InterPress News Service (IPS); January 10, 1997
Mario Osava

In response the government has intensified a prevention campaign which has as its centrepiece the distribution of by the Ministry of Health of 250 million condoms amongst the poorest sectors of the population. Information and prevention methods are being directed towards at-risk areas and sectors. Children and adolescents, street people and "garimpeiros" or informal miners are among those being targeted.

There is no accurate count of the number of carriers of Brazilians infected with HIV, the virus that causes AIDS (Acquired Immune Deficiency Syndrome). A study by the minsitry of health estimates that there are between 338,000 and 448,000 HIV carriers in Brazil. Up to December last year there were 94,997 confirmed cases. The others are either hidden or will take years to register on the official register.

When the full picture emerges, Brazil could be facing a bill of 3.6 billion dollars per year to cover the cost of treating AIDS. In the worst-case scenario of an uncontrolled epidemic, that amount could be 20 times as high within a decade.

Marcio Ruiz Schiavo, director of the non-governmental organistion (NGO) Comunicarte and representative of several other international NGOs specialising in population, health and communication, says AIDS is increasingly being spread among the poor who are exclusively reliant on the public health system.

Data from the Health Ministry indicated that up to 1984, 83 percent of sufferers were university graduates. By 1994 the picture had turned around: it was found that 69 percent had only finished primary school or were illiterate.

The "already marginalised" populations, who suffer "illnesses resulting from hunger and a lack of public hygiene," are also those who "are being infected with HIV more each day," said a document prepared for the National Congress for the Prevention of Sexually Transmitted Diseases and AIDS in December.

New medicines coming onto the market are expensive. The latest, most efficient "cocktail" costs between 1,000 and 1,200 dollars per month per patient, said Schiavo. And the law obliges the government to offer this combination of drugs to sufferers.

If an AIDS patient survives five years they could cost more than 60,000 dollars, but the greater efficiency of the medicine also increases chances of survival and, naturally, the cost.

But the most worrying feature is the increasing incidence of HIV amongst children, he said. The care for a child with HIV cost around 20,000 dollars per year and they have greater chances of survival.

A study by the Ministry of Health and the international NGO Global Orphans said Brazil currently has 183,000 "AIDS orphans" who are either already ill or have parents affected by the disease or killed by it.

The health ministry AIDS programme aims to tackle this with a manual for sex education and prevention for children aged four to 12. Some 1.4 million copies will be sent to schools, carrying comic strips for children under six years-old and information on AIDS, sex and injectable drugs for the older children.

Programme co-ordinator, Pedro Chequer, said the prevention campaign will be intesified in high-risk areas such as mines full of men looking for gold. The prositution which accompanies this high concentration of men is an explosive danger area.

A study carried out in the mining area of the Amazon showed 40 percent of the women used injectable drugs or had sexual relations with "garimpeiros" who inject.

The distribution of 250 million condoms this year is a step forward, as this is five times the amount distributed in previous years. However, the coverage is small, said Schiavo: he estimates there are between 980 million and 2.7 billion sexual acts in Brazil each year.

The current national production capacity is a bare 120 million, which means nearly two thirds will have to be imported, complicating quality control and suitable transport.

The main problem is how to get the condoms to where they are needed, he said. There is no experience of such widespread distribution and no strategy has been suggested. Prior study is needed to determine where to send these to guarantee the most effective coverage.

In an ideal situation, he said, the condoms "should be easily accessible" to people with promiscuous sexual behaviour. For instance, lorry-drivers could pick them up in petrol stations.

The sale of cigarettes, a universal phenomenon which reaches even the most remote corners of the country could be another possibility he concluded. (END/IPS/tra-so/mo/sm/fn97)

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