GUATEMALA CITY – Four of every 10 people infected with the Human Immunodeficiency Virus (HIV) in Central America live in Guatemala, according to the Joint United Nations Program on HIV/AIDS (UNAIDS).
The Ministry for Public Health and Social Assistance (MSPAS) reported 30,871 cases from January through August 2013, 3,893 more than what was reported during all of 2012.
HIV is a blood-borne virus typically transmitted through sexual intercourse, shared intravenous drug paraphernalia and mother-to-child transmission, which can occur during the birth process or during breastfeeding. AIDS is caused by an advanced HIV infection, which ultimately destroys a person’s immune system, killing white bloods cells so the body’s immune system can’t fight infectious diseases, resulting in death.
The country’s most remarkable progress has been in the number of tests, as 77,000 were conducted last year, and it’s expected that 200,000 will be carried out in 2014, according to the MSPAS’ HIV/AIDS Program.
Additionally, anti-retroviral medication coverage reaches 65% of cases, compared to 56% in 2011.
Critical to this success are the 18 Integral Assistance Units (UAI), which carry out tests to detect the virus, dispense retroviral medications to infected persons and provide preventative information to the public nationwide.
“[These UAIs] allow us to attack HIV infection at an early stage, as well as to provide medications to more people,” said Dr. Ernesto Ponce, the coordinator of MSPAS’ HIV/AIDS Program.
Panama and Guatemala are the two Central American countries with the largest prevalence of infection. At 0.7%, both exceed the global average of 0.4%, according to UNAIDS.
Discrimination, an unresolved issue
However, stigma and discrimination toward HIV-positive people – as well as those people who are at greater risk of infection such as transgender women, sex workers and men who engage in sex with other men (MSM) – are the main challenges for the country.
“Transgender women and MSM [have the] greatest rate of infection – 23.8% and 8.9% respectively – and those are the groups we are mainly focusing on in our efforts to provide them with information and assistance,” Ponce said.
Efforts should be aimed at education, according to Patricia Rivera, the director of Hivos, an NGO in charge of administering the resources in Guatemala provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria.
“This environment of hostility and punishment does not help,” she said. “Society is not yet ready to assimilate sexual diversity.”
Guatemalan Demetria Monroy, 48, knows what Rivera is talking about.
Monroy has lived with HIV for 22 years. Her husband, who died 15 years ago, infected her.
Living with a virus that people don’t understand has led her to lose her job, her home and the respect of her family and of society.
“In 2006, in the place where I had worked for nine years, they fired me when they found out I was infected with HIV,” she said. “They didn’t compensate me and my neighbors burned down my house because I was infected.”
There were 576 reports of human rights violations of HIV-positive persons in 2012, according to the Third National Report on the Human Rights Situation for Persons with HIV and Populations at Highest Risk from the Human Rights Commission.
Of that total, 531 reports were made for violations to the rights of health, life, personal safety and freedom of discrimination. The remaining 45 reports targeted the person’s rights to transportation, confidentiality and education, among others.
“In the San Juan de Dios Hospital, I had a problem with one of the doctors, who stepped away from me saying ‘she’s got AIDS and she still thinks she can complain,’” Monroy said. “I’ve also had to fight with my children’s schools because they weren’t allowed to attend because of my illness.”
In February, the Ministry of Work and Social Welfare implemented an HIV internal work policy that mandates, among other measures, the training and education of personnel to avoid discrimination against persons with the virus.
“One of the greatest weaknesses of our health system is our own employees because they don't have the necessary training to better assist people who live with HIV,” Ponce said.
Additionally, business organizations, which include the Association of Independent Banana Producers and Sugar Producers of Guatemala, have HIV-specific workplace policies.
“The objective of these policies is to create awareness that the problem of HIV can be fought with respect and education,” Ponce added.
Both associations have joined the Hazte la Prueba (Get Tested) program, in addition to creating prevention education programs for their employees. More than 3,000 workers have been provided with training and testing so far.
For Monroy, it was only eight years ago that the Association for Prevention and Assistance for People with AIDS allowed her to work as a volunteer – the only place where she found empathy for her situation.
“Now, I support infected persons like myself, as I’ve learned that risky situations become safe through information and education,” she said.