l G L H R C

INTERNATIONAL GAY AND LESBIAN HUMAN RIGHTS COMMISSION

ASYLUM DOCUMENTATION PROGRAM I SF P.O. Box 558, San Francisco, CA 94104-0558 USA Tel: (415) 398-2759· Fax: (415) 398-4635 e-mail: asylum@iglhrc.org· website: www.iglhrc.org

IG LH RC I NY c/o H RW, 350 Fifth Ave, 34th Floor, New York, NY 10118, USA

COUNTRY PACKET

SUPPORTING DOCUMENTATION FOR ASYLUM CLAIMS

CHILE #5

(2003- 2004)

STATUS OF PEOPLE WITH HIV/AIDS

Table of contents:

• Chile, 2004, UNAIDS

• Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: Chile, 2004, UNAIDS

• Joven con sida gana demanda contra centro medico por discriminacion, 8104, GLAAD LGBT Latino Media Activist List

• A young man living with Aids wins his Lawsuit against a medical center due to discrimination, 8/18/04, Human Rights Spanish Network Informative Bulletin

• Plan of a monitoring system and citizen control in the application of the AIDS law at a national level, 7111/04, 15th International AIDS Conference

• Understanding and responding to HIV/AIDS-related stigma and discrimination in the health sector (excerpt), 2003, Pan American Health Organization

• Chile: Anti-AIDS Commercials in Chile Spark Media Backlash, 12/4/03, Reuters

• Sociedad de Hematologia: Medicos temen riesgo por sangre de homosexuals, 6/19/03, El Mercurio

• Chile: Whether the government organization CONASIDA only helps terminally ill patients ... ,5/16/03, Canada Immigration and Refugee Board

• Sida en Chile: La Discriminacion Mata Antes Que el Virus Sobrevivir a Ia Exclusion, 1/3/03, CONASIDA

•••

Double sided pages: 20

The International Gay and Lesbian Human Rights Commission (IGLHRC) makes every effort to ascertain the accuracy of the items contained in this packet which are products of its own research. Nevertheless, some of the information contained is based on research by third parties unconnected with lGLHRC. Accordingly, IGLHRC cannot assume any responsibility for the accuracy of the information contained in this packet obtained by these third parties.

The information contained in the packet was supplied solely for the purpose of supporting an asylum or immigration claim. This information cannot be used in any other way without the consent of IGLHRC.

ChIle

[e n]

VN"CR'I.INIC£I'WfP·UN!)P·U"'F~A 1.INOIlC·'LO<UI'<EOCO·~·WOOD!IJ.KI

About UNAIDS

Geographical area In focus

Resources

Media Events

In the Southern Cone region aC Argentina, Chile, Paraguay and Uruguay aC" the severe economic crisis and its social consequences have created a favourable context for an increase o{HIV/AIDS.

Country HIV and AIDS estimates, end 2003

IIAdUlt (15-49) 10.30/0
H IV preva lence rate (range: 0.2%-0_5%)
! 26 000
! Adults (15-49) (range: 13 000-
I living with HIV 43000)
I
26 000 !
I Adults and children (0-49) (range: 13 000·
44 000)
,living with HIV
I
I
Women ( 15-49) 8700
living with HIV (range: 4300-14 000)
AIDS deaths 11400 (range: I
(adults and children) 700-2500)1
in 2003 Source: 2004 Report on the global AIDS epidemic

Additional couotry-by-country epidemiological information can be found in the UN Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections.

Country situation analysis

Access to prevention and care services has been severely damaged by the crisis, although Chile has been less severely affected than neighbourS Argentina and Chile.

Chite benefits from high quality professionals, With very strong civil society participation and a good participation of networks of people living with HIV secured, the systematic involvement of major ministries other than the Ministry of Health has just started.

In Argentina and Chile, the involvement of major ministries is more significant. In general, follow-up of national strategic plans is variable. Positively in Argentina and Chile the involvement of the respective PreSidents of the countries has been essential.

The severe economic crisis and its social consequences have created a favourable context for an increase of HIV / AIDS throughout the region. Nevertheless, the countries are committed to strengthening HIV/AIDS national response.

UNAIDS Support to the National Response

In the Southern Cone region, UN Theme Groups are functioning welt on an expanded mode, including National AIDS Committees, NGOs and people living with HIV networks, bilateral agencies and cosponsors. The UNAIDS office covers systematically all UN Theme Group meetings in the four countries. Rotations of the Theme Group chair are now smoothly taking place.

In Argentina and Chile, the existence of Country Coordinating Mechanisms has not changed the role of the Theme Groups as a key strategy and policy coordinating mechanism.

Theme Groups are actively contributing on UNGASS goals reporting, Millennium Development Goals, World AIDS Day and fully endorsed the new directions of UNAIDS support to countries.

The office continues to strengthen the capacity of civil society organizations, including people living with HIV networks, which are actively contributing to the national responses in the Southern Cone. Training and coordination activities are supported by the office. In the Southern Cone, a special emphasis on men who have sex with men and sex workers is currently in place. The

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office also actively pursues the promotion and utilization of best practices especially related to workplace, youth, harm reduction for injecting drug users, uniformed services and prisons. The office is also actively involved in resource mobilization, identification of resource gaps and strategic allocation of resources.T.his is particularly relevant in view of the economic crisis faced by the Southern Cone countries.

More information on the national AIDS response and countrylevel UN support can be found in the country annexes at the back of the UNAIDS at Country Level publication.

Contacts

Juan Manuel Sotelo

Chair, UN Theme Group on HIV/AIDS Telephone: +54 11 4312 5301/04 Fax: +54 11 4311 9151

Email: sotelojm@arg.ops-?ms.org

Laurent Zessler

UNAIDS Country Coordinator for the Southern Cone Telephone: +54 11 4314 2376

Fax: +54 11 4320 8754

E-mail: zesslerl@unaids.org

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Page 2of2

Chile

1(; •.... l.·~ ~ 'I. ~

~ 'I 1J!

-~ World Health Organization

unicef

Page -

2 Chile

HIV/AIDS estimates

In 2003 and during the first quarter of 2004, UNAI DS and WHO worked closely with national governments and research institutions to recalculate current estimates on people living witt) HIV/AIDS. These calculations are based on the previously published estimates for 1999 and 2001 and recent trends in HIVIAIDS surveillance in various populations. A methodology developed in collaboration with an international group of

experts was used to calculate the new estimates on prevalence and incidence of H IV and AIDS deaths, as well as the number of children infected Ihrough mofber-to-chnd transmission of HIV. Differem approaches were used to estimate HIV prevalence in countries with low-lever, concentrated Or generalised epidemics. The current estimates do not claim to be an exact count of infections. Rather, they use a methodology that has thus far proved accurate in producing estimates that give a good indication of the magnitude of the epidemic in Individual countries. However, these estimates are constantly being revised as countries improve their surveillance systems and collect more information.

Adults in !his repoFt are defined as women and men aged 15 to 49. This age range covers people in their most sexually active years. While the risk of HIV infection obviously continues beyond the age of 50, the vast majority of those who engage in substantial risk behaviours are likely to be infected by this age. The 15 to 49 range was used as the denominator in calculating adult HIV prevalence.

