By Dalia Acosta
HAVANA, Apr 30 1999 (IPS)

AIDS prevention campaigns in Cuba are doomed to fail unless they begin to take cultural elements into account, according to experts from 14 countries of Central America and the Caribbean meeting this week in Havana.

Studies conducted in Cuba, Jamaica and the Dominican Republic demonstrated that in order to be effective, all AIDS prevention actions must consider customs, traditions and beliefs particular to each social group, beyond the basic medically-oriented messages.

This week’s Subregional Workshop on AIDS Prevention and Treatment was held simultaneously with similar conferences in Africa and south Asia as part of a global project sponsored by the United Nations Educational, Scientific and Cultural Organisation (UNESCO) and joint UN Programme on HIV/AIDS (UNAIDS).

We must “educate, without preconceived ideas,” said UNESCO representative Salomon Kailu.

Kailu stressed that “the window of hope” lies in today’s five to 14-year-olds, who can still be educated to have safe and responsible sex as adults.

The UNESCO/UNAIDS project is seeking ways to involve international institutions, national authorities and civil society in each country in culturally-sensitive action plans against AIDS.

A culturally-appropriate focus and the mobilisation of the local population’s social and cultural resources were described as “indispensable prerequisites” for reducing the risks of contagion and bringing the AIDS epidemic under control, according to a report by UNESCO’s Regional Cultural Office for Latin America and the Caribbean.

Communication experts pointed out at the conference that prevention efforts in a Haitian shantytown, an African village or Mexico City must differ in essential aspects, even while based on the same central messages.

“How can we explain that someone who knows about AIDS, how it is transmitted and how a condom can help fails to protect him or herself during sexual relations?” asked Maria Gatorno, director of a cultural centre in Havana.

Gatorno, who spearheads an AIDS prevention project among young rock ‘n roll fans, told IPS that “the messages must attempt to break down the stereotype that condoms and pleasure are mutually exclusive.

“If I come to talk to rock ‘n roll fans about AIDS in the same style used on TV, they laugh at me, because that is simply not their language,” she stressed.

Cuba is one of the countries with the lowest HIV/AIDS rates in the world – 19.5 HIV-carriers per million inhabitants – but research indicates that Cubans “prefer to run the risk of contagion, rather than negotiating the use of a condom.”

A study carried out in three provinces of Cuba among youths aged 15 to 24 without stable relationships, who did not use condoms, found that all of the respondents knew how the AIDS- causing human immunodeficiency virus (HIV) spread, and how to avoid contagion.

That is not the case elsewhere in the Caribbean, however, where studies have found continuing ignorance with respect to HIV transmission and the possibility of avoiding contagion by using condoms during sexual relations.

UNAIDS figures indicate that some 33 million people are currently living with HIV and AIDS worldwide, more than 90 percent of whom reside in developing countries. Around 14 million people in the world have died of AIDS.

Sources with the Caribbean Epidemiology Centre (CAREC) say the region’s incidence of AIDS is the second highest in the world, after sub-Saharan Africa, where 7.4 percent of 15 to 49-year-olds are infected.

Two-thirds of all HIV-carriers are estimated to live in sub- Saharan Africa, along with 90 percent of HIV-positive nursing infants.

The number of AIDS cases registered annually has risen in the English-speaking Caribbean, where two percent of people aged 15 to 50 are living with HIV or AIDS, according to CAREC.

The organisation reported that in Antigua and Barbuda, population 64,000, three of every 100 local residents tested positive for HIV.

The National Aids Programme in Belize, meanwhile, estimated that more than 2,000 people in the country of 217,000 tested positive for HIV last year.

In Jamaica, population 2.5 million, authorities have reported more than 3,000 cases and nearly 2,000 AIDS-related deaths.

The preliminary conclusions of the UNESCO/UNAIDS project are that the spread of the AIDS epidemic is inextricably linked to problems of development in poor countries, and their complex interaction with local cultural aspects and the crisis of value systems.

The UNESCO Regional Cultural Office report states that among the factors hindering the fight against AIDS are economic, cultural and health inequities, lack of public policies, sexual tourism, extreme poverty and low levels of social development.

Other elements mentioned are rural migration, the urban demographic explosion, the negative socioeconomic impact of AIDS, conservative cultural traditions, certain fatalistic religious beliefs and a lack of social solidarity.

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