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AIDS-GUATEMALA Nov-24-2008 (960 words) With photo. xxxi
As more Guatemalans get AIDS, church, health officials fear epidemic
By Ezra Fieser
Catholic News Service
GUATEMALA CITY (CNS) -- For two decades, AIDS lingered among the forgotten members of Guatemalan society -- prostitutes working in seedy red-light districts and gay men. But now the disease is spreading among the general population, and health and church officials fear an ill-prepared country will soon face an epidemic.
Compared to other countries, Guatemala's AIDS problem looks mild. The United Nations counts 40 million people worldwide living with HIV or AIDS and more than 20 million who have been killed by it. In some sub-Saharan African countries, 8 percent or more of the adult population is infected.
In Guatemala, where less than 1 percent of adults are living with the disease, officials say the country faces a critical moment: It can tackle the problem or watch rates and deaths climb.
"The government does not have the interest even in knowing how many people have the disease, let alone investing the money that it needs to treat the problem," said Jose Jimenez, a member of the church's subcommission on HIV and AIDS.
Because of limited testing, the Guatemalan government has registered just more than 10,000 people living with the disease. The U.N. estimates the real number is closer to 61,000 and growing.
"We are very, very close to a generalized epidemic," said Maria Tallarico, the Joint U.N. Program on HIV/AIDS director for Guatemala. "And when that happens, you need to invest 10 times more. This government can't do it, so it puts more pressure on organizations" like the Catholic Church.
AIDS first appeared in Guatemala -- and most other countries -- in the mid-1980s. It has since spread principally in the areas near the main highways, which run from the Mexican border though Guatemala City to the Caribbean coast, Honduras and El Salvador. Truckers, migrants making their way north and thousands of prostitutes share the heavily traveled routes.
The corridor is also the target of most of the AIDS prevention work.
"If we could control the rates in those high-risk areas, we'd be able to contain most of the problem," Tallarico said.
Programs in sex education, sparsely available through the government, are key to addressing the problem, Tallarico said.
The church has responded to the dearth of programs by launching "Education for Love," a guide for parents and schools to teach children and adolescents about sex. The program was announced late last year as a scientific approach to teaching young people about sexuality. The Guatemalan bishops' conference expects to launch the program in schools next year.
But changing habits is difficult in a country where even prostitution is socially accepted.
Paola Ramirez, a Nicaraguan who has worked for three years as a prostitute in Guatemala, said she knows condom use can help prevent the spread of HIV, but she is afraid to turn down a potential client who does not want to use a condom.
"If I don't do it, then he's going to go to the next girl. And I'll have a bad reputation and lose money," she said.
In a country where prostitution is permitted but not legally recognized, Ramirez's story is not unusual. She turned to prostitution in a moment of financial desperation -- her two children were hungry. She had no food in the house and no husband to help pay the bills. Three years later, she's made plenty of money, but says life is worse than ever.
"I'm ashamed of what I do. My kids think I work in a factory," she said, standing in front of her one-room brothel in a dusty prostitution district set alongside defunct train tracks in downtown Guatemala City. "The worst thing is the fear, though. I come here every day and wonder if today will be the day that I get AIDS."
Her fear is understandable. An estimated 4 percent of Guatemalan prostitutes are HIV-positive.
"It's scary. I've had friends die," she said.
Infection rates are an estimated 10 percent among men who have sex with other men -- many of whom do not identify themselves as gay and are, in fact, married.
Health officials fear that men who have sex with prostitutes and other men carry the disease back to their wives and other women in the general population.
Within seven years, the U.N. estimates 125,000 Guatemalans will have HIV. Such growth will strain services dedicated to people living with the disease, health officials say.
The government's investment in social services is one of the lowest in Latin America, according to the U.N., and only a small percentage of that money goes to fighting HIV/AIDS. The church has stepped in with myriad projects, including funding orphanages for children, clinics and testing facilities.
"My fear is that if the number of people with HIV and AIDS keeps growing, there will be no way to treat them all. We won't have the ability to contain the disease," said Jimenez, who also founded the National Alliance for People Living With HIV or AIDS in Guatemala.
The church funds one of the country's few hospices. Located just outside of Guatemala City, Hospicio San Jose provides a home for 50 children living with HIV and offers treatment for adults.
Farther west in Coatepeque, where HIV rates are high, Maryknoll Sisters Delia Smith and Marlene Condon began Proyecto Vida, or Project Life, in 1997. The program provides testing, counseling and educational programs, and staffers visit homes in rural Guatemala, where government services are sparse.
Proyecto Vida's growth mirrors the increase in AIDS cases throughout the country. In 1997, it served 7 people in a one-room clinic. Since then, it has treated more than 1,000 people for HIV, AIDS and related diseases.
"The growth in demand for our services has been steady," Sister Smith said. "But recently it has really grown. We're trying to keep up with it."
END
Copyright (c) 2008 Catholic News Service/USCCB. All rights reserved.
This material may not be published, broadcast, rewritten or otherwise distributed.
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