ES!imated number Of adults and children liyjng wilh HIV/AIDS end of 2003

These estimates include all people with HIV in1ection, whether or not they have developed symptoms of AIDS, alive at the end 01 2003:

Adults and children

low estimate High estimate Adults {15·49)

Law estimate High estimate Children (0-15)

Low estimate High estimate Women (15·49)

Low estimate High estimate

2£,000 13,000 44,000 2£,000 13,000 43,000

t

A 8,700 4,300 14;000

Adult rate {%) Low estimate . High estimate

0.3 0.2 0.5

Esttmated number of deaths due to AIDS

Estimated number 01 adults and children who died of AIDS during 2003:

. Deaths in 2003

Low estimate High estimate

Estimated number of orphans

Estimated number of children who have lost their mother or father Or both parents to AIDS and who were alive and under age 17 at the end of 2003:

Current tiv~ng orphans

Low estimate High estimate

1,400 700 2,500

A A A

UNAIDSIWHO Working Group on Global HIV/AIDS and STI Surveillance

.C;Ii>baJSurVeiila,;'(""<J.!HIVi';';itis.ai1~· transmitted infections,·(STls}'.iSiijiiin! WHOanct l.INAID.S. TheuNAIP.· .•...

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needed foririfo,.me;fde<!ision' regior,ai,andglbbal iev~ls,: o~epf tllE!. products oflhisi:.1 the globe; . . . ..

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• ThE'fact SheetscilOb~oh~~S9~b:daiiiiforrri~ti~nn1~di. ; ....••....• 8Vi>ii8b!e to jheUNAlqSiWiKI~oMng(3ro~p<:i}J,G"'t1aJ> ' .:', HIVIAIDS andST! SUrVeillailre'~r",fortj, 1l1eWorking Group would like to encourageallpro9r3IiimemanaQers as.viellas' national and ·intemational expertsto communicate adClhional information to them whenever.sticbinloi;rila~R"·becomes availai:>le. The Working Group 'llso """IQamesany suggestions fo,·additional indicalors or infoi!'nation·p[oviW·!o.beusefun,,·

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. , UNAIDSfWHO Epidemiological Fact Sheet - 2004 Update

Page-

3 Chile

Basic indicators

For consistency reasons the data used in the table below are taken from official UN publications.

Total population (thousands)

Female population aged 15-24 (thousands) Population aged 15-49 (thousands)

Annual population groWth rate (%)

% of urban population

Average annual growth rate of urban population Crude birth rate (births per 1,000 pop.)

Crude death rate (deaths perl ,000 pop.) Maternal mortaHty rate (per 100,000 live births) Life expectancy at birth (years)

Total fertility rate

Infant mortality rate (per 1,000 live births) Under 5 mortality rate (per 1,000 live births)

2004 2004 2004

1992-2002 2003

2000·2005 2004 5,7 2000 2002 2002 2000 2000

15,996 1301 8425

1.4 86.8 1.62 17.8 5.7 30 76.7

2.4 14 16

UN population division database UN population division database UN population division database UN population division database UN population division database UN population division database UN population division database UN population diVision database WHO (WHR2004)/UNICEF World Health Report 2004, WHO World Health Report 2004, WHO World Health Report 2004, WHO World Health Report 2004, WHO

Gross national income, ppp, per capita (lnl.$) Gross domestic product, per capita % growth Per capita total expenditure on health (Inl.$) General government expenditure on health as % of total expenditure on health

Total adult illiteracy rate

Adult male ill~eracy rate

Adult female illiteracy rate

Gross primary school enrolment ratio, male Gross primary school enrolment ratio, female Gross secondary school enrolment ratio, male Gross secondary school enrolment ratio, female

2002 2001-2002 2001

792 0.9 792

WOrld Health Report 2004, WHO World Bank

World Health Report 2004, WHO

2001

World Health Report 2004, WHO

44

2000 2000 2000

2000/2001 1996 1996 1996

UNESCO UNESCO UNESCO UNESCO UNESCO UNESCO UNESCO

4.2 4.1 4.4 104 101 85 86

Contact address

UNAJDS/WHO Working Group on Global HIVlAIDS and STI Surveillance

20, Avenue Appia

CH - 1211 Geneva 27 Switzerland

. Fax: +41-22-791-4834

email: HIV-AIDS@who.inl or estimates@unaids.org

website: http://www.who.int/hiv

ht1p:/Iwww.unaids.org

Extracts of the information contained in these fact sheets may be reviewed, reproduced or translated for research or private study but not for sale or for use in conjunction with commercial purposes. Any use of information In these fact sheets should be accompanied by the following acknowledgment 'WHOIUNAIDS epidemiological fact sheets on HIV/AIDS and Sexually Transmitted Infections, 2004 Update·_

UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update ,

Page-

4 Chile

HIV prevalence in different populations

This section contains information about HIV prevalence in different populations. The data reported in the tables below are mainly based on the HIV database maintained by the United States Bureau of the Census where data from different sources, including national reports, scientific publications and international conferences are compiled. To provide a simple overview of the current situation and trends over time, summary data are given by population group, geographical area (Major Urban Areas versus Outside Major Urban Areas), and year of survey. Studies conducted in the same year are aggregated and the median prevalence rates (in percentages) are given for each of the categories. The maximum and minimum prevalence rates observed, as well as the total number 01 surveys/sentinel sites, are provided with the median, to give an overview of the diversity of HIV-prevalence results in a given population within the country. Data by sentinel site or specific study from which the medians were calculated are printed at the end of this fact sheet.

The differentiation between the two geographical areas Major Urban Areas and Outside Major Urban Areas is not based on strict criteria, such as the number of inhabitants. For most countries, Major Urban Areas were considered to be the capital city and - where applicable - other metropolitan areas with similar socio-economic patterns. The term Outsloe Major Urban Areas considers that most sentinel sites are nollocated in strictly rural areas, even ~ they are located in somewhat rural districts.

HIV sentinel surveillance'

Group Arc. 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Pregrwnl: MajOf urban N-Siles 2.00 4.00 2.00 1.00 tOO '.00 '.00
Mlnimun 0,10 0_10 0_12 0.05
Median 0,10 0.10 0_12 '0.05
Maximc.m 025 0_10 0_10 0,12 0.05
Ou'!sJdemaj.or N-Siles 2.00 3.00 '.00 1.00 1.00 1.00 1.00-
crbanareus Minimum
006 0_10
M«lan 0.10 0,10
Ma:rim..m o.ro 0_10
Se-:cworkltrs
Injecting drug
SJ1'pa1ie~rs. Maiorolbarl N-SililS 1.00 3.00 4.00 2.00 1.00 '.00 1.00 l.OO
Mi..wnum 1.02 1.00 1.00 DO 2.20 2.23 350 3.49
MIl'd"ran 1.02 2.50- 1,99 '.30 2.20 2'.60 3.50 3 . .019
Maximlnl 1.02 3.64 2.94 1.30 2.20 2.97 3.50 3.49
O~"'*" f\l.-Site:. 4.00 4.00 4.00 '.00 2.00 2.00 3.00
urban areas
Minimum 0.18 0.30 O.~5
Medl~1"+ 0.10 0.5'0 0 . .015 u.eu 0."" 0.40 0.51
1kOO1TI-..m 02. 1.00 0.90 0.30 o.7S 0,50 1.32
Me.nhavir.gselC
Ylilhmen
Tubun:uf.ooi'S Majo, urnan .N·SitlMI t.oo 1.00 ,00
pa6ents 0 rees Mmirnum 0.35 1.67 .....
M-!tdian 0.3.5 1.£07 .....
Maximum 0.35 , . .,. ....
Outsidl!~r N-~Ie$ '.00 1.00 1.00 '.00
urban areas
Minirn<lm 0.00 Q.S7 '.30 U9
Medtan 0.30 0.57 2.30 1.l9
Maximum 0.30 0 . .57 2.30 1.1!1
'Detailed data by site can be fbund in the Annex. UNAIDSIWHO Epidemiological Fact Sheet· 2004 Update

Page-

5 Chile

Maps & charts

Mapping the geographical distribution of HIV prevalence among different population groups may assist in interpreting both the national coverage of the HIV surveillance system as well in explaining differences in levels of prevalence. The UNAIDSIWHO Working Group on Global HIVJAIDS and STI Surveillance, in collaboration with the WHO Public Health Mapping Team, Communicable Diseases, is producing maps showing the location and H IV prevalence in relation to population density, major urban areas and communication routes. For generalized epidemics, these maps show the location of prevalence of antenatal surveillance sites.

