Alberto Mendoza
GUATEMALA CITY, Jun 23 2006 (IPS) – Discrimination by society and employers against Guatemalans living with HIV/AIDS is deeply entrenched, say local and international non-governmental organisations (NGOs), which note that they are often deprived of their basic rights to work, education and health.
Upon the mere suspicion that a person may be HIV-positive they are dismissed or demoted, or their contract is not renewed, and their rights to health care and to education for their children are denied, said Cristina Calderón of the Fernando Iturbide Foundation, an NGO working in AIDS prevention.
Some companies force their employees to undergo HIV testing, or the company has the test done without the worker s permission, Claudia Arelí Rosales of Positive People, an NGO that defends the rights of people living with HIV/AIDS, told IPS.
A United Nations report this year estimated that in 2005 some 61,000 people in this impoverished Central American country of 14.7 million were living with HIV, 6,000 more than in 2003. But as many as 100,000 could actually be infected, according to the report s more pessimistic projections.
According to the government, the rise in numbers is due to more cases being detected because of the increase in health services offering the HIV test, Karina Arriaza, coordinator of the Health Ministry s HIV Prevention and Control Programme, told IPS.
Arriaza denied that the epidemic is out of control and said that it largely remains concentrated in high-risk groups like male and female sex workers and gay men.
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In contrast, Rosales termed the increase in HIV cases a chronicle of a death foretold, and said it was a consequence of the lack of political will to enforce the law that requires schools to teach information about AIDS from the fifth grade of primary education (or age 11) onwards.
Young people and teachers are the main targets of a campaign for More Rights, Less Discrimination, funded by the British NGO Plan International and supported by the Guatemalan organisations Positive People and New People.
The programme, which was launched this month and will continue for three years, focuses on training some 1,000 teachers and raising the awareness of 32,000 primary school children, in addition to 30,000 young people aged 10 to 18 who are outside the formal education system.
However, the campaign will be carried out in only three of the 22 departments (provinces) of Guatemala, namely 178 communities in Escuintla, Santa Rosa and Izabal, in the south, southeast and east of the country, respectively.
Calderón, of the Fernando Iturbide Foundation, deplored the fact that the campaign would not be using radio, a means of communication that could span the entire country, to transmit its message in the different indigenous languages so as to reach every community.
The rising incidence of HIV/AIDS could be reversed, as the international community proposed in the Millennium Development Goals (MDGs) adopted in the year 2000.
The Health Ministry hopes that patients will comply with their antiretroviral treatments, Arriaza said. Another hope for reversing the course of the epidemic is bringing about more responsible sexual behaviour that is to say, abstinence, mutual fidelity, and always using a condom correctly, she added.
AIDS information campaigns in Guatemala are frequently controversial, owing to the opposition of the powerful Catholic and evangelical churches.
Government-sponsored prevention strategies, in fact, recommend abstinence and fidelity first, and promote the use of condoms as a secondary measure.
A health minister will never come out in public and openly recommend condoms, Calderón said.
Antiretroviral treatment for AIDS patients is free in Guatemala, whether from not-for-profit organisations like Positive People, New People, Doctors Without Borders and the Global Fund to Fight AIDS, Tuberculosis and Malaria, or provided by the Guatemalan Social Security Institute (IGSS) to its affiliates. However, IGSS patients often complain about the drugs not always being available.
But not all Guatemalans can afford an HIV test. Ilda Quiej, head of mission in this country for Doctors Without Borders, explained that it s not so easy to get testedàit costs between 60 and 120 quetzals (8 to 16 dollars).
According to the Health Ministry, 3,699 adults and 620 children are being treated for AIDS in the capital and in the departments of Izabal, on the Caribbean coast, and Quetzaltenango, near the Pacific.
The Global Fund to Fight AIDS, which for the past two years has run a programme to curb morbidity and mortality from the disease in Guatemala, has announced funding which will provide comprehensive treatment for 7,525 people by 2009, when the plan will end.
At that point, those people must enter the national health system, because once the treatment has started it can t be dropped, said Rosales, who is concerned that the state may not be able to absorb all of the patients from the programme.
According to Calderón, 8,000 people are in urgent need of treatment, and half of them may die without it. She also criticised the lack of follow-up of the patients, and the failure to test pregnant women for HIV in order to avoid vertical transmission, from mother to baby.
While some NGOs rely on education by means of prevention campaigns, others resort to legal action. The Fernando Iturbide Foundation, for instance, has brought a suit before the Inter-American Commission on Human Rights alleging discrimination by failure to provide universal AIDS treatment in Guatemala, and the absence of political will on the part of the government. Members of the Commission will arrive in Guatemala to investigate on Jul. 20.