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According to the latest UNAIDS report, Chile has the highest rate of increase in HIV/AIDS cases in Latin America, with 34% of new cases rising. The age group experiencing the greatest increase is between 20 and 29 years old. The head of the National HIV/AIDS Program at the Ministry of Health has just announced that the government will launch a prevention campaign on August 3rd.

By Víctor Hugo Robles 

“Chilean gay cancer patient dies,” headlined the newspaper La Tercera on August 23, 1984, in a red headline, igniting the reality of HIV/AIDS in Chile. Almost 33 years later, much has changed in how the pandemic is viewed and addressed.

AIDS is not synonymous with death because HIV has become a chronic health condition. However, despite medical advances and the mobilization of key populations interested in promoting prevention and information on sexual health, the number of people living with HIV continues to rise, particularly among younger people.

Campaigns

In the 1990s, following the actions of groups of people organized around the pandemic, the National AIDS Commission CONASIDA was created as a public body responsible for the development, executive coordination and overall evaluation of the AIDS Prevention and Control Program in Chile.

[READ ALSO: #HIV in Chile: lack of public campaigns denounced]

Initial efforts materialized in social communication campaigns for HIV/AIDS prevention that, starting in 1991, sought to raise awareness among the population, in addition to the enactment of Law 19.779 of 2001, which established regulations related to HIV, creating tax credits for catastrophic illnesses.

Both the public awareness campaigns and the "AIDS Law" had repercussions not only for people living with HIV, but also for the general population. The constant increase in HIV-positive individuals and the complexity of the associated health problems have shifted the focus from specific groups to the entire population, highlighting social vulnerability and the need for healthcare services.

The AIDS Law

The response to HIV/AIDS in Chile has been driven by civil society, and its public and political advocacy made possible the enactment of the "AIDS Law," guaranteeing the following fundamental rights: "Right to health care for people living with HIV; Right to free and informed consent for HIV testing; Right to confidentiality regarding test results and serological status; Right to voluntary participation in testing; Right to education and employment for people living with HIV or AIDS."

Due to the lack of information and awareness, “this influences the final decision to get tested or not, hindering early detection and obstructing international efforts and recommendations aimed at increasing testing,” states a public statement from the Social Platform for HIV/AIDS and Human Rights, which brings together 14 civil society organizations from Santiago and the surrounding region. “Since the enactment and publication of the AIDS Law, the Government has never publicized or informed the public about this important legislation,” they add.

Alarming figures from UNAIDS

The UNAIDS global report “Ending AIDS 2017” released on Thursday, July 20, revealed important news for Latin America: AIDS-related deaths have halved since 2005 and, for the first time in history, 53% of people living with HIV have access to antiretroviral treatment.

Regarding new cases, the report indicates that figures changed in the region between 2010 and 2016. Of the 13 countries considered, four reduced the number of new cases (El Salvador, Colombia, Nicaragua, and Mexico), while nine others saw an increase. Of these latter countries, Chile experienced the largest increase in positive notifications. According to the UNAIDS report, Chile has the highest rate of increase in HIV/AIDS cases in Latin America, with 34% of new cases. The age group with the greatest increase is between 20 and 29 years old.

[READ ALSO: Ten myths about young people and HIV]

According to the latest statistical report from the Public Health Institute of the Ministry of Health, in Chile there were 21,800 confirmed cases of HIV between 2010 and 2015 alone, which meant an increase of 45%.

According to estimated figures, there are 61,000 people living with HIV in the country today, of whom 69% are aware of their status and 53% are receiving treatment. “Unfortunately, since 2010, the Chilean government has not prioritized or focused its investments on HIV/AIDS,” Vasili Deliyanis of the organization ACCIONGAY told the newspaper La Nación.

And when will the prevention campaign start?

The “AIDS Law” obligates the State of Chile to conduct public awareness and information campaigns on HIV/AIDS. Article 3 states that “the State shall take the necessary actions to inform the population about the human immunodeficiency virus, its transmission routes, its consequences, the most effective measures for prevention and treatment, and the existing public programs for these purposes, placing special emphasis on prevention campaigns.”

