(Washington) Amid surging worries about a global pandemic, the United States launched border screening for swine flu exposure Monday and a top federal health official said people should brace for more severe cases, “and possibly deaths.”

While anyone could be susceptible to contracting swine flu, people with weakened immune systems, such as those with HIV,  are at particular risk. [TripOut has a post about gay travelers to Mexico.]

Richard Besser, acting head of the U.S. Centers for Disease Control and Prevention, revealed that American authorities were undertaking “passive screening” at its borders and reiterated the Obama administration’s call for people to remain calm. Besser said that U.S. officials at border checkpoints were “asking people about fever and illness, looking for people who are ill.”

Besser discussed the problem on morning news shows as President Barack Obama prepared to address it later Monday morning in remarks to a meeting of the nation’s top scientists.

The U.S. declared a national health emergency Sunday in the midst of uncertainty about whether a mounting sick count really meant ongoing infections – or just that health officials had missed something simmering for weeks or months. But the declaration did allow Washington to ship roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually need them.

Besser traveled the morning news-show circuit Monday, telling interviewers the U.S. government was being “extremely aggressive” and saying he wouldn’t personally recommend traveling to parts of Mexico where the new virus has taken hold. But he noted that the issue of a travel ban was under discussion and that nothing had been decided.

Besser said he was not reassured by the fact that so far in the U.S., no one has died from the disease.

“From what we understand in Mexico, I think people need to be ready for the idea that we could see more severe cases in this country and possibly deaths,” he said. “That’s something people have to be ready for and we’re looking for that. So far, thankfully, we haven’t seen that. But we’re very concerned and that’s why we’re taking very aggressive measures.”

A private school in South Carolina closed after some students returned from Mexico with flu-like symptoms.

Officials of Newberry Academy said in a statement that seniors were in Mexico earlier this month and some had flu-like symptoms when they returned. Calls to the school went unanswered Monday.

State Department of Health and Environmental Control spokesman Jim Beasley said test results on the students could come back as early as Monday afternoon. The agency has stepped up efforts to investigate all flu cases in South Carolina. There have been no confirmed swine flu cases in the state.

In Mexico, the outbreak’s epicenter, soldiers handed out 6 million face masks to help stop the spread of the novel virus that is suspected in up to 103 deaths. Most other countries are reporting only mild cases so far, with most of the sick already recovering. Cases have been confirmed in Canada – six – and the U.S. – 20.

Spain reported its first confirmed swine flu case on Monday and said another 17 people were suspected of having the disease. The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and the United States.

Also, three New Zealanders recently returned from Mexico are suspected of having it. China, Russia and Taiwan considered quarantines, and several other Asian countries undertook to question travelers arriving at airports.

Complicating response strategies across the globe was what World Health Organization spokesman Peter Cordingley described as major difficulty that experts were having in assessing precisely the nature of the threat.

“These are the early days. It’s quite clear that there is a potential for this virus to become a pandemic and threaten globally,” Cordingley said. He said it was spreading rapidly in Mexico and the southern United States.

Cordingley said they “honestly don’t know” the extent of the problem. He added: “We don’t know enough yet about how this virus operates. More work needs to be done.”

Multiple airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, said they were waiving usual penalties for changing reservations for anyone traveling to, from, or through Mexico, but have not canceled flights.

Meantime, the World Bank said it would send Mexico $25 million in loans for immediate aid and $180 million in long-term assistance to address the outbreak, plus advice on how other nations have dealt with similar crises. Mexico officials say the flu strain may have sickened 1,614 people since April 13 but laboratory testing to confirm that and how many truly died from it – at least 22 so far out of the 103 suspected deaths – is taking time.

Worldwide, attention focused sharply on travelers.

“It was acquired in Mexico, brought home and spread,” Nova Scotia’s chief public health officer, Dr. Robert Strang, said of Canada’s first confirmed cases.

A New York City school where eight cases were confirmed will be closed Monday and Tuesday, and 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week. Some schools in California and Ohio also were closing after students were found or suspected to have the flu.

In additions to preparations for quarantines in Russia, Taiwan and China, Singapore, Thailand, Japan, Indonesia, South Korea and the Philippines were checking for signs of fever among passengers arriving at airports from North America. In Malaysia, health workers in face masks took the temperatures of passengers as they arrived from a flight from Los Angeles.