Trends in antenatal sentinel surveillance for higher prevalence countries, or in prevalence among selected populations for countries with concentrated epidemics, are a new addition. These are presented for those countries where sufficient data exist.

\\~'"

(D :mo 520

_" --

Trends in HIV prevalence in high risk groups

HIV pr&valene" ''''ong SID potients

HIV prevalence among STI patients

latest avail able year for 1998 - 2000

Percent seropositive

Sj Less than 1
~ 1 - 4.9
• 5- 9.9
• 10 - 249
• 25 - 39.9 e 40 ana more

cmss and towns

PopUlation density !persJsq.Km) D Lass than 10 DIO-.49 f,\t%~,~15o - 99 _100-2.49 _250-.499 _500-7.49 .750 and more

The boundaries and names shown and the designations used on U1e map do- not imply the expression of any opinion whatsoever OIl the part of th-e Wortd Health Organization concem~ng the ~ega~ status of any counlry, territory, city or area or o~ its authorities, or concem~ng the delimUation of ns Irontlars or boundaries. Dotted roes on maps represent approximate border lines for which there may not yet be lull agreement.

WHO 2004, all righls reserved.

4 4 3

"i:ft. 3 > 2 I 2

1 1 o

1994 1995 1996 1997 1998 1900 2000 2001 2002 2003 years

Median prevalence and ranges are shown in areas with more than one sentinel site.

UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update '

Page-

I) Chile

Reported AIDS cases

Following WHO and UNAIDS recommendations, AIDS case reporting is carried out in most countries. Data from individual AIDS cases are aggregated at the nalionallevel and sent to WHO. However, case reports come from surveillance systems of varying quality. Reporting rates vary substantially from country to country and low reporting rates are common in developing countries due to weaknesses in the health care and epidemiological systems. In addition, countries use different AIDS case definitions. A main dfsadvantage of AIDS case reporting is that it only provides information on transmission patterns and levels 01 infection approximately 5·10 years in the past, limiting its usefulness lor monitoring recent HIV infections.

Despite these caveats, AIDS case reporting remains an important advocacy tool and is useful in estimating the burden of HIV-related morbidity as well as lor short-term planning of health care services. AIDS case reports also provide information on the demographic and geographic characteristics of the affected population and on the relative importance of the various exposure risks. In some situations, AIDS reports can be used to estimate earlier HIV infection patterns using back-calculation. AIDS case reports and.AIDS deaths have been dramatically reduced in industrialized countries with the introduction of Anti· Retroviral Therapy (ART).

___ 111l1li

_Am. .I'm. '~'''imiid.

654

5625

UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update

Page-

7 Chile

Curable sexually transmitted infections (STls)

The predominant mode of transmission of both HIV and other STls is sexual intercourse. Measures for preventing sexual transmission of HIV and STls are the same, as are the target auoteoces for interventionS. In addition, strong evidence supports several biological mechanisms through which STls facilitate HIV transmission by increasing both HIV infectiousness and HIV susceptibility, Thus, detection and treatment of individuals with STls is an important part of an HIV control strategy. In summary, if the incidence/prevalence of STls is high in a country, then there is the possibility of high rates of sexual transmission of HIV. Monitoring trends in STls provides valuable insight into the likelihood of the importance of sexual transmission of HIV within a country, and is part of second generation surveillance, These trends also assist in assessing the impact of behavioural interventions, such as delaying sexual debut, reducin·g the number of sex-partners and promoting condom use.

Clinical services offering STI care are an important access point for people at high risk for both STls and HIV_ Identifying people with S'l ls allows for not only the benefit of treating the STI, but for prevention education, HIV testing, identifying HlV-infected persons in need of care, and partner notification for STls or HIV infection. Consequently, monitoring different components of STI prevention and control can also provide information on HIV prevention and control activities within a country.

STI syndromes

Reported cases

1996

1997

1998

1999

2000

2001

2002

2003 I Incidence 2003

Comments;

Source:

Syphilis preyalence, women

Percent of blood samples taken from pregnat women aged 15-49 that test positive for syphilis - positive reaginic and treponemal testduring routine screening at selected antenatal clinics.

Year

Area

Rate

Range

2003

2.08

Comments:

Source:

Estimated prevalence of curable STls among female sex workers

-Chlamydia

Year

Area

Rate

Range

Comments:

Source:

- Gonorrhoea

Year

Area

Rate

Range

Commenls:

In 2002 sentinel sites reported live cases of Gonorrhoea.

Source:

UNA1DSJWHO Epid~miological Fact Sheet· 2004 Update

i.". ..

Page-

8 Chrre

Estimated prevalence of curable STls among female sex workers (continued)

- Syphillis

Year

Area

Rate

Range

Comments:

Source:

In 2002 sentinel sites reported 10 cases 01 Syphilis (7 primary and 3 secondary)

- Trichomoniasis

Year

Area

Rate

Range

Commen1s:

Source:

In 2002, sentinel snes reported 29 cases of Trjc1lomoniasis.

UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update

Page -

9 Chile

Health service and care indicators

H IV prevention strategies depend on the twin eHorts of care and support tor those living with HIV or AIDS, and targeted prevention for all people at risk or vulnerable to the infection. It is difficult to capture such a large range of activities with one or just a few indicators. However, a set of well-established health care indicators may help to identify general strengths and weaknesses of health systems. Specific indicators, such as access to testing and blood

screening for HIV, help to measure the capacilyof health services to respond to HIVIAIDS - related issues. .

Access to health care

Indicators Year

% of population with access to health services - total 1995

% of population with access to health services - urban

% of population with access to health services - rural

2000 2002 2001

Estimate Source
97.6 Ministry of Health
43 UNICEF/UNPOP
100 WHO
94 WHO/UNICEF
99 WHO/UNICEF Contraceptive prevalence rate (%)

Percentage of contraceptive users using condoms % 0' births at1ended by skilled health personnel

% ot t-yr-oid children fully immunized - OPT

% ot t-yr-old Children fully immunized - Measles % of ANC clinics where HIV testing is available

1990-1999

Number of adults (15-49) with advanced HIY infection receiving ARY therapy as of June 2004

Adults on treatment

Number:

4032

Source:

WHO

Estimated number of adults (15-49) in need of treatment 'in 2003

Adults needing treatment

Number:

6,200

SOUrce:

WHO/UNAIOS

Coverage of HIV testing and counselling

Number of public and NGO services providing testing and counselling services.

