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WORLD AIDS DAY-CUBA: Volunteers on the Front Line of Prevention

Patricia Grogg

HAVANA, Nov 28 2007 (IPS) - While scientists devote their best efforts to developing an AIDS vaccine, prevention continues to be the most effective way of containing the pandemic which has already caused the deaths of 2.1 million people this year, and new infections in another 2.5 million people.

"The world is doing its best to find an antidote, but the results of this work will clearly not be a short term solution, so prevention remains the only way to avoid infection with HIV," María Isela Lantero, head of the Public Health Ministry’s National Programme for HIV/AIDS Control and Prevention, told IPS.

Lantero reported that as of October, there were 7,379 people living with HIV in Cuba, of whom 5,524 were asymptomatic and 1,855 suffered from full-blown AIDS, the end-stage of the infection which severely damages the immune system.

She also reported that 81 percent of the HIV-positive group were men, of whom 86 percent were homosexual or bisexual, and the rest heterosexual. Lantero added that Cuba is one of the countries with the lowest prevalence rates of HIV/AIDS, at less than 0.1 percent of the population.

But official figures indicate an increase compared to 2006, when there were 6,541 HIV-positive people at year end. Other experts said that the low figures were not to be entirely trusted, because "the epidemic tends to spread a lot faster than the information."

As part of the Public Health Ministry’s strategy of prevention and control, and in particular of the World Health Organisation (WHO)’s "Take the Test" campaign, 341,821 HIV tests have been performed since June, in an active search for new cases, Lantero said.

This confidential testing is carried out with the support and participation of the community, especially of campaign volunteers, whose work is regarded as essential for HIV/AIDS prevention. In Cuba, World AIDS Day on Saturday, Dec. 1 will be dedicated to these volunteers.

"We promote the use of condoms in any sexual relationship as a basic prevention measure to halt the epidemic, but this must be accompanied by a great deal of information, which is where the volunteers have a key role," Lantero said.

AIDS campaign volunteers devote part of their spare time to different projects aimed at preventing the spread of HIV. They are motivated by simple solidarity, experience of personal risk, or the effects of the epidemic on friends or relatives.

"I used to look upon this voluntary humanitarian work as having nothing at all to do with me, until my best friend told me he was HIV-positive. My immediate reaction was to distance myself from him, because I was ignorant, but I changed my mind and got closer to him again. He’s no longer with us, but I’m here for both of us," said Joel Vega.

His experience had such a profound effect on him that now he is studying psychology at the university, and for the past six years he has worked as a volunteer at the National Centre for Prevention of Sexually Transmitted Infections-HIV/AIDS. At present he is the coordinator of Counselling Services for the northwestern Havana municipality of Playa.

"At the counselling service you see and hear all sorts of things. It’s a demanding job. We offer support and advice, but the most important thing is that people who come in for counselling should leave with the will to go on living. As a human being, I find it very satisfying to be able to help others," said Vega, 27.

In his view, volunteers are a key factor in HIV/AIDS prevention, involving information, dissemination, education and transmission of experiences. "The message has to reach every sexually active person, because no one is exempt from danger. Unfortunately, most people look upon HIV as something that will never touch their lives," he said.

Vega said he regards condom use, fidelity and abstinence as the three tools available at present to prevent infection. "Before, young people hardly ever used condoms, but now they do. A programme of social marketing of condoms ensures that they are always available," he said.

Ricardo Olbera, 35, a theatre actor, has been a volunteer for five years. He says that he is "doing his bit, because something has to be done to stop this epidemic." Equipped only with a video camera, he is making a documentary called "Angel, 1, 2, 3", in honour of the volunteer corps.

"HIV-positive people and AIDS patients are always the topic of conversation, but no one talks about the volunteers, who often do their work quietly, with great self-sacrifice, and all for free. It’s an angle that hasn’t been explored audiovisually. I think of them as angels, hence the title of the film, which includes three personal accounts," he said.

Olbera agrees with Vega that the most vulnerable sector of the population is men who have sex with men. "There’s a strong taboo in our country against homosexuals. We have made videos about them but they have never been shown on television, and society has a great need for information," he said.

"There’s a big job to be done and much more openness is needed, because there are still prejudices and taboos to be overcome," said Vega.

United Nations experts say that, while treatment is also important, prevention is a key strategy to combat the spread of HIV/AIDS.

"Globally, for every person who starts taking antiretroviral treatment today, another five to six become infected. We will never get anywhere near the goal of universal access to HIV prevention, treatment, care and support, if this pattern continues," said Peter Piot, the executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

"This highlights the need for a new approach to HIV prevention. An approach that brings hidden epidemics out of the shadows by tackling issues like homophobia," said Piot in the opening speech at the Fifth Central American Congress on STI, HIV and AIDS (CONCASIDA 2007), on Nov. 6 in Managua, Nicaragua.

"Today, more than 2.5 million people in developing countries are taking anti-retroviral treatment – up from 100,000 in 2001," Piot added.

In Cuba, 3,040 people are receiving free antiretroviral therapy, according to the head of the National Programme for HIV/AIDS Control and Prevention, at a meeting in preparation for World AIDS Day.

World AIDS Day has been held annually since 1988 with the goal of motivating governments, communities, other social sectors and individuals to talk about the HIV/AIDS pandemic.