Colombia: AIDS in the Time of War
Ballvé, Teo
NACLA REPORT ON THE AMERICAS report : hiv/aids Colombia: AIDS in the Time of War Combatants in Colombia’s armed conflict—like these members of the FaRC—are five times more likely to...
...Government-provided health care covers about half of Colombia’s population...
...Not missing a beat, he adds, “Even better...
...expenses is an uphill battle...
...Before, we were just a bunch of crazies in the street with sticks and stones,” he says, “and now we’re in centers of power where decisions are made...
...Soon, the paramilitaries were calling in threats to his home, and this time the threats were specific...
...She immediately knew they were from one of the three armed groups fighting in Colombia’s decades-long civil war—army, paramilitary, and guerrillas...
...Immersed in this new life, Cossio went on to become a founding member of the Girasol Project, a network of Colombian women living with the virus that now has several offices around the country...
...The Girasol Project now works with at least 600 women across the country, providing counseling, entrepreneurial projects, workshops, and legal aid...
...Javier leonardo varón of the colombian network of People Living With HIV or AIDS (Recolvih) sounds a hopeful note, saying the movement has made great progress...
...The UNHCR’s Sicard worries that the armed conflict is taking the epidemic among women in radically new directions...
...Sicard explains, “They see the virus as something dirty, something they can eliminate...
...And just in case, I’ll get my bags packed...
...We can’t let these people sitting beside me make the decisions on our behalf...
...A UNHCR report estimates that Colombia’s HIV-positive population could nearly triple by 2010 to 600,000, of which 15,000 would be below the age of 15...
...Recolvih and other organizations have led the charge against the pharmaceutical giants without any government help...
...Most importantly, they are subjected to conditions of absolute poverty and insecurity, along with a host of other precarious social and psychological conditions...
...18, and three quarters are female...
...Both guerrillas and paramilitaries often run prostitution rackets in areas under their control, forcing sex workers to have unprotected sex, which garners a higher price, and to serve as informants on enemy clients...
...Almost half are under the age of “Next time I see you, you better have that list...
...Both guerrillas and paramilitaries often run prostitution rackets in areas under their control, forc NACLA REPORT ON THE AMERICAS report: hiv/aids a brothel in a village near Colombia’s northern coast...
...By the time he received his HIV diagnosis, he already knew the ins and outs of government health programs...
...I never could have turned over that list,” Gómez says...
...in 1993, the ratio had fallen to seven to one...
...No, it’s never been done before...
...today, it gay men and sex workers...
...The packet is a request that Recolvih receive a “voluntary license” on Abbott’s drugs...
...Unfortunately, in a war, a woman’s body is considered territory,” he explains...
...As soon as he was given a chance to speak, Varón unloaded...
...The panelists were stunned...
...In November 2006, two men, who he later learned were paramilitaries, approached him after he dropped his says matter-of-factly, “It’s my life’s work, and I don’t know how to do anything else...
...Jorge Gómez (not his real name, which he asked be withheld) has dedicated his life to making sure such grim predictions never come true...
...This is largely the result of a lifestyle that generates behaviors and circumstances conducive to sexually transmitted diseases: little access to education or health care, and extended periods away from families, often in areas home to thriving sex industries connected to local economic bonanzas in oil, mining, or coca...
...No one here uses contraceptives...
...He thinks back to his early days in the movement...
...He began working in HIV prevention 15 years ago in the region surrounding his hometown of Barranquilla, a port city on Colombia’s Caribbean coast...
...NACLA REPORT ON THE AMERICAS report : hiv/aids Colombia: AIDS in the Time of War Combatants in Colombia’s armed conflict—like these members of the FaRC—are five times more likely to contract HIv than noncombatants, according to unaIDs...
...Colombia would be the first...
...On one side, the country’s armed conflict not only makes it dangerous to be involved with anything HIV related, but may also be aggravating the spread of the virus...
...According to Latin Trade, a regional business magazine, a month’s supply of the drug cocktail used along with Mexico, Colombia has the highest HIv drug prices in latin america...