Year

Area

2004

281

Comments:

277 Public and 4 NGOs.

Source:

UNAIDSfWHO Epidemiological Fact Sheet - 2004 Update '

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10 Chile

Knowledge and behaviour

In most countries the HIV epidemic is driven by behaviours (e.g.: multiple sexual partners, injecting drug use) that expose individuals 10 the risk of infection. Information on knowledge and on the level and intensity of risk behaviour related to HIVIAIDS is essential in identifying populations most at risk for HIV infection and in better understanding the dynamics of the epidemic. It is also critical information in asssessing changes over time as a result of prevention efforts. One of the main goals of the 2nd generation HIV serveillance systems is the promotion of a standard set of indicators defined in the National Guide (Source: National AIDS Programmes, A Guide to Monitoring and Evaluation, UNAlDSJOO.17) and regular behavioural surveys in order to monitor trends in behaviours and to target interventions.

The indicators on knowledge and misconceptions are an important prerequisite for prevention programmes to focus on increasing people's knowledge about sexual transmission, and, to overcome the misconceptions that act as a disincentive to behaviour change. Indicators on sexual behaviour and the promotion of safer sexual behaviour are at the core of AIDS programmes, particulary with youg people who are not yet sexually active or are embarking on their sexual lives, and who are more amenable to behavioural change than adults. Finally, higher risk male- male sex reports on unprotected anal intercourse, the highest risk behaviour for HIV among men who have sex with men.

Knowledge of HIV prevention methods

Prevention indicator: Percentage of young people 15-24 who both correctly identify two ways of preventing the sexua I transmission of HIV and who reject three misconceptions about HIV transmission.

Year

Male

Female

Comments:

Source:

Reported condom use at last higher risk sex (young people 15-24)

Prevention indicator: Proportion of young people reporting the use of a condom during sex with a non-regular partner.

Year

Male

Female

Comments:

Only data collected since t99B.

Source:

Age-mixing in sexual partnerships among youg women

The proportion of young women who have had sex in the last 12 months with a partner who is 10 or more years older than themselves.

Year

Area

Age group

Male

Female

All

Comments:

Source:

Reported DOD-regular sexual oartnerships

Prevention indicator: Proportion of young people 15·24 having at least one sex partner other than a regular partner in the last 12 months.

Year

Male

Female

2003

comments:

Source:

Encuesta INJUV

, UNAIDSIWHO Epidemiological Fact Sheet· 2004 Update

Page -

11 Chile·

Knowledge 'and behaviour (continued)

Ever used a condom

Percentage of people who ever used a condom.

Year

Area

Age group

Male

Female

All

Comments:

Source:

Adolescent pregnancy·

Percentage of teenagers 15-19 who are mothers or pregnant with their first child.

Year

Percentage

2000

34,444

Comments:

Sourcer

INE, Anuario de Estaoistlcas Vitales

Age at first sexual experience

Proportion of. 15-19 year olds who have had sex before age 15.

Year

Male

Female

2003

Comments:

Based on the tNJUV survey 2003 that included youths 15·29 years at age, the median age tor the lirst sexual experience in women is

17.36 years and men 16.19 years. General median: 16.75 years. .

Encuesta INJUV

Source:

" UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update

Page-

12 Chile

Prevention indicators

Male and female condoms are the only technology available that can prevent sexual uansrntssion of HN and other STls. Persons exposing' themselves to the risk of sexual transmission of HIV should have consistent access to high quality condoms. AIDS Programs implement activities to increase both availability of and access to condoms. Thes activities should be monitored and have resources directed to problem aresas. The indicator below highlights the availability of condoms, However, even il condoms are widely available, this does not mean that individuals can or do acess them.

Condom availability nationwide

Total number of condoms available for distribution naHonwide during the preceding 12 months, divided by the total population aged 15-49.

Year

N

Rate

2001

11.109.248

1.37

2003

21,437,670

Comments,:

unidades importadas

Regislro de importaciones del pais. Banco Central de Chile

Source:

Prevention of mother-to-child transmission (MTCT) nationwide

Percentage 01 women who were counselled during antenatal care for their most recent pregnancy, acceptedan oHer of testing and received their lest results, of all women who were pregnant at any time in the preceding two years.

Year

N

Rate

Comments:

Source:

Blood safety programs aim to ensure that the majority ol blood unils are screened for HIV and other infectious agents. This indicator gives an idea 01 the overall percentage of blood units that have been scre.ened to high enough standards that they can confidently be declared free of HIV.

Screening of blood transfusions nationwide

Percentage of blood units transfused in the last t2 months that have been adequately screened for HIV according to national or WHO guidelines.

Year

N

Rate

2002

226119

100

Comments:

Source:

Ministry of Health

UNAIDSIWHO Epidemiotogical Fact Sheet· 2004 Update

Page -

13 Chile

Sources

Data presented in this Epidemiological Fact Sheet come from several sources, including global, regional and country reports, published documents and articles, posters and presentations at international conferences, and estimates produced by U NAI OS, WHO and other United Nations agencies. This section contains a list of the more relevant sources used for the 'preparation of the Fact Sheet. Where available, it also lists selected national Web sites where additional information on HIV/AIDS and STI are presented and regularly updated. However, UNArDS and WHO do not warrant that the information in these sites is complete and correct and shalt not be liable whatsoever for any damages incurred as a result of their use.

Estudio Nacional de Comportamiento Sexual, CONASIDA. Chile 1998.

Encuesta Fundaci6n Nacional de Lucha Contra el SIDA, FUNACS, 1996.

Child, R., A. Arredondo, E. Ortiz 2000 Prevalence of·HIV in Chilean Population, 1992-1999 Xlllinlernational AIDS Conference, Durban, South Atrica, 7/9- 14, Poster Supplement LbPeC7070.

Chile Ministerio de Salud 1998 Caracterizaclon Epidemiologiea del VIHISIDA en Chile Boletin Epidemiologico Trimestral Conasida, number 4, marzo, serie

ducumentos. .

Chile Ministerio de Salud t 999 Caraeterizaeion Epidemiologiea del VIH1SIDA en Chile: diciembre de 1999 Boletin Epidemiologico T rimeslral, CONASIDA, Serie de Doeumentos CONASIDA, no. t 1, diciembre report.

Chile Ministry of Health 1993 PAHOIWHO HIV SurveiJtance PAHOIWHO.

lake, E. T., H. L. Smith, L. H. Aiken, et at. 1993 HIV Surveillance and Transmission Patterns in Santiago, Chile 1991 IX International Conference on AIDS, Berlin, 6/6-11, Posler PO-C06-2700.

Paz, A. A., Comision Nacional del SIDA 1995 PAHOIWHO HIV Surveillance May 31, PAHOIWHO.

Paz, A. A., Comision Nacional de SIDA 1996 PAHOIWHO HIV Surveillance August 8, PAHO~HO.

Yanez, A., M. Bachele!, M. T. Valenzuela, et at. 1995 La lntaccton porVIH y sus Gonsecuencias para la Endemia Tuberculosa en Chile Boletin de la Ofieina Sanitaria Panamericana, vol. 119, no. 2,·pp, 166-178.

