Better Aids Strategy in Peru
We are in the waiting room in a hospital in Lima. All people have undergone an Aids test and are awaiting the results. The doctor comes in and calls out the names of the people who may go home because their test results are negative. Those remaining are called in for an information meeting on HIV/Aids. “Some doctors forget that people with HIV/Aids also have rights,” says Paul Raygada from PROSA. “What you are suffering from is nobody else’s business. And of course the first consultation between the patient and the caregiver after diagnosis should be private, even if the doctor is very busy.”
Nevertheless Paul Raygada believes that the care for more than 50,000 Peruvians suffering from HIV/Aids is certainly not bad compared to neighbouring countries. “More than ten years ago the government developed a strategy to prevent the epidemic from spreading from the vulnerable groups who were affected first: male homosexuals, bisexuals, transsexuals, transgenders and sex workers. This policy has proved to be reasonably successful even though we now see an increase in the number of boys and young men infected. Although they would rather have sex with girls, they experiment with sex workers, transvestites or men. Moreover, they do not know very well how to protect themselves from sexually transmitted diseases. In many schools there is never any discussion about sexuality, condoms, HIV/Aids or sex workers, let alone about sexual diversity.
It is estimated that half of all Peruvians with HIV get the treatment they need. “Many people do not know that they are HIV positive,” Paul Raygada explains. “Others rely on alternative medicines or deny that the disease exists. Some people are not treated because of the expense. In theory, treatment with the modern highly active antiretroviral therapy (HAART), which has been available since 2006 thanks to the support of the Global Fund, is totally free. But the series of tests that people have to take first cost about ten dollars. There are many who cannot afford this. Added to this is the fact that the medicines are sometimes not available. If you have to buy them yourself they will cost from 600 to 700 dollars per month, which is more than the average monthly salary. PROSA has its own supply of medicines for people who are not getting the medicines at present or who have problems with their medical insurance.”
When PROSA was founded in 1991 there were no medicines available in Peru, other than some donations from other countries. “An important part of our work was giving emotional and practical support to people with HIV/Aids, who were often very ill and totally isolated. We still do this buddy work, as well as supporting self-help groups. In addition we undertake actions to change policy. In 1996 for example, we managed to ensure that HIV/testing was made voluntary. Before that testing was compulsory if you wanted to study, marry, and sometimes even for job applications. These past years we have been working closely with the Ministry of Public Health. Together we developed a model of multidisciplinary teams, which include someone with HIV/Aids, whose task is emotional support and counselling. This model has by no means been introduced everywhere, but it is a big step forward, especially because it shows that people with HIV/Aids are part of the solution and not just the victims.”
The Programa de Soporte a la Autoayuda de Personas Seropositivas (PROSA) strives to improve the quality of life for people with HIV/Aids and their families. PROSA encourages and supports self-help groups, runs an extensive buddy network that provides people with HIV/Aids with emotional and practical support, offers all kinds of services such as psychosocial support and tries to improve the national and local HIV/Aids policy.