December 17, 2017

experts blame religious opposition to sex education, perception that aids is problem of the past

Wednesday, August 13, 2014

Despite campaigns, HIV infections on rise in Brazil

By Adriana Gómez Licón
SAO PAULO — The devastating news didn’t make sense to Brazilian Pierre Freitaz. How was it possible that, at age 17, he was infected with HIV if his only boyfriend seemed fit and healthy?

Freitaz admits he knew little about the virus when he was diagnosed in 2004. He didn’t understand the difference between the infection and the disease it caused: AIDS. He was confused by the lack of obvious symptoms.

“It’s like I was living in a different part of the world, and I felt immune.”

While Brazil has long been seen as a global model in the fight against AIDS, activists say more and more youths share Freitaz’s unawareness of HIV risks, or are unconcerned about them. Even as HIV infection rates have begun declining in many other places, cases have been slowly rising in Brazil — with the sharpest jump among youths 15 to 24.

“The numbers are going up. It’s a paradox, a shame. After all the money spent on treatment and implementing a policy for everyone to receive it, we have these disastrous results,” said Dr. Caio Rosenthal, a Sao Paulo-based specialist at the Emilio Ribas Institute of Infectious Diseases.

UN statistics show 44,000 new infections detected last year in Brazil, up from fewer than 40,000 in 2005 — a rate outpacing population growth. The national Health Ministry says overall numbers of HIV infections has reached nearly 800,000. That’s half of all the HIV cases in all of Latin America.

By comparison, in the United States, the rate of new HIV cases has dropped by a third over the past decade, according to a study published last month in the Journal of the American Medical Association.

When the global AIDS epidemic erupted in the 1980s, officials here reacted quickly. Brazil carried out widespread sex-education campaigns and became the first developing nation to offer free antiretroviral treatment on a large scale. The pace of deaths fell and mother-to-child transmission was cut sharply.

Officials say the persistent rise in cases could be partly the result of better systems for tracking the virus. Others blame religious opposition to sex-education campaigns, or say some youths mistakenly believe that progress in treating AIDS means it’s a problem of the past.

Brazil’s dominant Catholic church frowns on the use of condoms, but the chief resistance to sex education campaigns has come from evangelical Christians, whose share of Brazil’s population has jumped from five percent to 22 percent between 1970 and 2010, making them an increasingly influential political force.

Dr. Dirceu Greco, the former head of the Department of Sexually Transmitted Diseases, AIDS and Viral Hepatitis at the Health Ministry, said opposition by evangelical leaders “caused notorious backtracking” in AIDS policy. Another former leader of the programme, Dr. Pedro Chequer, complained that the restrictions have hurt campaigns targeting vulnerable populations such as gays and sex workers.

In the past two years, for example, the federal government ordered schools to stop handing out comic books and other materials aimed at youth with stories encouraging the use of condoms to prevent HIV and teenage pregnancies.

Activists also complain the government scrapped the airing of pro-condom TV ads showing gay men hooking up at a nightclub while discussing safe sex. Health officials insist the ads were never intended for major television networks, but rather niche audiences.

The Health Ministry’s current top AIDS official, Fabio Mesquita, said nationwide, prime-time TV campaigns are a thing of the past because his team is studying ways to target younger, more vulnerable populations through the Internet and smartphones.

He placed much of the blame for rising infections on misplaced confidence among younger people who didn’t experience the disease’s most-deadly era.

The government says spending on education and prevention is rising, but Mesquita said the fight against HIV must expand beyond safe-sex education: “We have to stop thinking of condoms as the only alternative to prevent the infection.”

He said one path is an expanded programme to give retroviral drugs to all infected patients, even if there are not yet signs that the virus has weakened their bodies’ defence systems. Studies have suggested that HIV positive people who start taking medicines at that early stage are 96 percent less likely to infect others.

Brazil is studying another measure, pre-exposure prophylaxis, which involves a daily pill meant to protect those who are not infected. The US government issued guidelines in May for using that process.


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