United Press International - Saturday, 18 August 2001
Jennifer Pribble, UPI Science News

While there are currently 8,000 reported cases of AIDS in the country, it is estimated that more than 30,000 Chileans carry the HIV virus. The Ministry of Health estimates that by 2005 some 5,000 Chileans will die of AIDS annually and that by 2010 it will be the leading cause of death.

Edith Ortiz, the scientist responsible for the bulletin's research, said there were some surprises is the study's results. "New infections are now spreading slower among the adolescent 19-to-24 year-old population and more rapidly in the 25-to- 34 year-old age group."

This, she said, can be explained in a number of ways. Ortiz said younger men are more open to using condoms -- the method that's proven to be the most effective form of protection against the spread of sexually transmitted diseases including HIV.

Adolescents perceive a higher degree of risk in sex as compared to older age groups because they have had more exposure to information about HIV/AIDS according to Ortiz.

According to a report recently released by the National Women's Service and the National Institute for Statistics, the number of Chilean women living with AIDS in 2000 was 13 times higher than the 1990 figure. Among men, AIDS cases increased 1.5 times in the same period.

Ortiz refers to this phenomenon as the "feminization" of HIV/AIDS and says it can be explained in a number of ways. Chilean society has long perceived HIV/AIDS as a "gay man's" illness. Therefore, in the past women often weren't targeted in efforts to encourage safe sex practices.

"There are cultural factors that influence the rapid growth of the disease among Chile's female population," Ortiz said. "The Chilean culture places a large degree of importance on maintaining a stable relationship at all costs. Therefore, one doesn't discuss sexuality, especially not extra-marital affairs. In fact, the subject of protection is often ignored completely in the name of stability."

Chile is primarily a Catholic country, and Catholicism, traditionally, is against contraception. Yet, Ortiz said that the Church's role in Chileans' sex life is minimal and that the problems of low condom use are more closely tied to a breakdown in communication between men in women, which goes along with the "machismo" aspects of Chilean culture.

Another new development in the Chilean AIDS epidemic relates to the socio-economic nature of the disease. Originally, AIDS cases were distributed relatively equally among different economic classes in Chile.

Recently, however, epidemiologists have seen significantly higher growth of HIV infections and AIDS cases among low-income earners. Orbitz attributes some of this growth to lower levels of education, but warned that other factors should be considered. In her opinion, many low income earners have access to information, but simply do not perceive a serious risk.

Finally, a completely new development in the spread of HIV is related to geographic aspects. Traditionally HIV/AIDS almost exclusively affected urban populations in Chile.

Now cases have begun to appear in Chile's rural areas. According to Ortiz, there the rate of HIV infection and in the number of full-blown AIDS cases has grown in rural regions. This, she says, is the result of migration patterns.

Chile's centralized economy draws many rural dwellers to the capital in search of economic opportunities. While some stay permanently, others return to their home towns and villages. In this context men serve as the largest urban-rural transmitter because they are more likely to be sent to the city for work Ortiz said.

Despite the grim statistics, the Chilean government has not had a large-scale information campaign addressing HIV/AIDS since 1997 according to AIDS activists.

Rodrigo Pascual, president of the AIDS support, lobbying and education group "Vivo Positivo", said this lack of government initiative means that "an essentially controllable disease is taking the lives of far too many Chileans."
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