Travelers with flu-like symptoms would be given detailed health checks.

Vesser said that while the U.S. hasn’t advised against travel to Mexico, it has urged people to take precautions, such as frequent hand-washing while there.

Galan, 31, was nominated by the minority Mexican Social Democratic Party, or PSD. The party unveiled its slate of candidates on Friday.

Guadalajara elects a new government on July 5.

The city of more than three-million people is considered among the country’s most traditional areas with conservatives usually winning election.  Observers say Galan is unlikely to gain more than three-percent of the vote.

The area is best known for the manufacture of tequila and its numerous mariachi bands.

In a recent interview, Galan told the Efe news service that he wants to play down his sexuality in the campaign and focus on greater social issues.

“Proposals have to be made, beyond what the candidate’s [bedroom activities] are,” he told Efe.

Although Galan is the first openly gay person to run for mayor in Mexico, there have been serveral LGBT people who sought state and federal office.

Among them are Enoe Uranga of the leftist Party of the Democratic Revolution. In 2001, Uranga proposed legalizing same-sex unions.  The bill did not pass at the time but was ultimately approved in 2007.

The coordinator of an HIV/AIDS awareness tour, Polo Gomez, said the truck was taken Sunday from its parking spot in front of a friend’s house in Mexico City.

It was recovered Wednesday in a shopping mall parking lot in a northern suburb – minus the condoms and the equipment. Gomez said the thieves left some 800 HIV tests and a 23-foot inflatable prophylactic, which were also in the vehicle.

The truck wasn’t hard to locate. It features painted images of a peeled banana, the exposed part shaped like a condom, and a shirtless man saying: “I protect myself. Do you?”

After the theft received widespread media coverage, residents phoned police with the vehicle’s whereabouts, Gomez said.

The Condomovil program has toured Mexico since 1998 promoting safe sex practices while distributing 1.2 million condoms to more than 700,000 people, Gomez said. The inflatable condom was used to draw attention from passers-by.

The group bought the truck with a grant from Mexico’s federal Health Department. The department also donated the 5,000 condoms that were stolen.

The United Nations AIDS program says there are some 200,000 people living with HIV in Mexico.

Rincon Gallardo, born with shortened arms as the result of a congenital birth defect, was the head of the National Council for Preventing Discrimination. A government statement said he died in Mexico City but did not give a cause of death.

President Felipe Calderon issued a statement praising Rincon Gallardo’s “tireless, lifelong work for the rights of the disabled and his significant contribution to the democratic development of our country.”

Rincon Gallardo was the candidate of the tiny Social Democracy party in Mexico’s historic 2000 election, when the Institutional Revolutionary Party lost the presidency after seven decades of single-party rule.

Though Rincon Gallardo garnered few votes, he emerged as the conscience of the campaign by speaking out for homosexuals, the disabled, rape victims and Indians.

“In weak democracies like Mexico, legal protections are necessary to prevent a tyranny of the majority over minorities,” he said in a debate.

Rincon Gallardo, a former leader of the now-defunct Mexican Community Party, had a history of reaching across ideological lines.

Conservative Vicente Fox, who won the 2000 election, appointed him to head Mexico’s anti-discrimination council, a position he continued to hold under Calderon.

He also helped develop Mexico’s position favoring a U.N. convention on the rights of the disabled, signed in 2007 by 80 countries.

The Mexican federal official paused, then said publicly for the first time that he was gay.

As he held up a photo of himself with his partner, the crowd applauded wildly. Afterward, men from Africa and India congratulated him with tears in their eyes.

“They told me that I was a hero, and that they wished they could do the same in their countries,” said Saavedra, who is infected with HIV and also heads the AIDS prevention program in a country where many gay men live in denial.

Saavedra’s coming out on Tuesday at the International AIDS Conference sent a powerful message to the world: Homophobia must be stamped out if AIDS is to be controlled.

Fewer people are dying from AIDS, but new HIV infections among gay and bisexual men in many countries are rising at alarming rates.

Yet less than 1 percent of the $669 million reported in global prevention spending targets men who have sex with men, according to UNAIDS figures from 2006, the latest available data.