...Explaining this masterstroke of irony, Gómez Furthermore, along with normal impediments, like social stigma, the presence of armed groups discourages people from getting tested, making it difficult to know the true extent of the virus’s spread in Colombia...
...Their bosses are the ones with the guns, so they have no way of opposing these impositions...
...He called his mother to tell her he was going to be on television and said he was worried that his appearance could trigger a back to treat the virus in Colombia can cost as much as $900, while the country’s monthly per capita GDP is estimated at $600...
...He points to examples in Brazil and Thailand, where governments or international agencieswerethedrivingforcebehindeffortstoreduce the price of HIV medicines...
...The first big blow came late last year, when the Global Fund to Fight AIDS, Tuberculosis, and Malaria declined to renew Colombia’s grants...
...While fighting these battles, Colombian HIV activists face the challenge of cultivating future generations of activists...
...We were there sitting at the table in the discussions,” Varón says proudly...
...They call it ‘the faggots’ disease,’ and anything that smells gay to them has to be killed...
...The girlfriend of one of them has no idea what it means...
...Paramilitaries and guerrillas have also discovered that brothels are effective intelligence-gathering sources, often forcing prostitutes to extract bits of information from enemy clients...
...As a young activist, he began tracking how the local government was either misspending or stealing public health funds...
...As they peeled off on a largest internally displaced population in the motorcycle, one of the men turned back and warned him, world after Sudan’s...
...It reminds us: There’s something destructive going on inside our bodies...
...At the cafeteria, she no longer received her lunch on normal plates like everyone else...
...It’s an affront to health and shows that health is a business...
...I realized I wasn’t a walk a government ing virus, that I was a person,” study reveals the she says...
...But some of us have started dying or falling really sick...
...0 By teo Ballvé A few months before myrian cossio’s 20th birthday, in San José del Guaviare, a bustling frontier town deep in Colombia’s eastern tropical lowlands, armed men forced her into a car...
...she was the last to know...
...International health organizations and the Colombian government consider HIV/AIDS in Colombia a “concentrated epidemic,” meaning that while specific groups of people exhibit high rates of infection, there is a relatively low prevalence in the general population (between 0.3% and 2.5%, according to United Nations estimates...
...Varón, who describes himself as “openly gay and openly HIV positive,” cut his political teeth organizing campesinos near his native city of Ibagué, on the eastern slopes of the Colombian Andes...
...We’re fighting this with everything we’ve got...
...And we’ll realize this when it’s too late...
...People like Varón and Cossio have become experts in filing legal suits against reluctant providers...
...The armed groups themselves are a vulnerable sector, according to UNAIDS, which concludes that Colombian combatants are five times more likely than civilians to contract the virus...
...Is there a clear instance of civil society forcing a government to do that...
...he asks...
...Along with Mexico, Colombia has the highest HIV drug prices in Latin America...
...It will be years before we know the true gravity of the epidemic,” Sicard says...
...The first difficulty in tackling this problem, according to Sicard, is a lack of research...
...It stands at two to was these meetings that sent one, according to the armed men after her...
...Both activists describe the process of ensuring patient rights as being on a war footing, with alarm bells constantly sounding...
...The men on the phone talked about his kids and said they knew where he lived and that they were watching his extended family back in Barranquilla...
...We all used to feel invincible,” Varón recalls...
...today, it stands at two to one, according to UNAIDS...
...Her boss told the entire staff before telling her...
...government health and education programs are practically nonexistent in high-conflict zones and scarce in areas where displaced people end up, like urban slums...
...The organization also tries to publicize the epidemic’s feminization through research, having recently conducted 70 interviews with HIV-positive Colombian women...
...The meeting was life changing...
...A government study published in 1994 reveals the feminization of the epidemic: In 1985, there were 55 men infected for every one woman...
...They demanded a list of all known the 4 million internal refugees—the second-HIV-positive people in the region...
...The UNHCR calls The list would have ostensibly guided paramilitaries in HIV among Colombia’s displaced population a “hid-one of their notorious “social cleansing” operations of so den epidemic...
...Eventually, she was fired...
