The Bay Area Reporter - May 19, 2000
Homer Hobi, Survive AIDS Writers Pool

According to UNAIDS at the end of 1999, an estimated 1.7 million people in Latin America and the Caribbean were infected with HIV/AIDS; of these, 30,000 were children. During 1999, there were 207,000 new HIV infections in the region. Cumulative adult and child AIDS deaths number 780,000.

Officially, Chile has a very minor HIV/AIDS problem given the population of the region. According to an article in the main newspaper of Chile (El Mercurio, March 14, 2000) there are only 15,000 people with HIV/AIDS in Chile in a population of 15 million. They have a similar epidemic profile as San Francisco in that approximately 85 percent of people with HIV are men who have sex with men.

But government statistics often are misleading. Discrimination towards people with AIDS runs rampant within Chilean society, and often skews statistics. If an employer discovers that someone is HIV-positive, often they are fired.

Because of anti-discrimination laws against this practice, the claimed reason for job termination is never HIV. I spoke to a host of PWAs who lost their jobs: three from the Carbineros (national police), a former executive at a British company, and others. They suddenly receive unfavorable job reviews, or some other reason pops up for their being fired. For the PWA it becomes more difficult to get a new job; they are required to get an HIV test and they now have an unfavorable report from their ex-employer.

Additionally Chile has a names-based reporting system. The only way to get an anonymous test is to know someone at a laboratory and pay for the test yourself. Given the high level of discrimination, people are very resistant to getting tested. The net effect is to increase the overall risk level of the population: if Chileans do not know that they have AIDS, they will behave as if they do not.

I felt a certain amount of d j vu in reading Bill Snow's April 13 Survive AIDS column in which he wrote about the barriers to Latino gay and bisexual men in having safe sex: "machismo, homophobia, family cohesion (close personal involvement with homophobic families), sexual silence, poverty." One PWA who invited me to his home to have lunch with his parents told me that they know about his HIV status but he had never told them he was gay. He is 49 years old and lives at home with his upper middle class parents. Another PWA, whose sister moved to the Bay Area with her lesbian partner to have a child, told me that about 80 percent of his gay friends think that it is a horrible idea for them to have a baby. The amount of self-hatred is enormous. Most gay men in Chile assume that their partner is of the same serostatus, which makes unsafe sex permissible. Condoms are only available in drugstores and they are expensive (they cost between 50 cents to $1 while the minimum wage is around $300 per month).

The resistance to getting tested means that people generally find out their status either through mandatory testing or when they are taken to the hospital with PCP. I spoke to a lot of people with HIV/AIDS and not one found out through voluntary testing. Most gay Chileans feel that it is better not to know. The concept of knowing as soon as possible because you can take actions before you become sick only exists in some forgotten recesses of collective gay Chile's memory. This puts people who are at risk in a situation of double jeopardy. For those in the private health system, once the insurance company receives a person's HIV diagnosis they begin procedures to terminate the PWA's policy. (Of course, not for having HIV).

Even though people feel that health care is better in the private system, coverage does not include HIV medications. The public health system, which cares for 80 percent of Chilean society, does have a small program of providing HIV medications. However, the waiting list can take up to two years. The program only covers some 750 people with bitherapy (two nucleoside inhibitors) and some 700 people with triple therapy (a protease inhibitor and two nucleosides). For the people who find out that they are positive by going to the hospital with PCP, their situation is of dire need. They are at a moment when they need medications but cannot get them. And if they have private health coverage, they usually lose that within a few months.

Unlike here, Chilean PWAs are constantly worried about how they are going to get their medications in the coming months.

Additionally, because of the high level of discrimination against gays in general and specifically against PWAs, very few people are willing to commit to any sort of activism. Because of this and the relatively small number of people with HIV, the government can afford to simply leave things as they are. Meanwhile PWAs die. During the whole trip felt like I was in a time warp, being transported back to the beginning of the epidemic here.

The AIDS Medicine Recycling of Positive Humanists & Friends is supplying medications to some 50 people in Chile. Although this is not a solution to the problem, it is lifesaving support for those who receive the medications. We are also trying to get the PWAs there to pressure the government to provide medications, through working with legislators, lawsuits, and street demonstrations. Until the government does its part, you can help by giving us your extra, unused medications. Call for details (415) 285-0606 or e-mail me at hobi@humanist.org.

For more information, check out the Positive Humanists & Friends-Aids Medicine Recycling Project report at www.humanist.org/~hobi or at wwwgeo.to/aidsrx.
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