The InterDependent

GUATEMALA CITY -- Mary Guzmán is a 50-year-old mother of three adult daughters in this city high in the mountains. She has long black hair, brown eyes and a friendly smile. She is also HIV-positive.

Guzmán received her diagnosis five years ago, when she was tested after her husband died at the local hospital from what turned out to be AIDS-related complications.

“He didn’t tell me he had it,” said Guzmán, who was one of about 50 people participating in an HIV/AIDS-awareness march and ceremony here on May 15, International AIDS Memorial Day.

While she had heard of HIV, “I never in my life thought this would happen to me,” she said.

Guzmán’s sentiments reflect those of many Guatemalans, where HIV/AIDS has until recently affected mostly high-risk groups: men having sex with men, transgendered people and prostitutes.

“Most people still feel they are not at risk,” said Dr. Enrique Zelaya, the Guatemala coordinator of Unaids, the Joint United Nations Program on HIV/AIDS. Unaids recently issued a report saying that while overall infection rates around the world dropped 25 percent from 2001 to 2009, some “at risk” groups – gay men, prostitutes and IV drug users – are still contracting the virus.

In 1996, statistics showed 5 to 7 HIV-positive men for each affected woman in Guatemala. But since 2003, the share of women carrying HIV has risen sharply, with women now making up 40 percent of the total.

Many women contract the virus from their husbands, who get it from engaging in unprotected sex with other men, Zelaya said. An estimated 12 to 18 percent of Guatemalan men who have sex with other men are living with HIV. The overall prevalence of the disease in the country, which has a population of nearly 14 million, is around 1 percent.

Mirva Lempiainen

Gay men in Latin cultures still feel compelled to marry women but secretly have sex -- sometimes unprotected -- with men.

Because of the Latin macho culture, many Guatemalan gay men feel compelled to hide their true sexual orientation for fear of discrimination. They marry women but secretly have sexual relationships with men.

It is especially typical for homosexual men to lead double lives in conservative rural indigenous communities, like those in the states of Petén and Izabal.

“Every day we’re detecting more cases from those places,” Zelaya said.

Guatemala currently records 21 new cases of HIV a day, according to Unaids. More than 60 percent of the country’s nearly 66,000 HIV-positive cases were discovered in the last six years.

“I can’t say that it’s because of more effort or massive testing,” Zelaya said. Instead, “what we are detecting now are the final stages of AIDS.”
Many men put off getting tested out of fear that the community will hear about their sexual orientation. “People will know they are men having sex with men if they are HIV positive,” said Zelaya.

Those who do find out they have the virus often end up moving to another town to avoid rumors, Zelaya added. Most Guatemalans live in rural areas.

Aldo Davila, director of the HIV-positive people’s association, Gente Positiva, said that discrimination against gay people is a serious problem in Guatemala, which is one of the poorest countries in the Western Hemisphere.

“There is a lot of machismo, it’s a patriarchal society,” he said.

The attitude also translates to men not wanting to use condoms and infidelity being prevalent, Davila said.

These issues and lack of effective prevention programs explain why Guatemala’s HIV-positive rates still have not plateaued, even though presence of the virus was discovered in the country in 1984 and antiretroviral medicines have been prolonging lives elsewhere for decades.

“Here in Guatemala it’s still increasing, actually faster than in other Central American countries,” Zelaya said. He noted that AIDS-awareness programs in Honduras, for example, are much better organized than those in Guatemala, where the government tends to emphasize treatment of patients over prevention campaigns. The rate of HIV/AIDS in Honduras is higher than in Guatemala, making up 1.5 percent of the adult population, but the rate of new infections discovered has slowed.

While Belize has long been the regional leader in HIV/AIDS cases, with a 2 percent prevalence rate, in 2010 the rate of new infections was reduced by 33.8 percent. Nicaragua has the lowest figures in Central America, with just 0.2 percent of the population deemed HIV-positive.

The 30th anniversary of the first medical discovery of HIV/AIDS was marked last week internationally, with the media reporting on reductions in HIV infections in some areas of the world and increases in access to medicines, but that no cure has emerged yet. The UN General Assembly is holding a high-level meeting on the disease from June 8–10 at UN headquarters in New York.

Meanwhile, Guatemala’s Ministry of Health still hasn’t allocated money to an HIV-education program that was approved by the Congress three years ago. The program would teach primary and secondary school students about the disease.

Unaids said that only 2 percent of Guatemalan schools included HIV lessons in their curriculum in 2010, and less than a quarter of 15- to 24-year-old Guatemalans could correctly identify how the virus is transmitted from person to person.

The May 15 campaign was partly organized to get politicians’ attention and to remind them of the importance of prevention work.

“This is the way to press the government into giving money,” Zelaya said, pointing to an acrobatic dance going on in the city’s central square, with hundreds of onlookers curiously tuned in.

Another goal of the campaign day was to reduce the stigma of HIV and to get Guatemalans talking about the disease.

“When a person is diagnosed with HIV, it affects your emotional health, your work and your relationship with your family,” said Humberto Lopez, a Red Cross employee who works in HIV/AIDS prevention.

The day ended with dozens of people walking in line holding candles. In the darkening night, Davila of Gente Positiva encouraged the crowd to pay its respects to those who had died of AIDS and reminded people to take charge of their own health. “HIV is here, and it doesn’t discriminate,” he said.

Mary Guzmán, the homemaker, already knows that. While she at first felt sad and defenseless in facing up to the disease, she has since become active with the women’s HIV/AIDS support group, Associacion de Mujeres de Gente Nueva.

“I like spending time with other people who are also affected by this,” Guzmán said. “There are thousands of us living with HIV in Guatemala.”

[Click here to view an accompanying slide show of the May 15 International AIDS Memorial Day’s activities in Guatemala City.]