...Sure, it’s hard to compare Colombia with what’s happening in parts of Africa,” Sicard says, “but parts of Colombia have almost African characteristics for the virus in terms of violence, displacement, poverty, and state weakness...
...This knowledge has served him well over the last decade, in which drug makers, thus driving down prices...
...Like all activists in the movement,” he says, “I learned about things like law, international trade, intellectual property, along the way—in the march...
...HIV out of necessity, but also out of solidarity,” Cossio says...
...Armed with one woman...
...Cossio’s problems began the year before, in February 1996...
...On the other side, powerful activist groups are fighting for their rights, together with the usual obstacles facing HIV activists around the world, in a country at war...
...sTuarT buTLer JULY/AUGUST 2008 report: hiv/aids Colombia’s most vulnerable population group is children off at school...
...some discover their HIV status only when their partners become sick or die...
...Varón talks rapidly as his excitement swells in explaining the process...
...A reporter had invited him to be part of a panel on HIV for a TV news talk show...
...Finishing, he looked into the camera: “We need free treatments, we need to be included in decisions...
...Civil society shouldn’t have to exhaust itself defending what should be a human right...
...At night, cars would slowly move toward Gómez’s house and then quickly pull away...
...Government health and education programs are practically nonexistent in high-conflict zones and scarce in areas where displaced people end up, like urban slums...
...Her arrival in 1997 coincided with a groundswell of organizing by Colombian activists on HIV issues...
...They took her to the town’s outer limits and put a gun to her head...
...Surveys by humanitarian groups show this can lead youths to become sexually active at a younger age or to see prostitution as a viable source of income...
...Before her run-in with the armed men, a health worker in San José del Guaviare told her about a meeting in Bogotá of women living with the virus...
...Thinking he had left his problems behind in Barranquilla, Gómez began working in an HIV-prevention program in Bogotá with demobilized paramilitaries who had laid down their guns through a government amnesty program...
...At the health clinic where she worked as an administrator, her boss enlisted the staff for a blood drive, and Cossio had dutifully rolled up her sleeve...
...Roberto Sicard, an HIV/AIDS specialist at the Bogotá office of the UN Refugee Agency (UNHCR), laments that the statistics on the general population have led international agencies and specialists to focus attention on more “needy” areas of the world...
...Two weeks later, the results of her blood screening came back HIV positive...
...I never could have lived with the weight of all those murders on my shoulders...
...In 2001, UNAIDS found that almost a fifth of men who have sex with men tested in Bogotá were HIV positive...
...Cossio’s story encapsulates the battle in Colombia over HIV...
...ing sex workers to have unprotected sex, which garners a higher price, since clients prefer sex without condoms...
...I wanted to be a good example, so the community would do the same,” she remembers...
...Cossio says she received her surprising diagnosis nine months after her husband, who she later realized had infected her, died victim of a botched robbery...
...Varón says grassroots groups have lost some of their brightest and most committed activists to betterfunded agencies like the UN, while others have succumbed to the disease...
...Co-workers stopped using the bathroom she used...
...He was presented as the sole HIV-positive person on a panel made up of prominent experts and government health officials...
...And then we’ll realize that the phenomenon is terrible, that it’s huge, and that generations are living with the virus...
...I just wanted to help...
...called undesirables: in this case, people living with HIV...
...If Abbott refuses or does not reply, he says, the next step would be pressuring the Colombian government to gain an “obligatory license” from Abbott...
...But even when a patient is insured, forcing health care providers to cover HIV-related he has become one of Colombia’s most outspoken HIV activists and the leader of Recolvih...
...Teo Ballvé is a freelance reporter and editor based in Colombia...
...Loving someone shouldn’t include ceding control and care of our own bodies...
...If granted, the organization would pay Abbott a relatively negligible 4% royalty...
...Sexual abuse, mainly of women and children, has become a common part of the armed groups’ violent repertoire...
...A major victory for Colombian activists came in 2005, when the legislature passed a national HIV/AIDS law that compels NACLA REPORT ON THE AMERICAS report: hiv/aids the government to provide people living with the virus integral care...
...HIV is mentioned in the diary of Tanja Nijmeijer, a guerrilla whose account of life in the Revolutionary Armed Forces of Colombia (FARC) was discovered and made public by the Colombian military...
