SANTIAGO — Emilio Urrutia says it wasn’t because of lack of information that he got infected with HIV last year. The 29-year-old Chilean used to do what he calls a “routine HIV test” every six months.
“I am gay so I took the test for safety. And I got infected because I was irresponsible. I knew it could happen if I didn’t use protection, but in the heat of the moment I wouldn’t care,” he says. “I still think one shouldn’t be afraid of AIDS because there are many other diseases that are much more invasive.”
Young Chileans like Urrutia are part of the population targeted by a new HIV prevention campaign launched by the Chilean Health Department in August. The initiative calls for more people to use condoms and get tested — something they haven’t been doing enough in the past decade.
At the end of July, a UNAIDS report found Chile was the Latin American country with the highest percentage of new HIV infections since 2010, raising alert about a problem that wasn’t completely unknown in Chile, but has been underestimated by authorities.
“This is an epidemic spread that is out of control,” says Dr. Carlos Beltrán, an infectious diseases specialist and the head of Sida Chile, a non-governmental organization of physicians treating HIV patients. “The UNAIDS report speaks of a 34 percent increase in the past six years, but we have official statistics from the Health Department showing that in reality infections have raised by 66 percent.”
Chile is not the only country in Latin America that has seen a rising rate of new infections. According to UNAIDS, Guatemala, Costa Rica and Honduras have all seen new infection rates increase more than 10 percent since 2010. And a few other countries, such as Argentina and Brazil, have seen small increases. Latin America as a whole, however, has kept the number of new infected individuals steady, at around 95,000 every year.
What’s surprising about Chile, experts say, is that it isn’t hindered by the same kind of poverty that plagues the Central American countries battling an increase in infections.
“Chile is a country with high incomes, according to the World Bank’s categorization, so somehow we expect better indicators,” says Dr. César Núñez, UNAIDS regional director for Latin America and the Caribbean.
On one hand, Chile has been a pioneer in making antiretroviral therapy available for free to its population. The number of Chileans under treatment went from 14,000 in 2010 to 33,000 today, Núñez says.
But treating HIV patients, of course, is not the same as preventing their infections in the first place.
Chilean experts accuse health authorities of neglecting the need to get more people diagnosed — today an estimated 24,000 Chileans don’t know they are HIV-positive — and to adjust prevention measures to the mindset of younger generations, who tend to engage in riskier sexual practices.
“The rise in HIV infections is particularly high among teens and young adults,” says immunologist Alejandro Afani, who directs the HIV Center of the Universidad de Chile’s Clinic Hospital. “For them, sex is part of entertainment, of partying. They don’t like to use condoms and sex education barely exists in schools.”
Chile waited until 2010 to adopt a law making sex education mandatory, and only high schools have the obligation to teach it. According to doctors, that is too late considering that the average young Chilean starts his or her sex life at age 15. Conservatism, stigmatization of the disease and misconceptions, they say, are key factors in the current outbreak.
“Chile is very conservative and sex is still a taboo. Instead of looking at HIV as a disease like any other, people link it to deviant sexual behaviors. There is much prejudice and stigmatization,” says Mónica Lafourcade, a medical microbiologist and president of the Chilean Society of Infectious Diseases. “By the time kids start having sex, in many cases, no one at school or at home has talked to them about sex and STDs.”
Also worrisome is the fact that young Chileans appear to have less fear of HIV than those in previous generations. Andrea Huneeus, a pediatric and adolescent gynecologist in Santiago who has done research on condom use, explains that although safe sex has become more common, it is still not “at its best” and reflects inequalities: In public schools only 37 percent of teenagers use a condom during their first time having sex versus 60 percent in private schools.
“Kids today have no conscience of risk, they feel invulnerable and see HIV as something distant and unknown,” she says.
This, added to a lack of public policies aimed at making diagnosing HIV easier, have created what Beltrán calls an “explosive cocktail” that explains Chile’s poor performance in preventing HIV.
While other countries such as Peru, Honduras and Argentina have made quick testing available through a number of strategies, in Chile getting tested for HIV is a tedious procedure that requires multiple doctor’s appointments and answering invasive questions. If the result turns out to be positive, it can take up to four weeks before the person is notified.
The need to improve early detection is urgent. In the past few years, HIV experts have noticed more patients being diagnosed during later stages of the virus. Along with new infections, AIDS-related deaths have also increased. According to HIV experts, deaths jumped from 2.3 per 100,000 inhabitants in 2008 to almost 3 in 2013.
“I see patients in their 30s and over who present the disease at an advanced stage. Sometimes they arrive so late they can’t even start treatment. That shouldn’t happen,” says Afani, adding that in 2016, 43 percent of new HIV detections were late diagnoses. “HIV is not ideological, it’s not about values. It´s a health issue, so measures must be taken.”
Urrutia has seen friends wait a long time before getting tested; others don’t want to know if they are HIV-positive.
“When you say you have cancer, everybody is there for you offering help, but when you say you have AIDS, you don’t get the same treatment,” he says. “I have many friends who won’t get tested because they think they’re going to lose the support of their families. This is not a physical disease as much as a social one.”
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Chile Battles an Alarmingly High Rate of New HIV Infections originally appeared on usnews.com