However, despite its public importance and the alarming statistics that indicate a sustained increase in HIV notifications among young people, coupled with the absence of sexual education plans in schools, organized civil society continues to await a new social communication campaign for HIV/AIDS prevention from the State of Chile.

[READ ALSO: Da Morgue: the Peruvian artist who decided to dress up HIV ]

Edgardo Vera, head of the National HIV/AIDS Program at the Ministry of Health, announced to attendees at a meeting of the National Roundtable on HIV/AIDS and Human Rights, held in Santiago on Friday, July 28: “I have a surprise for you! The campaign will be launched next Thursday, August 3.” However, Vera did not specify the time or location, nor was a formal invitation distributed to the attendees, who included representatives from civil society, public institutions, and international organizations such as PAHO and WHO.

Starting this Monday, July 31, social organizations and activists committed to and involved in the issue expect to receive invitations for the public presentation of the long-awaited communication campaign.

“63% of people with HIV are men who have sex with men”

Luz María Yaconi, executive director of Fundación Savia, points out: “A prevention campaign is more than just a television commercial; an effective campaign should have local counterparts in different regions and be focused on specific communities.” It is announced that this new prevention campaign will, for the first time, include people living with HIV/AIDS and direct messages to Indigenous communities, “key populations” according to United Nations definitions.

Vasili Deliyanis, spokesperson for ACCIONGAY, an NGO soon to celebrate 35 years of fighting HIV/AIDS prevention in the LGBTI community, stated: “84% of Chileans living with AIDS are men, and of those, 63% are men who have sex with men: gay, bisexual, and transgender. Chile has a gay epidemic, and that is where public policies and investment must be focused. The State needs to take responsibility for the gay population, which is currently the most affected by HIV/AIDS.”

"Investment in medication has been prioritized over sex education."

“National and international figures demonstrate a failure of the pseudo-preventive guidelines that the Ministry of Health in Chile has,” Luis Bustamante of the Social Health Guidance Networks of the Conchalí commune, a community organization with more than 25 years of experience in the prevention, testing, detection of HIV/AIDS and treatment of various sexually transmitted infections, tells Presentes

“Although it is known that condoms are the primary method of HIV prevention, it was only in 2014 that they were recognized as the leading prevention option in the national campaign. The focus has been on investing in medication instead of condoms and sex education, emphasizing the evaluation of quantifiable data such as the number of people treated, medications distributed, and undetectable viral loads,” Bustamante explains.

“HIV prevention policy in Chile is approached from a tertiary prevention perspective, that is, from the perspective of those living with HIV/AIDS. The so-called social complacency occurs because medications give us an illusion and a promise of health in which the individual acts passively because the medications are the ones that act,” the activist points out to Presentes .

Similarly, Bustamante points out that “government prevention campaigns ignore epidemiological data showing that HIV/AIDS in Chile is a concentrated epidemic and instead appear to be directed at the general population.

Transgender people, invisible in the category "men who have sex with men"

There is no data on transgender populations because they are rendered invisible by the concept of "men who have sex with men, MSM." "The campaigns lack a target audience; we don't know what these populations are like due to the absence of studies on sexuality, sexual behavior, and gender identities—factors that reduce the possibilities of adopting preventive measures, limiting individual and public action," Bustamante concludes.

“All the prevention campaigns that have been done are not enough,” Sandy Iturra, spokesperson for the TravesChile group, told Presentes . “We have to call things as they are. In Chile, there are people who work on HIV/AIDS, they receive most of the public resources, they distribute condoms, and that's about it. I think the allocation of Chilean state resources is misguided,” Sandy asserted.

“There needs to be a more sensitive campaign, focused on the most vulnerable groups. We are invisible, even to the gay community itself. Our community should have greater participation, visibility, and influence in HIV/AIDS prevention campaigns,” says the renowned transgender activist.