siblings."
Dr. John visited a brothel in the company of Matias, a concierge from a major hotel who wanted to help. It was not a dingy place like some that Dr. John had visited in his travels. It was in a small one-story home in a lower class working neighborhood. Nothing about the exterior suggested that it was any different than the other houses on the block, including the Christmas lights strung along the roof. A scruffy young man opened the door but disappeared when a woman of about 35 came forward from behind a beaded curtain. The hotel man explained my mission and asked would it be possible for Dr. John to talk with them. Yes, of course, because it was a slow time in the hot afternoon before the rush hours, so to speak. Three teen girls came out of a common living room where they were watching soaps. As the concierge corrected Dr. John's Spanish, the teen girls and an older one, grew more animated. "How can you tell if a man has it?" And "Many of the men don't want us to use condoms. Is 'chupa' (a blow job) okay?" As he answered their questions, the girls' arms and legs were entwined like young children. When Dr. John explained that unprotected sex was always "peligroso," the bored madam said that they had to get ready for their clients' arrival. She said she had a total of 11 girls who worked for her, but usually not more than five at a time (the number of rooms available for liaisons). She added it was always easy to find girls to work for her in the poor neighborhood. When they left, Matias slipped the woman a 100 peso bill (about $10) for her cooperation. He had been there before with guests from his hotel.
On the Saturday before he left, Dr. John stumbled upon Guadalajara's Gay Pride Parade. At breakfast in the hotel, a 21 year-old legal assistant from Puerto Vallarta said that was why he was in town. He said Guadalajara was known for its tolerance of gays. Dr. John asked where it was taking place and was surprised to hear that the main viewing area was beside Guadalajara's imposing Cathedral and City Hall.
Led by police vehicles and an honor guard carrying the Mexican flag to great applause, thousands of marchers went by. While the parade itself was not spectacular in any sense, the crowd viewing it was. Made up mostly of families with children and curious bystanders, it was as if the circus was coming to town. Even when the over-dressed "travesties" strutted by, the onlookers commented on the hair, the sequined gowns and make-up in admiring tones, not derision. "It was a bit surreal," Dr. John wrote, thinking that none of these parade watchers would ever dress like the drag queens. One mother pushed forward her young, boy of about seven. He gawked at the spectacle to his mother's laughter. It was Dr. John's impression that most of the bystanders were ordinary folks who didn't seem upset in he slightest.
Everywhere he went in Guadalajara and environs, Dr. John was welcomed by people interested in his message. AIDS is on the minds of many people even if it might be in the back of their minds most of the time. Mexico's youth are at great risk like their peers across the world, because they are experimenting with sex at earlier ages and with random partners -- made possible by easier migration, more disposable income and ability to function independently.
View pictures from Dr. John's trip here
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