AIDS-LATIN AMERICA:
Prejudice and Ignorance, a Deadly Alliance
Mario Osava

RIO DE JANEIRO,  (IPS) - Prejudice and lack of information about HIV/AIDS are damaging to society and to people with the disease, creating obstacles to the prevention and treatment of the pandemic, agreed the participants in a weekend conference in Brasilia.

Strategies for overcoming such barriers were at the core of the "Regional Consultation", a meeting sponsored by the Pan American Health Organisation (PAHO), and coordinated by the Latin American and Caribbean Horizontal Technical Cooperation Group.

Too few trained personnel, lukewarm willingness on the part of governments and society to fight the pandemic, and the high costs associated with prevention, diagnosis and treatment were identified as difficulties shared by the countries of the region.

"Towards universal access to HIV prevention and AIDS treatment in Latin America and the Spanish-speaking Caribbean" was the main topic of the three-day event, which brought together some 100 representatives from 18 countries, social associations and international organisations.

The goal of offering universal access to prevention, care and treatment for HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) by 2010 has been agreed worldwide.

In Latin America and the Caribbean, where 300 people a day die from AIDS-related causes, meeting that target would prevent 1.4 million new infections and save 300,000 lives in the next five years, according to PAHO.

The Regional Consultation in Brasilia also focused on the lack of coordination amongst different public health sectors, and between treatment and prevention. Further discussion centred on religious opposition to using condoms, varying depending on the country concerned.

Prejudice constitutes "the most serious obstacle," Carol Vlassoff, head of the PAHO HIV/AIDS programme, told IPS. Many people are afraid to undergo a diagnostic test or receive treatment because of the stigma, she explained.

Homophobia is generalised throughout the region. Some Caribbean countries still have laws condemning homosexuality, and bisexual men remain in the closet, thus spreading HIV amongst their male and female partners alike, she noted.

This difficulty contributes to the very high prevalence of HIV in the adult Caribbean population, with 1.6 percent or, in some countries, over two percent of the population being HIV positive. In contrast, the overall Latin American average is 0.6 percent..

Small, poor countries, of which the Caribbean region has so many, find it hard to make progress towards universal access to AIDS medications, Vlassoff acknowledged. She added that in the Andean region, with its isolated populations, lack of information makes matters worse.

However, she remarked that these countries can still do a lot if governments and society decide to get the information across and combat prejudice.

One example is Suriname, where much progress has been made in prevention and reducing the stigma suffered by people with HIV.

Training of human resources is the key to AIDS prevention and treatment, according to Jahel Vidal, associate coordinator of the Sexually Transmitted Diseases and AIDS Programme in Uruguay.

But it is also necessary to promote an "associative work ethic," integrating health and education activities with civil society participation, added the expert, who emphasised that the latter had been essential for the success of the Brazilian AIDS treatment programme.

Brazil has achieved recognition for its free and universal distribution of antiretroviral medicines through its public health service. Many non-governmental organisations, HIV-positive people's networks and social movements have taken part in this effort.

At present, approximately 170,000 HIV/AIDS patients receive the medicines. But there are an estimated 600,000 HIV positive people, and prevention must be improved, admitted the programme coordinator, Pedro Chequer.

In Uruguay, as in Brazil, Argentina, Chile and some Caribbean countries, access to treatment is already universal, but not all those who need it receive it because of prejudice, which leads many who have the disease to avoid diagnostic tests, Vlassoff admitted.

One of the difficulties in Uruguay, which is now on its way to being resolved, was the wide variety of types of treatment. Now protocols are being drawn up which will establish three or four treatment models, Vidal said.

The conclusions of the Brasilia meeting will be presented at the General Assembly of the United Nations in May. The delegates recommended that the countries of the region should define indicators in order to evaluate access to prevention, care and treatment.

The developing world, particularly Latin America and the Caribbean, has a battle on its hands to reduce the costs of such items as condoms, HIV tests, and - above all - antiretroviral medicines.

To accomplish this, the countries have agreed to negotiate en bloc, unify purchases, seek allies so that international economic agreements will favour cost reduction, create a network for technology transfer, and look for ways to deal with patents, which currently drive up the prices of HIV/AIDS medications.