HT: Why is it precisely the LGTB community, and especially within it the group of MSMs (Men who have sex with men), to which greater attention is given in the field of prevention?
YF: Men who have sex with other men is the group that is most affected by the HIV epidemic. Because of this, efforts toward prevention and the promotion of self-care have been directed basically at this group. Also, risks are increasing among these individuals because there are greater vulnerabilities among them (biological, social, epidemiological and psychological risks), and this plays a preponderant role in the spread of HIV/SIDA.
The social exclusion that this group has endured for such a long period has worked to influence it, compelling them to carry out sexual acts in settings that are non-conducive to health, sometimes in clandestine conditions so to speak, and this makes them tend not to insist on using condoms, for example.
HT: Are health promoters well received by the public or has there been a lack of work in this area to raise their awareness?
YF: In the more than 20 years of the AIDS epidemic, work by the volunteer promoters in Cuba has been increasing in numbers every year. These are grouped in work areas that consist of the following:
1 – Teenagers and children in the prevention of HIV/SIDA
2 – Men who have sex with other men (MSM)
3 – Women in the prevention of HIV/SIDA
4 – People who practice transactional sex or prostitution, or people connected to prostitution.
5 – People who live with HIV
I should add that promoters see to the social marketing of condoms. In addition to the existence of a much more integral and refined profile in terms of prevention, there are various forms of communication (telephone, postcards, face to face and anonymous contact). These of course allow the voluntary promoters to feel much closer to their population group.
As for education we approach this between pairs, or as equals (a methodology introduced in this country more than a decade ago after having being drawn from experiences in the United States).
We have been introducing these techniques gradually, and they’ve generally had a good reception on the part of the public.
HT: What do the statistics look like right now regarding sexually transmitted illnesses and HIV in the country, and especially in Santiago de Cuba, the municipality with the greatest population on the island?
YF: The rhythm of the epidemic here is not so different from what is occurring right now in the great majority of countries, although the situation in Cuba is not comparable with other situations given the benefits and treatment that people who are sick here receive, both in sanatoriums and as out-patients. This makes the number of cases much smaller in relation to other countries.
However, I can verify that the epidemic is growing, and every year the number of diagnosed cases is larger because the active search is very refined – despite the prioritized attention and effort made by the Cuban government. I can’t say anything more about this, the statistics are not public.
HT: The cases of HIV in Cuba are running in high figures. However to counteract this, the Cuban government and of course its health care system has prioritized the creation of an entire mechanism for extenuating this malady. Could you discuss some of the elements that exemplify this?
YF: The Cuban government allocates considerable resources in educational programming and in prevention – like, for example, the purchase and subsidy of condoms as well as supplying all those with HIV who need anti-retroviral medicines (which are extremely expensive). The Cuban government gives these away for free in very public campaigns directed at vulnerable groups.
Multi-sectorial work is one of the priorities and directives of the government for prevention work on the job or as a multi-sectorial response to the epidemic. What prevails is the concept that public health is a social product and therefore the public should assist with this situation.
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