HEALTH-BRAZIL:
Older Women at Higher Risk from AIDS
By Mario Osava
RIO DE JANEIRO, Feb 13 (IPS) - The HIV infection rate in women over
50 in Brazil has more than tripled since 1996, making this
population group the prime target of the government's HIV/AIDS
prevention campaign during the carnival festivities.
A survey by the Health Ministry found that 55.3 percent of Brazilian
women aged between 50 and 64 regularly have sex, but only 28 percent
practice safe sex including condom use with casual contacts, that is
with men who are not their regular partners.
"It is worrying," said Health Minister José Gomes Temporão, because
infections are rising in this female age group, as well as among
young men who have sex with men, although in the general population
the number of HIV-positive people has stabilised, at around 630,000
people. Brazil has a total population of 190 million.
In 1996, only 3.7 AIDS patients per 100,000 population were women
over 50. Ten years later, there were 11.6 cases per 100,000 in this
group.
Consequently, the campaign launched on Friday is aimed at "mature
women", seeking "to empower them" to insist that their partners use
condoms, and also raising awareness among men and promoting the
"democratization of sexuality within relationships", the health
minister told foreign correspondents at a press conference.
"Sex has no age limit. Neither does protection," is the slogan to be
broadcast on television and radio spots and in printed matter in the
coming weeks. One 30-second video shows a group of women aged
50-something encouraging women not to tolerate men who refuse to use
condoms - not even if it's "just a fling".
The campaign is not only about casual sex, according to Maria Luiza
Pereira, of Maria Mulher, a non-governmental Afro-Brazilian women's
organization.
"In stable couples, women find it difficult to negotiate the use of
a condom. They believe the stability of the union makes for safe
sex, but infidelity may still occur," Pereira told IPS in December,
when the rising trend of HIV infections in older women first
emerged.
"Another factor that makes older women vulnerable is the lack of
pregnancy risk, which reduces concerns over not using condoms," she
said then.
While investigating the background for a story on this issue, IPS
found that many statistical sources on AIDS disregarded the upper
age range.
The most recent report by the Joint United Nations Programme on
HIV/AIDS (UNAIDS) said that an estimated 1.9 million people in Latin
America are infected with the AIDS virus, 210,000 of whom were
diagnosed within the past year. The UNAIDS statistics for adults are
limited to 15 to 49-year-olds.
This month, when carnival fever spreads parties, dancing, hedonism
and sensuality throughout Brazil, the Health Ministry will
distribute 55 million condoms, 10 million more than the usual
monthly supply, said Mariángela Simão, the head of the ministry's
National Programme on Sexually Transmitted Diseases (DST) and AIDS.
The prevention campaign reaching out to older women comes in the
wake of a similar crusade in December 2008 to raise awareness among
men over 50 of the need to practice safe sex.
Brazil usually carries out two AIDS prevention campaigns a year.
Their results can only be assessed after several years, because
behavioural change takes time, and older people in particular are
more resistant to changing their habits, said Simão.
"Young people are used to condoms, but the older generation is not,"
Minister Gomes Temporão said.
That the total number of HIV-positive people in this country has
stabilised indicates the success of the campaigns, as does the fact
that 96 percent of the adult Brazilian population now knows how the
virus is transmitted.
Of the 630,000 people living with the HIV virus, some 255,000 do not
know that they are HIV-positive because they have not been tested. A
rapid diagnostic test has been developed in Brazil and is available
to test people who are in doubt about their HIV status.
HOMEMADE AIDS MEDICATION
Another way to combat AIDS is to lower the cost of the
antiretroviral medicines that fight the infection. The Brazilian
AIDS programme is internationally recognized as an example in the
field of treatment, as it was one of the first countries to provide
free antiretroviral medication to all who need it.
One milestone in the fight against the disease was the decision, in
2007, to break the patent on Efavirenz, a drug used by 85,000 out of
the 200,000 HIV/AIDS patients who were taking the "cocktail" of
antiretroviral drugs which drastically reduces mortality and
improves quality of life.
Less than two years after decreeing compulsory licensing of the
patented drug, made by the U.S. pharmaceutical company Merck Sharp &
Dohme, the Rio de Janeiro-based Oswaldo Cruz Foundation succeeded in
producing the generic version, chemically identical to Efavirenz.
This year, half of the 30 million pills consumed in Brazil will be
produced in-country.
The compulsory licensing imposed on Efavirenz does not deprive Merck
of the royalties for its patent, which represent 1.5 percent of the
cost of the pills, but the government saves around 60 percent of the
price Merck was previously charging for them.
The cost of the Brazilian generic version is a little higher than
that of the equivalent drug imported from India since the patent was
bypassed, but the main thing is that "the technological capacity of
the country" to manufacture its own generics has been proven, Gomes
Temporão said
This could be important in future for fighting tropical illnesses
that do not attract much interest from the transnational
pharmaceutical industry (because profits would be meagre), such as
malaria, leishmaniasis and Chagas' disease, he said.
Eight of the 17 drugs used to treat AIDS in Brazil are manufactured
within the country.
The health minister said that the global financial crisis will not
affect the health budget, which is "protected under the
constitution". He is guaranteed at least the same level of resources
for 2009 as for last year, with additional funding index-linked to
inflation and the country's economic growth.
The AIDS Programme, including distribution of antiretroviral
treatment to all those who need it and medical care provided by the
public health system, costs 1.4 billion reals (600 million dollars)
a year, Simão said.
Brazil is using its experience to help some African countries,
especially Portuguese-speaking nations like Guinea-Bissau, Cape
Verde, and São Tomé and Príncipe, to deal with their own AIDS
problems.
Guinea-Bissau treats 3,000 AIDS patients with Brazilian aid, Simão
told IPS. Technical cooperation and medical training have been
stepped up in other countries, and the Oswaldo Cruz Foundation is
transferring technology to Mozambique to set up a drug manufacturing
facility there, she said.
Simão said that, regrettably, Brazil's accumulated social experience
in AIDS prevention and mechanisms to ensure successful treatment,
like promoting organizations for HIV-positive people, are difficult
to transfer to Africa, the continent most afflicted by the AIDS
pandemic, because of the great cultural gap between them. |
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