UNAIDS says these men receive the lowest coverage of HIV prevention services of any at-risk population. And experts say discrimination has driven gay and bisexual men in developing nations underground – turning them into one of the epidemic’s hardest groups to reach. From Mexico to India, a surprising number of men who have sex with men insist they are not gay, and in many countries, governments still refuse to admit homosexuality exists.

“It’s very difficult to provide services to men who have sex with men in countries that don’t acknowledge they exist or criminalize them if they do exist,” said Craig McClure, executive director of International AIDS Society, which organized the conference.

In 86 nations, homosexual sex is considered a crime, and in seven countries it is punishable by death, according to the Foundation for AIDS Research, known as Amfar.

During the conference’s inauguration, U.N. Secretary General Ban Ki-moon urged nations “to follow Mexico’s bold example and pass laws against homophobia.”

In 2003, Mexico banned discrimination based on sexual orientation, and it has opened what it calls homophobic-free health clinics. The government has a national campaign that includes radio spots with mothers accepting their gay sons. Saavedra’s program has earmarked 10 percent of its $12 million budget toward prevention among gay and bisexual men.

Worldwide, few developing nations check the rates of HIV infection among men who have sex with men, but researchers who have surveyed some of these countries say they are finding the rates are nearly twice that of the general adult population.

“This fight needs to be driven by epidemiologists” who urge making this high-risk group a priority, not only for the human rights argument, but for the public health argument, said Chris Beyrer, director of the Center for Public Health and Human Rights at Johns Hopkins University. “It’s a virus so you need to put the money where the virus is.”

Gay and bisexual men are 19 times more likely to become infected with HIV than the general adult population, according to Amfar, which collected data on these men in 128 countries. In Mexico, this group is 109 times more likely to acquire HIV. To date, 57 percent of the HIV diagnoses in Mexico are from unprotected sex between men.

Thailand is seeing “an emerging epidemic of really unbelievable proportions” among its gay and bisexual men after being held up as an example for its success with a massive condom campaign that curbed HIV’s spread among sex workers, drug users and migrants, said Kevin Frost, Amfar’s chief executive officer.

Prevalence of HIV among gay and bisexual Thai men was more than 15 percent this year compared to 1.4 percent for the general adult population, according to Amfar. Frost said the country’s prevention programs ignored one of its most vulnerable groups.

“These men believed they were not at risk because they were not having sex with sex workers or women, which is what the campaign focused on,” Frost said. “That scenario is being played out across the developing world.”

Complicating matters is that in countries from Latin America to Southeast Asia, many men who have sex with men insist they are not gay. More than 30 percent of Latin American men who reported having sex with men said they also had unprotected sex with women, according to UNAIDS. Many are married.

“Everybody knows somebody like that,” Saavedra, 48, said. “Instead of saying they are gay, it’s easier for them to justify their behavior. They say they were drunk and they were really sexually excited and willing to have sex with whomever.”

Some have beaten up transvestites after having sex with them because they are ashamed of themselves, experts say.

Even governments deny these men exist. Last year, President Mahmoud Ahmadinejab said at Columbia University in New York, “In Iran we don’t have homosexuals like in your country.”

In Malawi, that country’s first organization working on behalf of gay men was created in 2006 with the backing of World Bank officials and other international agencies.

Called the Centre for the Development of People, the group surveyed 100 gay men about discrimination to prove to the government that such men existed in Malawi. Homosexual sex is punishable up to 14 years in prison in the African country.

The organization also found through testing 200 gay men that about 21 percent carried HIV compared with 12 percent for the general adult population.

“This means that we are not moving ahead with the fight against AIDS,” said Gift Trapence, the organization’s director who has received e-mails threatening hanging.

AIDS activists say they avoid using words like “homosexual” or “gay” and instead use the label “men who have sex with men,” or MSM, so their work is not impeded by the stigma.

Ashok Row Kavi said he has learned the importance of carefully choosing his words in India, where he started one of the country’s first organizations to work with gay and bisexual men.

The Humsafar Trust found nearly 14 percent of the gay and bisexual men it surveyed in 1999 were infected with HIV. Kavi said when he told India’s AIDS officials they “totally panicked because until now they believed these men did not exist.”

But last year they added a definition of men who have sex with men to their health planning program to start prevention campaigns. The definition includes married men.

