These Are The Faces Of People Facing HIV/AIDS: #WorldAidsDay

There's a place in the city of Tijuana, Mexico, called El Bordo, which has always been somewhat reminiscent of a post-apocalyptic movie scene. The name comes from "the border," which is where it's located: right by the fence that separates the U.S. from Mexico, among the enormous paved canals that run through Southern California like concrete veins. Hundreds of people live in those canals, often in makeshift tents, the smell of sewage made ripe by the hot Tijuana sun. It's a place where many deportees try to get by. It's also a site of heavy drug use.

El Bordo is one of the main locations for Tijuana's HIV/AIDS epidemic, which is concentrated among drug users and sex workers. According to a 2006 study, the number of men and women age 15 to 49 who are infected with HIV in Tijuana may be as high as one in 125.

Jon Cohen, who covers HIV/AIDS for Science magazine, and photographer Malcolm Linton have been documenting the lives of HIV-infected people in Tijuana for two years. In their new book, Tomorrow Is A Long Time, they tell stories of the people in El Bordo as well as the Zona Norte (the red light district) and La Mesa prison.

Reyna Cortiz once dreamed of being a policewoman. Outside her makeshift shelter, she holds a syringe in her mouth before injecting heroin. She has tested negative for HIV but lives in fear of contracting the virus.

Courtesy of Malcolm Linton

Both a nurse and a photographer, Linton was uniquely positioned to approach this project. A few years ago, frustrated with how little work he was getting as a photographer, he studied nursing at Hunter College. He figured his degree would allow him to continue working with communities that are often marginalized. As he finished his studies, the opportunity to do the book in Tijuana came about. Linton moved there and worked as a nurse for a research project that tested IV drug users to monitor the rate of HIV.

Linton was able to zoom into the community — slowly. "It took several weeks before I even took my camera out," he says. "I didn't want people to feel like I'd come in, taken a few pictures and ripped them off. I wanted to build trust slowly. I wanted to make sure they knew me and liked me, and also that I could safely go out after dark."

Linton says he couldn't have done the work without a woman named Susi Leal, whose photograph and story is featured in the book. Many years ago she'd begun receiving assistance from AFABI (Binational Family Agency), a nonprofit in Tijuana that allowed her to receive antiretroviral drugs. She has been off heroin since 2001, and her HIV levels have been undetectable since 2005. Leal now works in outreach for at risk communities in the area and was key to helping Linton gain access.

The book documents the impact the epidemic has had on entire families. Juanita Ortiz moved from the state of Michoacán to Tijuana with her father when she was 12. Three years later, in 1995, she learned that her mother back in Michoacán had died of AIDS. Eight of her siblings were living there. Eunice and Noemí were infected. Juanita, who was not, co-founded an orphanage for children affected by HIV/AIDS and named it after them: Eunime

Dr. Patricia Gonzalez examines a patient's neck at a first-aid clinic that she started in 2014 in the Tijuana River Canal, where hundreds of drug users live. Some of them inject in the neck; wounds can result.

Courtesy of Malcolm Linton

Linton says one of the biggest challenges faced by people living with HIV/AIDS is stigma, which he feels weighs more heavily in Mexico than in the U.S. "There is a sense that they are second-class citizens and that they don't necessarily deserve a lot of money spent on them," he says.

Mexico has made advances. In 2003, antiretroviral therapy became covered by universal healthcare, although shortages have been reported. And in 2006 the government began setting up care facilities for people living with HIV. But activists have complained about a scarcity of essential goods, such as condoms and breast milk for babies whose mothers are infected. "I think the government is not devoting as much money as is necessary, because they regard the people who are infected as marginalized and dispensable," says Linton. "It's a mistake, because the epidemic will continue as long as you fail to treat the people who are the reservoir of the infection."

Another common complaint is that government facilities are too far from the epicenters of infection. Many of those who need help the most simply cannot spend the day traveling. "The government clinic is an hour away from town," Linton points out. "And people who are surviving day to day can't afford to lose the day. They need to be earning money to get food.

Oscar Villareal, 28, lived in Wisconsin as a boy, married and had a son, returned to his native Tijuana, became a sex worker (above, he makes himself up as his female alter ego, Ale), binged on meth, has tested positive for HIV.

Courtesy of Malcolm Linton

Of all the inhabitants of Tijuana's underworld, transgender people suffer the most stigma. As in the rest of Latin America, being trans in Tijuana makes it extremely difficult to have a mainstream job. The usual options are prostitution or hairdressing. For Linton, this was the most insular community, and it took around a year to find a way in. "They are a group that has been abused and mistreated so much," he explains. "They suspect foreigners. They suspect anyone who wants to be friendly and isn't a client."

The book also looks at Mexicans caught between two countries — their birthplace and neighboring America.

That's the case for Reyna Ortiz, born in Michoacán in 1968. When she was a year old, her parents took her to live in the suburbs of Los Angeles. She dreamed of joining the police force but dropped out of high school to work and help her mother raise five children. Around that time she started using heroin and at 23 was sent to jail for robbery. She was deported twice to Mexico, a country she could not even remember. "I didn't know nothing about TJ [Tijuana]. Even though I'm not originally from the USA, I felt like I was from the USA," she says in the book. "My whole life was robbed."

After 9/11, as the border closed down, she didn't even consider crossing back a third time. Instead she settled in El Bordo.

Martha Patricia Ruiz ran away from home in fifth grade to escape her abusive father, married a trapeze artist, left him, cleaned houses, became a sex worker ("I really didn't want to, but I told myself I had to"), became addicted to heroin, tested positive for HIV in 2012.

Courtesy of Malcolm Linton

The tales of life in the underbelly of Tijuana are unsurprising. After all, the city does have a reputation as a place where poverty, addiction, sexual exploitation and the desperation of those caught on the border come together. But Linton says the goal of the book went beyond showing that anguish. "There's a lot of exuberance," Linton says. "I enjoyed the people. I liked hanging out with the people of the canal. I found them in many ways very pleasant. In some sense they have little contact with reality, because they are high a lot of the time. But in other senses they have a high degree of self-knowledge. They are realistic, they don't have a lot of inhibitions, there's not a lot of attitude."

El Bordo has changed in the time since Cohen and Linton did their work. In March of this year, the mayor of Tijuana began an aggressive campaign to "clean" the canal. More than 500 residents were moved into rehab centers. Others were shipped to their home states. But many others began sleeping on the streets. Police set up round the clock patrols to make sure no one returned.

Sergio Gonzalez (top bunk, left) lies on his bunk in Tijuana's La Mesa prison, where he was jailed the previous February for holding more crystal meth than legally allowed. He is HIV positive as is his young son, Eduardo, who now lives in an orphanage.

Courtesy of Malcolm Linton

Dr. Patricia Gonzalez, who works in the area clinics, says, "They swept the people away like cockroaches."