InterPress News Service (IPS); Thursday, 10 April 1997.
Dalia Acosta

Simple hallway conversations, evening get-togethers, glances on the street and other seemingly trivial moments are imbued with a soft, sensuous quality which is attributed to "tropical heat." A poll conducted in 1996 by an Italian magazine gave Cuba five stars for its "overall erotic climate," and declared the island a paradise for travellers in search of sensual pleasure.

The sexual freedom that many Cubans take for granted , however, can have its price - a rising incidence of sexually-transmitted diseases (STDs).

Earlier this month, Dr. Jorge Perez, director of the Cuban Institute for Tropical Medicine, confirmed the widespread risk of STDs at a meeting of representatives from more than 100 institutions comprising Cuba's National AIDS Prevention Program.

Perez said the number of cases of those testing positive for hhe HIV virus that led to AIDS reached 1,500 this month and 406 people had died of AIDS-related.

Sexual activity remained the chief cause of infection, he said, and only nine AIDS suffers had been infected by blood contamination - seven of them prior to the inception of a prevention program in 1986.

Officials at Cuba's Public Health Ministry revealed that 14,339 cases of syphilis were reported in 1995 and 45,000 cases of gonorrhea. These numbers translated to infection rates of 130.6 and 411.7 per 100,000 inhabitants in Cuba - a country of 11 million inhabitants.

Specialists say that people who have had sexually transmitted diseases like syphilis, gonorrhea, and condyloma have six times the likelihood of contracting AIDS as those who have never experienced these infections.

The World Health Organization (WHO) says that sexual contact is the cause of transmission in 76 percent of AIDS cases occurring in Central America and the Caribbean. A WHO document released last November reported that the AIDS pandemic wass growing at an accelerated pace in Latin America and the Caribbean, home to 450,500 of the 6.7 million adults suffering from AIDS throughout the world.

Authorities note that Cuba's 1,517 cases - including asymptomatic carriers - is insignificant alongside the number of cases reported elsewhere in Latin America: Brazil (82,852), Mexico (29,954), Argentina (8,505), and Colombia (6,811). Nevertheless, alarm over the increasing number of AIDS and STD infections has found its way into the Cuban press.

Jose Antonio de la Osa, a journalist who writes for Granma, the official organ of Cuba's Communist Party, says that "the only way to protect yourself is with a condom. However, if condoms are going to be used it is crucial that perception of risk be internalized."

The weekly publication of Cuba's Central Worker's Union, "Trabajadores," reports that the Cuban AIDS control program halted the advance of the epidemic, but also produced "a sense of security" among the populace.

Cuban control efforts have included a in-house sanatorium care for all seropositive people through 1994, the year in which ambulatory care was approved as a method of health care delivery. Until now ambulatory care has been chosen by 254 carriers of the HIV virus.

Long considered one of the most debatable aspects of Cuba's AIDS control program, sanitorium treatment successfully controlled the spread of the disease during that period when great uncertainty prevailed over the characteristics of the virus and its transmission pathways.

Similarly, sanitorium treatment guaranteed that carriers - and people with full blown AIDS - received proper nourishment and care needed to improve their quality of life. As a result, Cuba extended the period of asymptomatic survival to an average of 10 years.

Besides creating the AIDS/HIV sanitorium in the mid 1980s, Cuban authorities discarded all blood stocks, simultaneously ordering AIDS testing for all blood donors regardless of cost.

More than 16 million free blood tests have been administered in Cuba since the program's inception. These tests are given to all pregnant women and to certain categories of health care professionals. Health experts, in conjunction with social scientists and seropositive individuals, issued an alert two years ago stating that Cuba's success in AIDS prevention might soon be undermined if sexual behavior patterns are not changed.

In spite of frequent television announcements, the word "condom" is still taboo in large sectors of the Cuban population which identify condom use with "infidelity and lack of confidence" between two people who love one another, even when love lasts but a single night.

Last year, a study was conducted in Cuba which showed that 31.9 percent of single and married people had non-committed sexual relationships in the 12 months prior to interviewing, and that only one-fifth of them used condoms.

Another study by the Public Health Ministry, sponsored by the United Nations Population Fund, revealed that while 81.2 percent of the Cuban women admitted knowing what a condom is, only 9.2 percent had ever used one. For the moment, health officials have decided to focus attention on sexual education projects and on strengthening efforts to encourage "safe sex" practices.

Among Cuba's many AIDS-related challenges is the need to obtain sufficient financing to acquire a 120 million condoms annually. This is the number or condoms that will be needed to satisfy demand if the condom utilization campaign is successful.

Health officials emphasize the need to discard terms such as "risk groups," and to begin a more vigorous discussion of risk behaviors among those who are sexually active. (END/IPS/da/aa/mk/97)

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