Kavi has been training health workers how to ask men if they have had gay sex and not scare them away.

“I tell them to say things like, ‘There are many cultures where men are very close to men. Are you one of these men?’” he said. “These questions have to be sensitive,” especially in India, where sodomy is illegal.

“That’s why the word homosexual is not used,” he said. “If anyone asks a man that, he will slap you.”

U.S. President George W. Bush signed legislation last week repealing a rule that prevented HIV-infected immigrants, students and tourists from receiving U.S. visas without special waivers. The ban also held up U.S. adoptions of children with HIV. Seven nations still have an outright ban on entry for HIV-infected people, and more than 65 impose some travel restrictions on the estimated 33 million people worldwide living with the virus.

U.N. Secretary General Ban Ki-moon, whose native South Korea denies entry to HIV-infected visitors, said the restrictions “should fill us with shame” in his opening address to the AIDS conference in Mexico City, which brings together 25,000 officials, scientists and activists this week.

Ron MacInnis, director of policy for the International AIDS Society that organized the conference, said travel restrictions often force people with HIV to hide or even lie about being infected.

“It’s blatantly discriminatory to single out people with HIV. It’s stupid and ridiculous,” said MacInnis, who has HIV. “These restrictions are really impeding our ability to control HIV and AIDS.”

Many nations adopted their restrictions during the 1980s when mass hysteria surrounded the virus and little was known about how it is spread.

Dr. Peter Piot, executive director of UNAIDS, said there is no public health justification for the bans, and that they undermine efforts to control the epidemic by painting it as a foreign problem that can be curbed by controlling borders. UNAIDS formed an international task force in January to work toward their elimination.

The European AIDS Treatment Group says seven nations ban people with HIV from entering: Brunei, Oman, Qatar, Sudan, South Korea, United Arab Emirates and Yemen. About 30 deport foreigners once they are discovered to have the virus, including North Korea, Singapore, Taiwan, Hungary, Egypt, Sri Lanka, and Russia, the group says.

Last year, Australian Prime Minister John Howard said he opposes letting HIV-positive people immigrate, triggering anger among health care workers.

For now, the country allows HIV-infected visitors but requires testing for those intending to work as doctors, dentists or nurses, and for sub-Saharan Africans over 14 wanting to study, a spokesman for Australia’s immigration department said. It can also reject migrants for fear they will run up large medical bills.

Developed countries say the travel restrictions keep them from having to swallow the costs of caring for HIV-positive people from poorer nations. But activists say studies show that isn’t occurring on a significant scale in countries without restrictions.

The AIDS virus is spread through bodily fluids via sexual intercourse, blood transfusions, the sharing of needles and in rare cases, breast-feeding. Activists say the best way to control the epidemic is by raising awareness so people are tested for the virus and take precautions.

The international travel bans have complicated the work of prominent AIDS activists, including Shaun Mellors of South Africa, a former co-chair of the UNAIDS international task force.

He has been banned from entering the United States since 1994, when he traveled to New York to participate in the Gay Games and told a reporter he had refused to declare his HIV-positive status or ask for a special waiver.

“I told him ‘no’ because I thought it was stupid and discriminatory,” said Mellors, 43.

When U.S. immigration authorities saw the article, Mellors said his name was put into the U.S. consular alert system as someone who obtained a visa fraudulently. When he passed through the United States on his way to Canada, authorities found him in the system and deported him.

He is unsure whether he will be allowed back into the United States now that Bush has repealed the ban. But he hopes other nations will now be motivated to ease their restrictions.

“It’s been humiliating to constantly be classified as a criminal,” he said. “I think it’s great that America has finally seen the light.”

China has promised to lift its ban, though it has not said when, and nations from Russia to the United Arab Emirates are revising their policies, said Craig McClure, executive director of the International AIDS Society.

“The U.S. always sets the tone,” McClure said. “This is huge not only for the people who have not been able to enter the U.S., but finally these laws might be overturned throughout the world.”

The soldier from the western Mexican state of Jalisco was removed from his job after 20 years of service. But a federal court has ruled in his favor.

The Center for Justice, Peace and Development helped fight the soldier’s case. The group said Tuesday the decision includes back pay.

The soldier’s name was not released to protect his privacy. Both he and the army discovered he was HIV positive after a work accident required blood tests and surgery.

