Marcela Valente

BUENOS AIRES, Nov 21 2005 (IPS) – In Haiti, the poorest country in the hemisphere, HIV prevalence fell in urban areas due to changes in sexual behaviour. But in the region as a whole, the number of people living with HIV, the AIDS virus, rose in 2005.
The good and bad news was announced by the AIDS Epidemic Update 2005 , the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO), whose Spanish language version was presented Monday in Buenos Aires.

Laurent Zessler, UNAIDS coordinator for the Southern Cone region (Argentina, Chile, Paraguay and Uruguay), underlined that prevention is key to curbing the epidemic, and said governments and civil society are not providing the right solution.

According to the report, the number of people living with HIV in the region rose from 1.6 million to 1.8 million between 2003 and 2005. It also notes that 66,000 people died of AIDS in the past year while 200,000 new cases were registered in 2005.

Zessler said the exceptional response required has not been seen, and pointed to the large number of adolescents in Latin America who have no access to information on HIV prevention or condoms.

The highest number of cases in Latin America are found in three of the biggest countries: Brazil, Argentina and Colombia. Brazil alone accounts for one-third of those living with HIV in the region.
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The spread of the disease in the region is mainly by means of unsafe sex behaviour that can be modified through health campaigns, the official noted.

However, it is in the small states of Central America that the largest proportions of people living with HIV are found. Between one and two percent of adults in Belize, Guatemala and Honduras are infected, compared to the regional average of 0.6 percent, said Zessler.

Within a grim global outlook, the UNAIDS coordinator celebrated that infection levels had fallen in a few poor African countries like Zimbawe, Burkina Faso and Kenya.

The spread of HIV/AIDS also slowed in Haiti, despite the soaring levels of poverty and marked social and political instability. According to the report, HIV prevalence among women in urban areas dropped from 9.0 to 3.7 percent between 1993 and 2004, and infection rates also fell in rural areas, although to a smaller extent.

The government and civil society improved their responses in Haiti, focusing on a change in sexual behavior, Zessler told IPS.

According to the report, more adults in that country now abstain from sexual relations (the proportion rose from seven to 11 percent in the past 10 years) and more are faithful to a single partner (the proportion rose from 37 to 45 percent among men and from 20 to 32 percent among women).

On the other hand, there is still much to be done in terms of raising the age of first sexual relations and extending the use of condoms. Young people in Haiti become sexually active one year and eight months earlier, on average, than they did six years ago, while condom use dropped among sexually active 15 to 24-year-olds.

In a conversation with IPS, José Maria Di Bello, coordinator of the Argentine Red Cross HIV/AIDS programme, said it would be difficult to adapt the formula used in Haiti to reduce infection rates throughout the region, mainly because of cultural, rather than budgetary, reasons.

We believe it is impossible to recommend abstinence and faithfulness in Latin America, because it implies an ideological slant that the majority of society rejects, said Di Bello, who added that it was important to focus all campaigns on the use of the condom.

The activist also said machismo or sexism must be fought in countries in the region. In our societies, HIV/AIDS is an epidemic that is spreading fast among women, because many of them do not dare demand that their partners use condoms, he said.

The tendency towards the feminisation of the epidemic in the region was also described as alarming by Silvia Rucks, chair of the HIV/AIDS theme group in the U.N. country team in Argentina. In Honduras, for example, AIDS has become the leading cause of death among women.

Dr. Lorena Di Giano, a representative of the Argentine Network of People Living with HIV/AIDS, said an ongoing campaign on sex education and prevention is needed in the schools.

If we fail to inform our children and adolescents, we are violating their rights, she declared.

Di Giano noted that while the anti-retroviral drugs needed to slow the progression of AIDS are widely available in Argentina, Brazil, Chile, Cuba, Mexico, Uruguay and Venezuela, coverage is not yet universal.

She said access is better in large cities than in small towns or villages, where people are also infected, but where municipal or provincial authorities are doing little to nothing in terms of prevention and treatment.

Di Giano also pointed to the need to raise awarenes in the business community. She said the problem was no longer so much fear of infection as a subtle form of discrimination arising from the fear that the antiretroviral treatment will reduce the productivity of employees and thus affect the bottom line.