Finetuning the Fight Against AIDS in Cuba

HAVANA, Jun 18 2012 (IPS) – New attitudes are emerging among Cubans toward the AIDS epidemic, as HIV-positive people who are aware of its causes seek other ways to reduce infection rates in the country.

“People are not internalising the perception of risk, even when they know that their sexual partners might be infected. People are having sex without protection, because they don’t care if they get infected,” said Jorge Brito, one of more than 300 members of the AIDS Prevention Group (GPsida) in Cuba.

This network of HIV-positive and negative voluntary health advocates has been working for the past two decades to promote safe practices for curbing the spread of HIV and helping improve the quality of life for HIV-positive people, backing up the work of government health agencies.
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According to the most recent figures available, about 14,000 HIV cases had been recorded in this country of 11.2 million people as of 2010.

“Fear of HIV/AIDS has been lost,” said Brito, who coordinates GPsida in the Havana municipality of Arroyo Naranjo, one of the network’s 16 points. “Ongoing work is needed to increase the perception of risk.”

“Living with HIV is difficult, despite the fact that there is medication now,” he told IPS.

The discovery of antiretroviral therapy turned HIV/AIDS into a chronic illness in many cases. Those who receive the treatment and follow medical advice, such as maintaining a healthy diet, can live for many years. In Cuba, the government covers 97 percent of the treatment free of cost in the country’s 16 provinces.

“One of the reasons (for unprotected sex) is the idea of ‘what do I care if I get infected, if medicine exists to keep me alive for many years!’” Echeverría said. Over the past decade, an increased number of cases of infection from contact with people known to be HIV-positive have been detected worldwide.

In Cuba, more specific studies are needed to learn about what proportion of cases fall into that category, and whether or not they are “intentional” or “non-intentional,” according to experts Angela Gala and Yasel M. Santiesteban, of the state-run Pedro Kouri Institute for Tropical Medicine.

The former refers to cases “where the express desire to be infected is demonstrated,” while the latter involves those “where no desire to be infected is demonstrated in sexual relations with a person who is known to be living with HIV,” the scientists said during the GPsida’s 9th National Scientific Event.

Every year the network organises a conference for its members with the goal of learning about “what is being done in the country, communities, research centres and universities.” The most recent conference was held Jun. 6-8 at the Centre for Comprehensive Services for People with HIV/AIDS in Havana.

Opinions of HIV-positive Cubans regarding forms of infection were brought to the conference by the two experts after being collected in discussion groups. After presenting the views of participants from Holguín, Santiago de Cuba, Camagüey and the capital, Gala and Santiesteban advocated new approaches to analysing risks of infection.

“This epidemic could be slipping out of our hands because of certain elements, and if we don’t take them into account and don’t investigate, we’re not going to beat this disease,” Santiesteban warned about the pandemic, which at the close of 2011 affected 34 million people on the planet, according to the World Health Organisation.

A sampling of about 3,000 outpatients was surveyed as part of the study “Survey of People with HIV/AIDS, 2009: A Tool for Action”, which looked into different causes of infection.

The study asked people in what circumstances they were infected with HIV, and 0.5 percent of those surveyed said they “wanted to be infected.”

Meanwhile, 15.8 percent said they did not believe there was a chance they would be infected, and 13.2 percent said “fate had played them a bad turn.”

The study, published in 2011 by the National Office of Statistics and Information, found that the leading risk factor was “not using a condom during sexual relations.” For that reason, educating people about safe sex continues to be one of GPsida’s main objectives.

This Caribbean island nation has an infection rate of just 0.18 percent in the 15-49 age group, described as “exceptionally low” by the joint United Nations Programme on HIV/AIDS.

That situation actually makes it more difficult to make significant progress in terms of prevention, experts say. Carlos Aragonés, who founded GPsida in 1991 and is its national coordinator, explained to IPS that “very personalised work needs to be done” to be able to reduce the number of new cases annually.

“The first thing we want is to understand why people continue to be infected,” said Aragonés, who is also a computer engineer. He said that the network’s annual conference is “more of a necessity than a choice. It is a place for seeing whether or not our strategies are appropriate or whether we need to change them,” he said.

Some of the main challenges for the project include supporting patients in adherence to antiretroviral therapy. This “increases life expectancy and reduces the real possibility of HIV transmission. That is why it is so important,” he said.