Websites:

Ministry of Health: Comicion Nacional del SIDA {Spanish only}: www.minsal.c:llinciativas/eonasidalconasida.htm

UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update

. to·

Page-

14 Chile

Annex: HIV surveillance by site

Group Area 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

P.-egnant MajO! Ulban Mll'tropoliJaIl
areas C011lJalrf'~
Me-tropolilan Q.1O
region.
Mltlropoiilan r
I\Ihmopolhan D.12 0.05
Santiago region
Santiago 0.10 0.10
Tarcchuaeo 0.25-
Outslde majol A"mco 0.06
urban areas
Concepcion O.tO 0,10
fighlh region O-.lD
Eighth Il'gkln, 0.10
~ighlh re-~ioni
"",an
S-e)l~i:tt;.
.lnjox:lil"Jgdrl.lg"
STlpalienis M*rlJl'b<m Menopolilan 3." 2.94
tlo.!'lhre-gion
IIdl!lropoiil<J1'l '.00 1.49 1.30 2.;7
IltIJion.
'~hrlrnpcli"!an r
MelropoFi'tBn 2.23 3.4-9
SanliaElo region
Sanliil~ 11)' 250 ,00 t_30 2.20 3.50
O"'I$idetn~Iot -AnlolagastiJ 0.20 030
urb<ln.<l-Ie<ls,
Arilof'l~s'ta 025
legion
Anto'!ag .. ~ 0.1B-
leg.ot;..
Allto1::I:g::JSI<ltE'9-
~Ighlh Ie-gion 1.32
V;;,lp8r8~50 0.20 1.00 D."" O.B{J 0.50
Valparals.o 0.22 0.75 O.Sl
leglon
Valparaiso 0,9;- 0]1)
re-gion.
Valpataiso 'e-g;o
Men I1.avingUiX
withml!ln
ToJbt"rcuklsis ME.;orurban Melropoiitan 0.35 1.67 2.""
~ti-en~ erees region .
Millrupclitanr
OYlsid&major Va;palai~S<m 0.30 0.57 2.30 r.rs
vrbanareas An"""" UNAIDSIWHO Epidemiological Fact Sheet - 2004 Update

*********************************************************************************

Chile:

Joven con sida gona demanda contra centro medico por discriminaci6n

Punta Arenas (Chile), Terra.com .- Un folio de primera instancia del Segundo Juzgado de Polida Local de Punta Arenos conden6 0 una mutual de seguridad de esa ciudad a pagar 200 unidades tributarias rnensuoles. unos seis millones de pesos a un joven que acusa a la entidad de salud de hoberle negado 10 atenci6n medica por estar diagnosticado can el virus del VIH ..

EI demondante, quien octuolmente tiene 23 enos de edad, fue acuchillado quedando con graves heridas en un incidente que aconteci6 a fines de junio del orio posada, par 10 que fue derivado a 10 mutual donde presuntamente le negaron otenclonrnedico.

EI veredicto de 10 titular del Segundo Juzgado de Polida Local, Patricia Espinoza, estableci6 que hubo discriminaci6n por parte de los funcionarios, quienes 01 saber que el apunalado era portador de side. no Ie prestaron asistencia yoptaron par pedir uno ambulancia 01 hospital regional.

AI respecto, Fred Focusse, vocero de lo. entidad demandado, senolo que fueron notificodos del folio condenatorio, en contra del cual interpondr6 el recurso de apelaci6n respectivo, seg0n seriolo Lo Tercero Digital../ Ir 01 inicio

--

************************************************************************************

~ 8/18/048:34 AM -0700, Fwd: Human Rights Watch defends the rights of the J~GBT com

1

To:

From: Dusty Araujo <asylum@iglhrc.org>

Subject: Fwd: Human Rights Watch defends the rights of theLGBT communities Ce:

Bee:

Attachments:

Issue No. 55 - August 18, 2004 - Bogota, Colombia

In this issue ...

Founder Director German Humberto Rinc6n Perfetti rinconperfettigerman@hotmail.com

Designer & Editor David Morales Alba

Translator Cecilia Sarmiento

A young man living with Aids wins his

Lawsuit against a medical center due to discrimination

Printed for Dusty Araujo <asylum@iglhrc.org>

1

,8/18104 8:34 AM -0700, Fwd: Human Rights Watch defends the rjghts of the I.GRT com

2

Punta Arenas, Chile, Terra.com - A decision by the Second Court of The Local Police in Punta Arenas sentenced a health care cqmpany in this city to pay 200 monthly tax payments, about 6 million pesos, to a young man who accused the company of denying him medical services because he had beendiaqnosed

with the HIV virus.

The plaintiff, who is currently .23 years old, was attacked with a knife and sustained serious

iniuries ,-J~ , ... ;-- ,,- ;-c;...J--_J.. +1-.._+ h_p ....,J last ~~-- ..... -+ ~t-. ...... end ot lune and ---", 0&. ......... 601."1._

IIIJ IIC" UUIIlIY all til IU<::;;11l u rcn, I lei 1-'t'IICU 10 11;;;01 at lilt' U I VU IC, al U "Clll LU II IC

medical center where he was medical attention. ..

The verdict by the Judge of the Second Court of the Local Police, Patricia Espinoza, established that discrimination took place on behalf of the medical personnel, who denied him treatment once they found out he was an AIDS carrier, they opted to transport him by ambulance to the regional hospital.

Fred Facusse, a spokesperson for the medicaJ center that was sued, stated that they were notified of the decision and that they will file an appeaJ .! Back to top

Printed for Dusty Araujo <asylum@iglhrc.org>

2

AEGiS·15IAC: Plan of a monitoring system and citizen control in the application of the AIDS law at a national level.

4/512005 1:28PM

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

k!e-Iltl~t~ and H.'!'alth (..are Wt:w"o:el'3 Commfmd to HlVJAlOS

PRINT THIS ART1CLE

Plan of a monitoring system and citizen control in the application of the AIDS law at a national level.

Int Conf AIDS 2004 JuI11-1S; 15:(abstract no. MoPeE4083)

Deliyanis VD, Novoa PN, Canales Fe VIVO POS/T!VO, Santiago, Chile

ISSUES: There is a law since December 2001 that protects the rights of PLW H1V/AIDS in Chile, however, the government has not participated in the involvement of the process of diffusion. Paradoxically in spite of this law being hard to obtain, only three lawsuits have been sponsored by VIVO POSITIVO, in spite of the fact that these law protected rights have been violated.

DESCRIPTION: A monitoring' system and citizen control was designed on the application ofthe AIDS law which consists of installing focal spots in region and cities where VIVO POSITIVO considers as parameters to emphasize region interventions: the incidence, the prevalence, the external and internal migrations and the degree of organizational development. Following this logic, nine monitors will be assigned in nine regios of the country. For the selection of the monitors four workshops in the cities of Copiapo, Concepcion, Punta Arenas and The Region Metropolitana were carried out, which gathered people coming

. from the 38 groups along the country. The workshops were designed, people were called out and the workshops were carried out.

LESSONS lEARNED: A number of fifty seven people were trained in terms of identifying and proceeding in cases of law violations to the law of AIDS, which allows the groups of PLW HIV/AIDS to turn into loea citizen local agents. Since the establishment of this strategy the number of accusations for violations to this legal regulation has increased, and initiatives aiming to involve other social protagonists have been generated in the defense of the rights of PLW HIV/

AIDS at a local level. .

RECOMMENDATIONS: The decentralization of the activities done by VIVO POSITIVO in terms of the defense of the PLW HIV/A1DS allows to increase on the one hand the amount of detected cases, as well as the diffusion of this legal entity, which not onlyprotects the rights of PLW HIV/AIDS, but also of the whole

citizenship which improves the integration of PLWHIV/AIDS to the community. .

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Health Planning, HIV Infections, Human Rights, HIV Seropositivity, Prevalence, Incidence, Chile, United States, prevention & control, legislation & jurisprudence, surgery, education

040711 MoPeE4083

Copyright ©2004 - International AIDS Society (lAS), Reproduction of this abstract (other than one copy for personal reference) most be cleared through the lAS.

http://www.aegis.com/conferences/lSwac/mopee40 83 .htrnl

Page I ofl

It I I J I ( .

