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Women, Migration, and Sexually Transmitted Diseases in the Migration Process of Altar, Sonora: Agency in the Midst of Multiple Vulnerabilities Katherine Careaga Sexually transmitted diseases (STDs) and, in particular, transmission of HIV, have come to the forefront of public health agendas focused on the border and migration. This priority has been articulated in binational arenas, with one of the principal and longstanding activities being the red ribbon parades held annually on both sides of the U.S.–Mexico border (Avilés and Jiménez Cruz n.d.), the Border 2010 objectives, and newer initiatives funded by USAID (http://ihccm.ucsd.edu/ties/index.html) and CONASIDA (www.salud.gob.mx/conasida). In Mexico, the first cases of HIV/AIDS were in men who had spent time working in the United States, and the second highest prevalence of the disease is reported in the border state of Baja California, with other border states experiencing rising prevalence as well. Albeit spotty, prevention efforts that specifically target border localities and migrant populations have long been in place, reflecting the rationale that the disease is being “brought” to Mexico via (internationally) “mobile populations.” In Sonora in recent years, the secretary of health reports an important epidemiological change in what had been a relatively stable rate: Between 2000 and 2005, the number of new cases increased from 80 to 115, an increase of approximately 40 percent (Pacheco 2005). This coincides with the state’s increasing prominence as a stopping point in the flow of undocumented migrants to the United States and particularly the rise of the Altar–El Sásabe corridor. Until very recently, however, Sonora has not been a focus of national prevention efforts. Finally, prevention efforts in Mexico have fallen into two broadly defined gender-based categories: one targeted at male migrants and Katherine Careaga received her Ph.D. in social science from El Colegio de Sonora. She is the EducationUSA outreach advisor for Chiapas and Tabasco states, in Mexico Journal of the Southwest 51, 4 (Winter 2009) : 543–561 544  ✜  Journal of the Southwest the other targeted at women as a vulnerable group due to the presumed infidelity of their husbands (and there is possibly a third category, targeted at sex workers). In relation to the migration process, this has led to stereotypes of the mobile male migrant, women as sex workers in the stopping points and receiving communities, and the “women that stay behind” as spouses in the sending communities. These categories also imply an exclusive geographical distribution of different types of women that reflects widespread stereotypes about the Mexican side of the border (Vila 2003). These stereotypes do not however reflect the empirical realities that women from the sending communities are joining the flow of undocumented migrants to the United States in ever-increasing proportions , and that their participation has changed qualitatively in that they are migrating, sometimes alone, not necessarily as wives seeking reunification with their spouses, but rather in search of their own work opportunities and with varying goals (Valdéz Gardea 2006). Despite these facts of the migration process and of HIV/AIDS prevention , women continue to be painted as passive victims, as vulnerable due to actions and processes beyond their control. It is well known in both expert and popular circles that undocumented women migrants face the threat of rape1 and involvement in sex work, albeit temporary, in exchange for trafficking or other goods and services along the migration route. Similar to the reasons given for male migrant “vulnerability” (Bronfman 1995; Gayet and Magis-Rodríguez 2004), women migrants also face feelings of loneliness, possibly with different subjective connotations . Little work has been done to address the specific concerns and needs of women migrants during migration, nor to explore how their STD risk/vulnerability fluctuates with their changing participation in the migration process. Even less is known about how these women understand their own changing risk/vulnerability and, in turn, how they respond to and negotiate it. The purpose of my investigation was to reintroduce the agency of women migrants into the STD prevention picture, first, by recognizing their diverse and active roles in the migration process and treating them as worthy research subjects; second, by...

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