Miami Herald; Sunday, November 10, 1991
Elinor Burkett, Herald Staff Writer

Five girls -- all Havana high school seniors -- take a study break and gossip about sex.

"I don't worry about AIDS," says one. "Everyone with the virus is locked up in the sanatorium."

The attitude is typical.

"People outside feel too safe," Raul Llanos worries.

He and Juan Carlos de la Concepcion run their own personal crusade -- for the use of condoms. Both are HIV positive. They are Cuba's only AIDS activists.

"What will hurt Cuban grandmothers more?" de la Concepcion asks on the radio. "Frank talk to their granddaughters about condoms -- or the death of their granddaughters because we didn't talk about condoms?"

Says Dr. Jorge Perez, "We can't wed ourselves to condoms to stop the spread of AIDS. People lose them or forget to put them on. They break. They are forgotten. It makes people feel too safe. Even with condoms, they aren't totally safe."

The argument is irrelevant. Requests at 17 Havana pharmacies recently failed to turn up any for sale.

* CASTRO SILENT ON ISSUE

Fidel Castro, an incessant orator, hardly ever talks about AIDS -- or Cuba's AIDS sanatoriums. Never once has he made a speech about it.

But during a trip to Brazil last year, he mentioned AIDS casually, as an aside almost.

"As you know, I greet and embrace many people everywhere I go. Perhaps, if someone has an injury and if there is contact between my blood and somebody else's blood . . . even that could happen."

According to the U.S. Centers for Disease Control, no one has ever contracted the AIDS virus by greeting or embracing.

* A SECURITY BLANKET

Outside the sanatorium, Cuba is a land of peeling paint and long lines.

Inside the sanatorium, Cuba is a small town of well-kept houses, manicured lawns and tranquillity.

Marialena Riego and her husband, Chupa, both HIV infected, prefer life inside. Although Dr. Jorge Perez, the administrator, offered them the chance to go home, they refused.

Los Cocos is their security blanket.

Inside, they're served a high-protein and high-fat diet, 5,400 calories per day. All AIDS drugs -- AZT, DDI, gancyclovir -- are readily accessible. So, too, are non-Western medications, acupuncture, Chinese herbs.

Physicians notice -- and treat -- every sniffle. Psychologists listen enthusiastically to every rumored complaint.

Riego is a nurse, the mother of three kids, now 23, 22 and 14. Her children live outside. "They are living alone in my house in Sancti Spiritus. My mother helps them, but it's not the same.

"I don't know how to decide what is right."

* THEY'RE ALL NEIGHBORS

In Cuba, AIDS is sex -- heterosexual and homosexual. Period. In the United States and Europe, AIDS is sex. But it is also drug abusers infected by shared needles, babies infected by their mothers, health workers infected by patients, hemophiliacs infected by transfusion.

In Cuba, intravenous drug use is virtually unknown. Almost all pregnant women infected with HIV choose abortion. Only two of Cuba's 500 hemophiliacs are HIV positive. In the United States, at least 8,000 of 20,000 hemophiliacs are HIV positive, according to the Centers for Disease Control.

In Cuba, government epidemiologists interview every individual who tests positive. They ask a pointed question: "Whom have you had sex with during the past 10 years?"

Then epidemiologists try to locate all persons named and test them, too. Since 1986, the government has administered more than 10 million tests -- on an island of 10.5 million people.

Everyone HIV positive is sent to a sanatorium.

Take Jose Antonio, infected by an unknown Mexican man. Jose gave the virus to his Cuban boyfriend, Armando Alvarez. He passed it on to his fiancee, Tania Fonseca. She had no idea her betrothed also liked men. Husbands, wives, mistresses, lovers, whoever, they all become neighbors in a sanatorium.

* ARE STATISTICS TRUE?

Cuban HIV statistics seem too good to be true.

How could a nation that opened its doors to students from all over AIDS-plagued Africa and sent more than 40,000 troops to Angola have so little AIDS?

Dr. Antonio Gordon, a Hialeah physician, refused to believe the figures. He tested samples of frozen blood drawn from Mariel refugees for AIDS. When 20 of 999 turned up positive for HIV, he denounced the Cuban government.

"The Cuban health care network has turned into a bizarre facade, behind which strategic and propaganda issues overrule public health matters," he wrote in a letter to The New England Journal of Medicine.

Others took issue with his analysis. Dr. Eliseo Perez-Stable, of the University of California at San Francisco, said the figure should have been four in 999, not 20.

The four, he noted, showed positive on the most accurate test, the Western Blot. False positives are not unusual on the ELISA, the other test Gordon used.

Perez-Stable pointed out that the 4 in 999 is much higher than the official Cuban numbers. That is because of a "selection bias," he said. "Given the high percentage of men, homosexuals and prisoners who came to Miami during Mariel, you cannot expect the sample would be representative."

Like Gordon, Perez-Stable is also critical of Cuba's confinement policy.

"What are they doing to people? I have a problem with putting people in confinement when they may be healthy for 10 or 12 years."

911110
MH911106

Always watch for outdated information. This article first appeared in 1991. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1991. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .