AIDS No Longer Taboo in Latin America

PORT-AU-PRINCE, Haiti (AP)—Standing beneath a towering crucifix, the Rev. Andre Pierre thundered at the faithful crowded elbow-to-elbow in the Sacred Heart Church to show mercy for the poor and the elderly.

Then he did something that until recently would have been close to heresy: He urged his flock to pray for people with AIDS.

"Today, we stand in solidarity with them,'' Pierre intoned, lighting a candle in remembrance of AIDS victims and passing it through the crowd, which spilled onto the church steps.

Such sentiment was virtually unheard of a few years ago in socially conservative Latin American and Caribbean countries, where open debate about sex is rare and many still consider AIDS a punishment for deviant behavior.

But 25 years after the pandemic began, a new spirit of openness is emerging, spurred by education and by a growing awareness that AIDS touches every sector of society. While discrimination persists, the stigma of HIV is diminishing as more people contract the disease.

Haiti's AIDS rate is the highest in the Western Hemisphere. The Caribbean HIV rate is second only to that of sub-Saharan Africa, and the virus is now the main killer of adults under 50.

Throughout Latin America and the Caribbean, the number of new HIV infections increased from 200,000 in 2003 to 230,000 in 2005, U.N. officials say. Most of the new patients were between 15 and 24, and health officials worry that awareness campaigns may not be reaching youths who are becoming sexually active earlier.

"Eighty to 90 percent of new infections are contracted sexually, so this clearly indicates we need to do something to reduce risky behavior,'' said Dr. Rafael Mazin, Western Hemisphere adviser on HIV/AIDS for the Pan-American Health Organization.

He said young people were most at risk.

"They were not in contact with the ravages of the AIDS epidemic in the early days. They are becoming sexually active but without the awareness of the ... severity of the scourge,'' he said.

Even so, many officials say frank talk from Barbados to Brazil is a plus.

"Now people are willing to talk about AIDS. ... It's a radical change,'' said Dr. Eddy Genece, director of POZ, a Haitian group that lobbies church leaders to discuss AIDS with their followers. "The stigma is still there, but it's less strong.''

In Brazil, where more than a third of Latin America's 1.8 million HIV-positive people live, officials credit an aggressive prevention campaign with limiting the cases to fewer than half the number the World Bank estimated Brazil would have by 2000.

The campaign has been helped by widespread discussions about the virus—and by the Roman Catholic church's low-key approach to its opposition to condom use.

"One of the things that's really helped is that the Catholic Church hasn't come out aggressively against condom use,'' said Paulo Teixeira, a former director of Brazil's anti-AIDS program. "In some cases, they've even supported it quietly,'' despite the church's birth control prohibition.

While Haiti's HIV rate remains the highest in the Americas, it has fallen from 9 percent of the population in 1993 to about 4 percent today—a drop health workers credit to greater awareness and the aggressive promotion of condoms.

POZ officials said informal surveys indicate that the overwhelming majority of Haitians would care for a friend or relative with AIDS, while just a few years ago few said they would.

But the tolerance hasn't caught on everywhere. In Ecuador, which has a relatively low HIV rate, students and workers often must submit to HIV tests despite a 2000 law to crack down on AIDS discrimination, said Xavier Alvarado of the Kimirina Foundation, an AIDS research center in Quito.

Meanwhile, in Haiti's state-run hospitals, many patients lie on the floor for lack of beds. Doctors still regularly turn away people with AIDS, said Jean Sorel Beajour, head of Haiti's National Association for Solidarity with People with AIDS.

"For someone living with AIDS in Haiti, it's still a very degrading existence,'' said Beajour, a gay man who has HIV and was denied treatment for a cut three years ago.

He said the stigma will continue as long as the virus is associated with immorality.

"It's not just one group that is affected by AIDS,'' he said. "It's all of us.''

Associated Press correspondents Michael Astor in Sao Paulo, Brazil, and Jeanneth Valdivieso in Quito, Ecuador, contributed to this report.