A year ago, Mexico’s Supreme Court ruled it was unconstitutional for the military to expel soldiers who test positive for HIV. Military officials refuse to comment.

Fellow inmates also begged for help after Victoria Arellano started vomiting blood in their holding cell, where her lawyer said 105 detainees were crammed onto bunks and mattresses in a space designed for 40.

She died three days later, chained to a hospital bed.

The death of the 23-year-old transgender Mexican immigrant is at the forefront of discussions at this week’s international AIDS conference in Mexico City. Rights activists say it shows the failure of immigration officials to deal humanely with HIV-positive inmates among the 30,000 migrants held in detention centers across the United States.

New York-based Human Rights Watch says it found 14 cases, including Arellano’s, in which HIV-infected immigrants were not given proper care while in custody of U.S. Immigration and Customs Enforcement.

ICE officials deny this, saying detainee safety is a top priority, but have declined to comment specifically on the cases since Arellano is suing the agency.

Activists say many HIV-infected migrants in U.S. detention centers are not given their medicine regularly, which is crucial to their survival. People with HIV can live otherwise healthy lives if they take a strict regimen of specific medications each day and closely monitor their blood cells to be sure their immune systems are working.

That’s difficult to do for people being deported, particularly in overcrowded detention centers. When the regimen is interrupted, the virus rebounds and the immune system crashes.

The family’s lawyer, Steven Archer, says Arellano never got proper medical attention after she was stopped for drunk driving and handed over to immigration officials in June 2007.

“They filled her prescription with the wrong strength, and they never diagnosed the meningitis, even though she had been complaining about headaches, sweats and generalized pain for weeks. That is what killed her in the end,” Archer said. “It was so advanced that it involved her brain, her liver, her lungs, her heart, and a couple of other organs. She died in terrible pain.”

ICE spends nearly $100 million annually on medical services for its detainees, officials say. Still, 71 people out of 1.5 million have died in ICE custody since the agency was formed in 2003.

Human Rights Watch says detention centers do not collect essential information to monitor HIV cases. It also accuses ICE of failing to complete anti-retroviral regimens consistently, failing to prescribe prophylactic medications to prevent infections and failing to ensure continuity of care when HIV-infected detainees transfer facilities.

The Homeland Security Department’s internal watchdog recommended last month that ICE improve its oversight and medical screening procedures and work harder to identify and fill clinical staff shortages at detention facilities.

Still, some HIV-positive Mexicans complain that they don’t get proper care until after they are deported.

Victor Manuel Serrato, 43, was deported in May after living 24 years in California. He said he told U.S. immigration officials when he was detained that he is HIV positive. “I told them I needed my medicine, but they didn’t give me anything,” he said.

Interviewed by the AP at a shelter in Tijuana, he said he missed out on nearly a week of taking the drugs he needs to keep his immune system from weakening, until his mother brought medication to the shelter in Mexico.

In Victoria Arellano’s case, her mother was powerless to help.

“She told me after a month in detention that she still hadn’t seen a doctor,” Arellano said. “I told her I could send her more medicine, but she said they would not give it to her. They were mostly giving her Tylenol.”

Other inmates at the San Pedro facility outside Los Angeles yelled “Hospital! Hospital!” when Victoria started vomiting blood, Arellano said. At one point, a guard came in and turned her head toward him with his boot so as not to touch her, fellow inmates told Arellano.

When Victoria’s fever spiked and she could no longer go to the bathroom alone, a fellow inmate phoned her mother.

“He told me that Victoria wasn’t eating and was urinating blood, but that the officials still were not paying her any mind,” Arellano said. “He told me: ‘Get outside help, but try not to worry. We’ll take care of your daughter.’”

A U.S. immigration officer soon called saying Victoria was hospitalized and gravely ill. Arellano spent three days by her side.

“Her foot was chained to the bed and when she tried to turn over, it would hurt her,” Arellano said. “That made it twice as hard. It was so humiliating. No human should have to live their last days like that.”

Arellano said she pleaded with the immigration guard to remove the chain. It was finally taken off minutes before she died.

Scientists and immigration experts are discussing the challenge of dealing with HIV in an increasingly mobile world at the conference, the first in Latin America, attended by 25,000 people.