Warning: This is completely untested. I don't have MS Access, and I never use Win32:OLE, but at least I know what it is.

I found the VBA script (emdeded in POD in the program below), to do this here, and I've made an attempt to convert is to Perl/OLE to give you a starting point. (But don't ask me questions cos I won't know the answers. Well, you can try, but you've been warned:)

use strict;
use warnings;
use Win32::OLE;

=VBA
Dim accessApp as Access.Application
Dim strDB as string
Dim strImport as string

set accessApp = new Access.Application
strDB = "C:\Test\MyDatabase.mdb"
strImport = "R:\Download\ImportFile.txt"
accessApp.OpenCurrentDatabase strDB
accessApp.DoCmd.TransferText acImportDelim, , "TableX", strImport, -1
accessApp.CloseCurrentDatabase
=cut

## connect to Access
my $access =  Win32::OLE->new 'Access.Application' )
    or die "Cannot create Access object:$!\n";

## connect to the database
$access->OpenCurrentDatabase( 'x:\The\path\to\your\database.mdb');

## run the import command
$access->DoCmd->TransferText(
    ',',                                            ## The delimiter
    0,                ## First line contains field names. (1 if yes)
    'YourTableName',           ## The name of the table to import to
    'x:/the/path/to/the/file.csv',                 ## file to import
    -1                       ########### Haven't a clue what this is,
    ## but you should be able to work it out by looking at the
    ## Text Transfer menu
) or die $^E;

## and done
$access->Quit();
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