V'" III S t cr~ 0\1 "')

31

4. HEALTH CARE SETTINGS: LATIN AMERICA AND THE CARIBBEAN

Studies "and reports of HIV/AIDS-related stig. rna and discrimination in the health services in Latin America and the Caribbean that use similar methodologies suffer from the same defects and portray a similar situation as in the rest of the world. Extreme forms of discrimination, such as calls for isolation, are rare, but discriminatory attitudes and behavior continue in many communities, with a negative impact on the psychological and physical wellbeing of people Jiving with HIV/AIDS.

Because most of the surveys reviewed below took place at a time when antiretroviral therapies were not widely available and the disease still had strong associations with death, they do not necessarily reflect the current situation. Furthermore, anecdotal evidence suggests that while the stigma of

HIV/AIDS is indeed diminishing in some communities, sex between men remains highly stigmatized, with the result that some individuals are more concerned to hide their sexuality than their Hl'V-positive status (see below). While homophobia is recognized by some organizations as .an issue, stigmas

14 Unusually, Nicaragua criminalized sex between men in 1992.

associated with injecting drug use and women sex workers are almost certainly widespread but have not been the subject of investigation.

Regrettably, this review identified only a handful of studies in the region. It is certain that many other surveys of stigma and discrimination in the health services in Latin America and the Caribbean have been undertaken and so conclusions here must be taken as preliminary.

Homophobia

Despite the emergence of gay rights organizations and some acceptance of openly gay men in liberal social circles, homophobia remains widespread throughout Latin America and the Caribbean and is a major factor in HIV/AIDS-related discrimination.

In many sectors of Latin American society, homosexual activity is acceptable if the man only penetrates his partner. Men who are penetrated or perceived as being penetrated are considered "less-thanmen" and therefore "legitimate" subjects of stigma.

Violence against men known or suspected of having sex with other men is common in the region and includes rape and murder. Cases have been most documented in Brazil but are reported from almost every country. H1V/A1DS is often a rationale for attacks, with the victim being accused of spreading

" the virus, whether or riot he is H1V-positive. Violence often occurs in sexual situations and is fueled by the attacker's fear and anger that he is being accused of . being a man who is penetrated. (Mott et a11002)

Although sexu'al activity between two men is legal in most countries in the region", the police use laws referring to public morality to prevent men from congregating or to restrict their behavior in public or

32 - Understanding and responding to HIVIAIDS-re1ated stigma in the health sector

semi-public places such as bars. Police violence against homosexual men is also widely reported.

Homophobia in the health services .in the region is widely reported (see Chile, Guatemala and the Caribbean) but the extent to which it is a factor in HIV/AIDS-related discrimination has not been statistically researched. Such research is essential in the construction of an appropriate response to stigma and discrimination.

Legislation

The American Convention On Human Rights (Additional Protocol) contains an article on "Right to Health': which compels countries to ensure "satisfaction of the health needs of the highest risk groups and of those whose poverty makes them the most vulnerable':

A 1991 surveyofHIV/AIDS-related legislation in Latin America noted the wide range of factors influencing the drafting of legislation, including the attitudes of health workers, the effectiveness of government bureaucracy in addressing the issue, the role of the Catholic Church and the mass rnedia. Three approaches were identified: restrictive, "based on the perception that the AIDS epidemic can and should be controlled by restrictive laws and regulations" and humanistic, stressing "the need to respect the human rights of AIDS patients and persons who are HIV positive, as well as those of their families and friends': and pragmatic, based on the rationale that "only regulations which address specific; concrete situations can accomplish the goal of preventing and controlling spread of the disease': The survey pointed out that several countries adopted more than one approach,

.: such as a Costa Rican decree that prevents discrimination against prison inmates on grounds of sexual orientation or HIV/AIDS status, and a law in the same country requiring HIV tests for foreigners seeking

, permanent or temporary residence. (Linares 1991)

More recent reviews of legislation have been less . comprehensive. The Pan American Health Organization published a brief report on legislation and access to treatment in 2003 (PAHO 2003), and a review of Central American legislation is discussed in Section 4.3.

4.1. Spanish-speaking South America

4.1.1. Argentina

Health workers' attitudes

A 1996 survey of health professionals working in HIV/AIDS confirmed high rates offear in treating injecting drug users (57%), homo/bisexual men (26%), the children of Hlv-positive mothers (12%), hemophiliacs or blood product recipients (J2%) and heterosexual patients (5%). (Frieder 2003)

A 2000 study in five hospitals in Buenos Aires showed reduced rejection of people with HIV IAIDS; however, a strong link between stigmatized behaviors - focusing on sex and injecting drugs - continues to produce difficulties in the relationship between doctor and patient. (Biagini 2000)

Experiences of people with HIV/AIDS

Patricia Perez of the Latina branch of the International Community of Women living with HIV/AIDS comments that discrimination has fallen as health workers have more information about the disease 'and have more contact with people who are HIV-positive as an increasing number of people are diagnosed, She points out that a minority ofVIH positive people have been helped by greater knowledge of their rights, JCW Latina is working with the Anti-discrimination Office to reduce stigma and discrimination in hospitals, self-help groups and schools. (Personal communication)

4.1.2. Bolivia

Health workers' knowledge

An undated (believed to be 1998) study revealed very high rates of ignorance among 305 health workers in Cochabamba regarding HJV/AIDS diagnosis and treatment (79.4% were unaware of the need to confirm a positive ELISA test; 72.1 % were unfamiliar with drugs used to combat HIV/AIDS) and low rates of confidence regarding working with patients with the disease (30.3% considered they had the skills to

Understanding and responding to HIV I AIDS-related stigma in the health sector - 33

work with HIV/AlDS patients; 33.8% were afraid of the patients and believed they should be isolated). These figures crossed all aspects of the profession, including doctors, nurses, nursing assistants and laboratory assistants. (Valdez Carrizo & Saudan nd)

4.1.3. Chile

General population

According to a speech made by a Chilean government delegate to the United Nations in November 2000,75% of the population "is willing to share social spaces, such as places at work and at school with persons living with HIV/AIDS" while the "number of those surveyed who declared that we are all vulnerable increased from 6.9 per cent in 1991 to 28.2 per cent in 1994. It is believed that this figure has increased significantly since then." Since then anti-discrimination legislation has been passed that promotes prevention and non-discrimination against persons living with HIV/AlDS had been approved by the Chamber of Deputies was being considered in the Senate.

Health workers' attitudes

A ] 997 study showed that 48.5% of nurses in the health services in Concepcion were favorable to working with patients with HIV/AIDS, 41.6% were indecisive and 10.1 % had negative attitudes. (Ortiz & Del Carmen 1997)

Experiences of people with HIVIAIDS

A 70-page report on "Situations of discrimination affecting people living with HIV/AIDS in Chile': including health care settings, collected data and interviews from 13 cities was made in 2002. The document describes in detail "the situations of discrimination which people living with HIV experience in health settings, particularly in the lack of access to antiretroviral treatments, discrimination in health services as well as the infringements of medical ethics which occurs in these clinics. (Vivo Positivo 2002)

15 sidoso: insulting Spanish term for sOllJeone with AIDS.

"Informants reported the fewest positive experiences in health settings. Even when, in general, people recognize that they have noticed a change in [health] professionals' attitudes towards patients, particularly within HIV programs, this change does not match the requirements and needs of people living with H]V /AlDS." (Vivo Positivo 2002)

The report notes underlying causes of discriminatory behavior, including lack of staff, training and information and carries extensive criticism as well as recommendations.