...She had 48 hours to leave town, or they’d kill her...
...We know you have AIDS, and we know you work with those whores and faggots,” they told her...
...The higher rates are mostly concentrated among men who have sex with men and intravenousdrug users...
...The TV panel was public relations coup...
...His work mostly involved promoting government-sponsored HIV testing and assistance programs for people living with the virus...
...JasoN P. HoWe / WorLd PIcTure NeWs JULY/AUGUST 2008 report: hiv/aids As news of her diagnosis spread around town, parents at her two-year-old son’s kindergarten forced her to withdraw her child, even though he tested negative...
...Another government report estimates that 30,000 children are involved in sex industries...
...By reducing royalties and buying in bulk, Recolvih would be placing Abbott’s drugs in competition with generic lash against his family back in Ibagué (small town, big hell...
...An array of factors makes displaced people particularly vulnerable to the virus...
...She didn’t always think this way...
...a month’s supply can cost as much as $900, while the country’s monthly per capita gDP is estimated at $600...
...Consensual sex is not the only factor driving the epidemic’s feminization...
...in information and the backing of a growing network, Cossio 1993, the ratio had returned to San José del Gua fallen to seven to viare, where she immediately began holding meetings with one...
...For his efforts, he was threatened just as Cossio was...
...With the Colombian government, drug prices are “an unmentionable issue,” according to Varón...
...After being forced out of town by the armed group— whose identity she asked not be disclosed—Cossio moved to Bogotá and found what she calls her “second life...
...They also told me: ‘We have a nice little piece of land picked out for your hole of a grave.’ ” When the government’s only offer of protection was a bulletproof vest and a radio for his wife in case of an emergency, Gómez left the country with his family, seeking asylum in Canada...
...She shot back: “Don’t worry, I know your appearance will help a lot of people...
...The loss of livelihoods and the disintegration of family ties or other support networks are inherent parts of displacement...
...Sicard adds that Colombia is seeing a steady increase in heterosexual transmission, which means that HIV is being transmitted from groups with high concentrations to previously less affected populations, particularly women...
...her meals now came on disposable plates with plastic utensils...
...Neighbors told him that “strange men” were asking about him in the neighborhood, and two days later the Gómez family left Barranquilla for Bogotá, realizing that the paramilitaries had made him a marked man...
...This is atrocious,” Varón says...
...A government study found that 9% of forcibly displaced women reported being raped...
...The next day, the health ministry called him for an appointment...
...In these countries, civil society got on the government bandwagon, and that’s the way it should be,” Varón says...
...The study found that husbands are the main source of infection for most of them...
...On April 7, in an alliance with a coalition of NGOs, Recolvih sent a packet of documents to Abbott Labs, a U.S.-based producer of antiretroviral drugs...
...But seven months later, he noticed strange men once again lurking around his Bogotá home like vultures...
...This puts them at exceptional risk of both contracting sexually transmitted diseases and suffering reprisals from opposing groups that consider them enemy spies...
...The conference par ticipants gave her practical feminization of the information about treatments epidemic: In 1985, and her rights, and she be came part of a support and there were 55 men information network of HIV infected for every positive women...
...He attributes these gains to grassroots muscle, which he says is what differentiates Colombia’s HIV experience from those of many other countries...
...He admits, “Scientifically, we don’t know exactly what’s happening, but we do know there is a serious causal relationship between the epidemic and displacement...
...In an entry from June 2006, Nijmeijer writes, “I almost forgot the big news: Two comrades have AIDS, and there may be more...
...He talked for several minutes rattling off laws and statistics...
...It’s like we say: small town, big hell,” Cossio says...
...But she quickly adds, “We can’t generalize by laying all the blame on men, because women have to take responsibility for our bodies...
...Istartedorganizingaround unaIDs...
...If girls, boys, and women are sexual commodities within the perverse logic of the war,” Sicard reasons, “then they’re going to be the ones most affected by the epidemic...
...These women are basically in a situation of sexual slavery,” Sicard notes...
Vol. 41 • July 2008 • No. 4
