HEALTH-BRAZIL: More Women with AIDS, Disinformation the Culprit

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Jun 20 2002 (IPS) - Ignorance about health issues and lack of information are a factors contributing to the rapidly rising infection rates of the human immunodeficiency virus (HIV, the precursor to AIDS) among women in Brazil.

Figures from the National Organisation of Sexually Transmitted Diseases and AIDS, a division of the Health Ministry, indicate that the ratio of infection has shifted from 5.8 men for each woman, in 1990, to two to one in 1999, the last year for which complete data are available.

Partial reports from the last two years show that this trend persists, nearing 1.8 men with HIV/AIDS for every woman with the disease.

Among young people ages 14 to 20, “men and women are already equal,” Katia Souto head of the AIDS prevention division at the Health Ministry, told IPS.

Young women are engaging in sexual activity at increasingly younger ages. In addition to the general fact of women’s greater vulnerability to the virus, there are specific problems, like inexperience and the fact that their male partners tend to be older and have engaged in prior relations, Souto said.

“It is very difficult for a 13- or 14-year-old girl to convince a young man who is three years older to use a condom, especially the first time.” Furthermore, at that age, that “feeling of magic” which young people often associate with the notion of sex can wipe out any worry about infection, she added.

The sharp rise in unplanned pregnancies among adolescents is evidence of the fact that teenagers are not using condoms, said the official.

However, the incidence of HIV/AIDS among adolescents is low in absolute as well as relative terms, as that age group represents just 2.2 percent of the 222,523 cases diagnosed in Brazil from 1980 to September 2001.

Official figures show that the epidemic began its decline in Brazil in 1999, when 20,395 new cases were recorded, 14.8 percent lower than the previous year. Women represented exactly one-third of that total, and 80 percent were infected with HIV through heterosexual relations.

The data underscore the growing “feminisation and ‘interiorisation'” of HIV/AIDS in Brazil.

The number of municipalities in which there are more women than men with the disease rose from 59 in 1995 to 159 last year, while in some small cities in the Brazilian interior, there are more than five women for every man with HIV/AIDS, according to the Health Ministry.

Faced with this reality, the authorities distributed more than four million female condoms since 1999 and have acquired another four million for distribution this year.

According to Souto, the female condom has been well received by the population, and this “complementary” form of protection encourages dialogue between couples to the woman’s benefit.

The extent of disinformation is “alarming” in the small towns of the interior, says Silvana Gomes dos Santos, an activist with the Interdisciplinary Association on AIDS in Londrina, a city in the southern state of Paraná.

“Many of the people living in poor districts are unaware that HIV leads to AIDS,” which is why some pregnant women do not take steps to prevent the transmission of the virus to the child, she said.

Gomes dos Santos, 39 and a former domestic employee, heads a project that provides information and guidance to low-income women about AIDS-related matters, and is part of the National Network of People Living with HIV/AIDS (RNP+).

Her efforts began in 1994 when she found out she was HIV positive. The year before, her 14-month-old son had died of pneumonia and other health problems. She had not realised that he had died as a result of that fact that she had infected him with the virus.

HIV can be transmitted from mother to baby during childbirth or through breast-feeding.

The chain of infection began with the activist’s husband, who had been an intravenous drug user before they married. He was already extremely debilitated when he was diagnosed with AIDS in November 1994, and died six months later.

“He was able to escape drugs, but not AIDS,” laments his widow.

Through some stroke of luck, the couple’s other son, now eight years old, was not infected with the virus in spite of the fact that Gomes dos Santos had breast-fed him as well.

The family’s ignorance was total. “I did not even know what AIDS was,” recalls the woman who is now dedicated to combating the ignorance that can prove fatal.

“Too many people still think it is a disease affecting ‘high risk groups’, like homosexuals, not married women,” she said.

In Londrina, a city of 500,000 people, there were just 150 known cases of HIV/AIDS in 1996, when the government launched its programme providing free antiretroviral medications to the patients.

Today there are 1,260 who are HIV-positive and 40 percent are women, most of whom were infected by their long-term partners, said the activist.

Gomes dos Santos said that she defends the human rights of the infected women, but also stresses their “duty” to disseminate information about the disease to the rest of the community.

Ana Paula Prado, a 32-year-old social worker in Brasilia, charges that women, in addition to more information, need better, fully integrated public health services.

Prado discovered that she was HIV-positive in 1997, when she underwent tests during a pregnancy in which the baby died at birth.

Prado’s child did not die from AIDS but was strangled by the umbilical cord after she was turned away by several hospitals when she sought assistance after labour pains began. The lack of medical attention was fatal.

She, too, was infected by her partner – in a stable five-year relationship – who was unaware that he carried the virus and did not know how he had become infected.

Because of her own situation, Prado defends access to frequent testing and ongoing educational campaigns to prevent infection among people who believe they are free of danger.

She also stresses that women with HIV/AIDS require special treatment because they suffer the secondary effects of the antiretroviral medications more than men do.

Prado is demanding better reproductive health services for women. She charges that there are doctors, particularly in northern Brazil, who sterilise women they find to have HIV/AIDS, violating their human rights.

She stresses that, despite the traumatic news she received in 1997, she wants to be a mother someday.