CHILE: Anti·AIDS Commercials in Chile Spark Media Backlash

4/512005 10:57 AM

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

CHILE: Anti-AIDS Commercials in Chile Spark Media Backlash

Reuters (12.02.03) . Thursday, December 04, 2003

Ignacio Badal

The Chilean government's media campaign against HIV/AIDS hit a snag recently when three leading Chilean TV stations refused to air commercials that were launched for World AIDS Day along with radio jingles, pamphlets and bus-stop posters. The four commercials feature a married man who has a lover, a teenager having unprotected sex, a housewife whose husband is cheating on her, and a gay couple in bed. The channels said the spots, which promote condom use, violate their editorial policies. Two other channels aired the spots.

Throughout latin America, homophobia is one of the biggest obstacles to proper treatment of the estimated 2 million people with HIV/AIDS, a study by the Pan American Health Organization said. The Chilean Catholic Church, like the Vatican, has objected to the government's emphasis on condoms as a prevention measure.

"We're talking about people dying here," said government spokesperson Francisco Vidal. ") have my own opinion about infidelity and homosexuality, but they exist. So how do we deal with a problem like this? Looking at the ceiling or dealing with it?"

Roughly 4,000 Chileans have died of AIDS and 28,000 have HIV, according to government figures. Chile's government has promised free anliretroviral treatment for all HIV/AIDS patients through donations from international organizations.

The commercials show people looking in the mirror, asking themselves why they are not taking precautions against HIV/AIDS. The spots are based on studies showing Chileans are well informed about the causes of HIV/AIDS but do little to prevent it

031204

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Copyright ©1980, 2003. AEGiS. AI! materials appearing on AEGiS are protected by copyright as a coliecUvB wort< or compilation under U.S. copyright and o!her laws and are the property of AEGiS, or the party credited as the provider of the content com ments@laegis.org.

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ELM,ERCURIO

Chile http://diario.e]mercurio.com!_portadal_portadalnoticias/2003/6/19/342315.htm?id=342315

Sociedad de Hematologia:

Medicos temen riesgo por sangre de homosexuales 19 de Junio de 2003

Denuncian al Ministerio de Salud de aprobar sin apoyo tecnico Ia norma que permite donaciones s610 declarando uSQ de condon.

Una dura acusaci6n formul6 ayer la Sociedad de Hematologfa en contra del Ministerio de Salud.

Acuso ala cartera de dictar hace tres afios, de forma irregular y sin consentimiento tecnico de los expertos en la materia, una norma que faculta a los homosexuales a donar sangre s610 declarando haber usadocond6n en sus' relaciones sexuales de los ultimos 12 meses.

"Esto implica un grave riesgo para 1a sa1ud de Ia poblaci6n receptora"; dijo

ayer el presidente de la sociedad y jefe del banco de sangre del Hospital . Clfnicode Ia Universidad de Chile, Milton Larrondo, y el presidente del Colegio Medico, Juan Luis Castro, quien es hemat6Iogo.

La revelaci6n surgi6 luego que el Movimiento deIntegracion y Liberaci6n

Homosexual (Movilh), encabezado por Rolando Jimenez, iniciara una fuerte of ens iva pidiendo una libertad absoluta para donar sangre y que al momento de hacerlo no se consulte al donantesi ha lel!ido relaciones homosexuales protegidas.

Basta 1999, en Chile loshomosexua1es no podfan donar sangre, pues era considerado un riesgo por la eventual transmision de VIH u otras enfennedades de tipo sexual.

Una comision tecnica de la Sociedad de Hematologfa trabaj6 con Salud en una norma - record6 Larrondo- , pero la regIa "fue aprobada sin que nosotros conocieramos el texto final y ello no contaba con el apoyo de los tecnicos".

La sociedad envi6 una carta en 2000 al subsecretario de Salud de la epoca, Ernesto Behnke, sefialandolela irregularidad de una disposicion en la que se encontraron "serios reparos tecnicos que ponen en riesgo la seguridad transfusional". Se Ie arguy6 que 1a Food and Drug Administration (FDA) de EE.UU., asf como otras naciones desarrolladas consideraban que los homosexuales no debfan donar sangre, pues implicaba un riesgo. Pese a ello, Ia cuestionada norma sigue vigente, Continue leyendo estanoticia.

Mientras para los homosexuales no es mas que una muestra de "homofobia", los expertos argumentan que las conductas de. riesgo exponen a los receptores en forma innecesaria.

VICTOR HUGO DURAN

l,Homofobia 0 riesgo sanitario? Esos son los dos argumentos que esgrimen medicos y homosexuales para rechazar 0 apoyar que los gays puedandonar sangre, tern a que se reactiv6 luego que el Movimiento de Integraci6n y Liberacion Homosexual (Movilh) pidiera flexibilizar la norma chilena respectiva, que data de 2000 y en la que se les permitio donar siempre y cuando declaren

que en los ultirnos 12 meses tuvieron sexo con cond6n.

El tema esta gatil1ando una fuerte rebeli6n de los jefes de bancosde sangre, que pedirian una reuni6n con las autoridades sanitarias para plantearles su malestar por esta situacion y la posible flexibilizaci6n porsegunda vez de la norma.

Para el presidente de la Sociedad Chilena de Hematologfa, Milton Larrondo, el Ministerio de Salud expuso a Ia poblacion receptora a un riesgo innecesario al perrnitir desde hace tres aiios la donacion sangufnea de homosexuales.

Afirm6 que aunque se realizan tests sofisticados, "siempre puede haber errores, como no desecharuna bolsa que presente algun tipo de patologia como VIH. hepatitis, citomegalovirus y otros, y e110 afecta a los receptores".

Por eso, le es ins61ito que la carteraaprobara en 2000 una norma que no tuvo el aval de expertos, 10 que a su juicio es "irregular", dado que el cond6n no siempre es seguro y adem as se trata de una declaracion personal en una entrevista, no verificable ni constatable.

Para el presidente del Colegio Medico, Juan Luis Castro (tambienhematologo), la donaci6n de sangre "no es un derecho, sino un privilegio que establece diversos requisitos.de seguridad y selecci6n".

Por 10 mismo, explic6, no se permite que mujeres en lactancia 0 de bajo peso, anemicos, enfermos de hepatitis, mal de Chagas u otras infecciones, donen

su sangre. "En el caso de los homosexuales y el sida, siempre existe una ventana que puede ir de un rnes a seis meses 0 mas, en la que el virus nose detecta. Pueden aparecer falsos negativos y finalmente una persona se contamina.j Y que le decimos despues a esa persona?".

Para Rolando Jimenez, del Movilh, el tema no es tecnico, sino una clara discriminacion. "Es una norma arbitraria, que. estigmatiza a un grupo, se mete en lavida privada y atenta contra la igualdad ante la ley", dijo. A su parecer, toda lasangre debe ser testeada, y por 10 misrno "no

hay argumentos cientfficos 0 sanitarios para rechazar a priori 1a donaci6nque hacen ]05 homosexua1es, pues no hay un riesgo para el receptor".

El jefe de la Division de Planificacion y Presupuesto del Ministerio de Salud, Claudio Farah, dijo a este diario que si bien en su minuto los tecnicos fueron escuchados y se les pidio opinion, "finalmente la responsabi1idad de construir una norma es del ministerio y no es delegable. Adernas, 1a norma acoge el 95% de 10 propuesto por la sociedad y hay 56]0 un punto sin acuerdo".

