An HIV-positive diagnosis is always difficult to deal with, but in a developing city like Tijuana, the difficulty is tenfold – both for those living with HIV/AIDS and for those treating them. The activists at the ACOSIDA Clinic, the oldest HIV/AIDS clinic in Tijuana, hope to ease that burden. To that end, ACOSIDA recently announced the completion of the Casa Nicole hospice and transitional housing program in central Tijuana.

The facility is the only one of its kind in the Republic of Mexico, providing accommodation for 12 persons living with HIV/AIDS. It also provides room and board, medical, dental, psychological treatment, substance abuse treatment, employment assistance, nutritional and hygiene counseling, medication adherence and monitoring, and HIV-prevention education for positives.

“The primary goal of Casa Nicole is to help clients stabilize their lives, assist them in securing entitlements and to refer them to permanent housing,” said Jess San Roque, board president of ACOSIDA Clinic, which sponsors the shelter. “The need for a transitional home for people with HIV/AIDS is great in Tijuana because HIV/AIDS does not stop at the border in San Diego. For providers to focus HIV/AIDS care for U.S. citizens only in San Diego would not make sense because there are many people who spend time bi-nationally.”

According to the International HIV/AIDS Alliance: “Mexico has 11 percent of the estimated HIV cases in the Latin American region, with 180,000 people living with HIV (0.3 percent prevalence). Mexico’s epidemic has leveled off somewhat in recent years. It is still largely concentrated among men who have sex with men, but there has been a gradual shift toward injection drug users and women [are] becoming more affected.”

The San Diego AIDS Foundation provided initial funding of $20,000 for Casa Nicole. San Diego community activist Ben Dillingham III led the campaign to raise those funds, and San Diego-based Alliance Healthcare Foundation distributed the money after visiting the facility last year. The Imperial Court de San Diego provided additional funding and helped to pay the facility’s rent for the first month.

Once the schedules of supporters and dignitaries in Tijuana and San Diego can be coordinated, organizers will hold an official grand opening. However, the hospice began providing services before it officially opened its doors in December 2006.

“A client so desperately needed a place to stay that he moved in prior to opening,” said Maria Galleta, vice president of ACOSIDA’s board of directors. “He didn’t care if the renovation of the facility was complete or if he even had a bed to sleep on; he was just so grateful to have a roof over his head.” The organization bought a temporary bed for the client to sleep on while Galleta and volunteers finished working on the facility that used to be an orphanage.

But Casa Nicole, which currently houses four residents, doesn’t only have tales of desperation; it also boasts stories of success. Two formerly homeless residents moved into the house in December, and, by February, they were able to find jobs and transition out of the facility into an apartment together, Galleta said. “They were very grateful for the services provided to them and wanted to make sure that there is room for others who need it,” she said.

Residents are often referred to Casa Nicole by a doctor at the ACOSIDA Clinic and they also come from the nearby Tijuana General Hospital.

“Since there are no other housing, social or medical support services offered to this population in Tijuana, the need for support of these social services targeted to this community is desperate,” Galleta said, explaining that the stigma for people living with HIV/AIDS in Tijuana is far greater in Mexico than in San Diego.

Currently, ACOSIDA serves an average of 50 patients infected with HIV/AIDS per year. Somewhere between eight and 10 of those patients have no shelter or housing, and are at the mercy of the streets, where HIV/AIDS can spread easily.

“People being treated for an illness at the general hospital who are HIV positive are often disregarded and discharged because they aren’t expected to live. If they have nowhere to go, they are just left to live on the street,” Galletta said, noting that often they can be nursed back to health if they are given proper care and treatment with antiretroviral medication.

While ACOSIDA Clinic has provided services at no cost to thousands of persons living with HIV/AIDS since 1983, activists allow there is only so much they can do at the clinic staffed by volunteers, some of whom travel 70 miles by bus from Ensenada to provide assistance to the community.

“By providing these crucial services to homeless individuals living with HIV/AIDS, it will help reduce the spread of HIV,” Galleta said, noting that, so far this year, the clinic has tested 40 individuals for HIV and 10 have been positive.

Galleta has become a familiar face to many in the local HIV/AIDS communities on both sides of the border. The San Diego resident began caring for people with HIV/AIDS after receiving Red Cross training 15 years ago. She saw a need and decided to fill it after a family member became infected. Galleta later co-founded Christie’s Place, which serves families affected by HIV/AIDS, investing a considerable sum of her own savings in the effort. After two years at Christie’s Place as a non-paid volunteer, she decided to move on, eschewing the personal politics in which she said AIDS-service groups are often mired.

This woman on a mission not only serves on the ACOSIDA board but also as HIV program coordinator for the Asian Pacific Islander Community AIDS Project (APICAP) in San Diego. “The opening of a shelter for HIV/AIDS in Tijuana has been a dream of mine for a long time,” she said.

APICAP, which has served San Diego for more than 13 years, has been a key partner in the design and development of the project, named after San Diego City Commissioner Nicole Murray-Ramirez, a longtime civil rights and AIDS activist. Murray-Ramirez said he is touched and humbled that such an honor has been bestowed upon him.

“It is my hope to continue to support Tijuana and its people living with HIV/AIDS, and that God will bless and take care of everyone who enters this residential facility,” he said. Murray-Ramirez became involved in HIV/AIDS in Tijuana, Mexico, more than two decades ago and has helped provide assistance to numerous HIV/AIDS organizations in Mexico. He is also the founder of the Tijuana AIDS Fund of the Imperial Court, which has committed to long-term maintenance funding of the project through ongoing fund-raising and benefit events.

San Roque stressed the importance of private donors in making Casa Nicole. “All of this would not have been possible with everyone involved, and we hope to be able to continue to develop and implement programs to help those who have been marginalized,” he said.

For more information or to contribute to the work of ACOSIDA Clinic and/or Casa Nicole, call 619-229-2828.