Aunque Farah no estaba en la cartera en 2000, planted que si en ese minuto se.permitio Ia donaci6n sanguinea de

homosexuales "es porque no hay los argumentos y antecedentes clfnicos suficientes para respaldar un rechazo. Estamos en un nivel intermedio entre las posturas duras y las mas liberales en la materia". EI medico estirno que aunque "todas las nonnas son revisables, por ahora el ministerio no esta evaluando la posibilidad de modi ficar1 a" .

En el mundo

A nivel internacional hay un amplio rechazo a la donacion sanguinea de homosexuales. La FDA de Estados Unidos, 1a profesora de rnedicina transfusional del Servicio Nacional de Sangre de Inglaterra, Marcela Contreras, 0 el mismo Ministerio de Salud de Francia u otras naciones europe as rechazan esta opci6n para evitar riesgos. En Argentina, Mexico, Canada y Nicaragua

. tarnbien hayprohibicion; en Guatemala se establecen restricciones para portadores desida

y otras afecciones como en Chile. Pero en todas ellasse pregunta al donante si ha tenido relaciones sexuales con otros hombres y, en caso de ser asi, se le pide noentregar su sangre para

transfusiones. .

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CHL41316.E

16 May 2003

SUbject:

»Chile~: Whether the government organization CONASIDA only helps tenninaly ill patients; availability of health care to Hlv-positive homosexual men; whether medication is being denied to Hl V-positive individuals based upon their ... sexual," ... orientation-a; whether positive results ofHIV tests are reported by doctors and hospitals to the government and to the patient's employer; treatment ofHIV -positive individuals by employers; legislation preventing the dismissal ofHIV-positive individuals; attitude ofthe general population toward those who are Hl'V-positive (1 997-present)

Regional Office: 5

. From.

Research Directorate, Immigration and Refugee Board, Ottawa

General Information on HIV/AIDS in »Chile+c

Health Care Available to HIV-Positive Individuals

Between 1996 and 1999 the budget for HIV therapies increased by 320 per cent, allowing more people to benefit from better quality treatments (»Chil~ Dec. 200 I, 13). But in September 2000, it was estimated that only 50 per cent of those who needed treatment were receiving it; that is, only 750 patients hadreceived the "double therapy cocktail" (biterapia) and the same number had received the "triple therapy cocktail" treatment (triterapia) (ibid.). The President estimated that, despite the increase in funds, 400 people who need the "triple

therapy cocktail" will not be able to access it in the public health care system due to a lack of resources (ibid., 4 dec. 2001a). According to Inter Press Service (IPS), this means that at least 2,241 patients will have to pay US$714 a month for treatment when the minimum wage in »-Chil~ is US$178 (IPS 26 Feb. 2001).

In 1997»Chile+C became part of the United Nations international AIDS project (UNAIDS) to facilitate access to IllV/AIDS treatment (»Chile+C Dec. 2001, 11). This project led to negotiations between pharmaceutical companies and the private and public sectors to reduce the cost of treatmentand to discuss the means of distribution (ibid.). On .15 JUne 2001, an agreement was reached that would allow 80 per cent of the people under the public health care system to receive treatment (ibid.), This meant that the government could provide 2,600 "triple therapy cocktails" to IDV-positive patients (ibid.), However, commenting in mid-2002, Roa, the director of Opusgay newspaper, said that "only 60 per cent" ofHIV -positive individuals have access to the "cocktail therapy," although he saw this as rna big advance, if we consider that "'Chil~ is not exactly a developed country" (IPS 13 June 2002). Contrastingly, the Public Health Minister, Osvaldo Artaza, said that tt84 percent of those living with HIV receive the triple-therapy AIDS cocktail free of charge"(ibid.). He added that the new Universal Access to Explicit Guarantees plan (AUGE), which was designed for people living with the 56 diseases classified as "catastrophic," should hopefully allow all HIV-positive individuals to receive antiretroviral drugs, "in the private.as well as the public sector" (ibid.).

A February 2001 IPS news report also noted that, although the international standards for HIV treatment set the level oflymphocyte count at five hundred, drug therapy in»Chile~ was only given to those whose lymphocyte counts were below three hundred, "a level at which a risk of death is already present" (26 Feb. 2001).

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Reporting in 2002, World Markets Analysis said that, because of the "high costs of treatments for fatal illnesses" such as HIV / AIDS, a black market for pharmaceuticals had emerged in ~Chile~ (26 Nov. 2002). The President of the Chilean Pharmaceutical Chamber, Jorge VAfA(a)1iz [sic], estimates that approximately 20 per cent of the medical black market concerns the trade ofilIegal HIV/AIDS drugs (World Markets Analysis 26 Nov. 2002). Health officials wony that this may be putting people's lives at risk, but "unless a greater number of patients are permitted to receive free drugs or financial assistance for drug purchases, many people will be left with no other choice than to procure the drugs as cheaply as possible on the black market" (ibid.).

According to Rodrigo Pascal, leader of Vivo Positivo, the health care coverage provided by the National Health Food (Fonasa),the government insurance company, "is somewhat better than the service offered by private companies" (Santiago Times 14 Aug. 2001). Yet he adds that Fonasa's bureaucracy makes the service very slow when delivering the results of medical exams (ibid.). Patients often wait four to five months to obtain medical results which normally should take two weeks (ibid.). Pascal also says that both the private and public health system do not distribute the medication properly and treatments are often delayed because the medicine

does not arrive at the hospitals on time (ibid.). .

Discrimination Against HIV-Positive Individuals

. Specific funds for HIV education campaigns were set up to establish projects, in col1aboration with nongovernmental organizations, targeting the homosexual community and the adult sex workers, the "vulnerable population" (poblacion mas vulnerable) (~Chile" Dec. 2001, 13). There were three education campaigns which targeted the homosexual community: between 1997 and 2000 two separate campaigns set up to reduce the risk ofHIV I AIDS contamination each covered a part of the Chilean territory, although together they did not cover the whole country; and in 1999 a programme was set up in the cities to change people's attitudes towards HIV I AIDS and homosexuality (ibid.).

The 2001 legislation on HIV prohibits discrimination againstHIV-positive people (Santiago Times 6 Dec. 2001). Article 5 of Ley No.19.779 states that the mY/AIDS test is confidential and voluntary, but a regulation will establish the conditions under which testing wi11 be compulsory with the results to be disclosed to the sanitary authorities (~Chile'" 4 Dec. 2001 b). (No reference to whether or not the regulation is in place was found among the sources consulted by the Research Directorate.) Article 7 prohibits the making employment or promotion, both in the private and public sector, conditional on the results ofHIV/AIDS testing (ibid.). The sanction for violating article 7 is a fine paid to the government "without prejudice to the liability of damages caused" (sin perjuicio de la responsabilidad por los daiios causados) (ibid., Art. 9). A repeated offence doubles the original penalty (ibid., Art. 10). The legal actions must be brought before the local police court in the affected person's place of residence without prejudice to the competence of the employment court and customs or criminal tribunals (sin perjuicio de fa competencia que corresponda a los juzgados del trabajo y al tribunal aduanero 0 criminal respectivo, en su cas 0 ) (ibid., Art. 12).

CONASIDA's objectives for 2001 were to broaden the coverage ofHIV/AIDS infected people who receive treatment, to offer a better quality of treatment and to. diminish discrimination O+Chilefl Dec. 2001, 3). The Health Minister, Michelle Bachelet, claiming that "prevention and non-discrimination are social vaccinations for the epidemic, If said that Chilean society in general must learn to be more accepting of individuals living with AIDS (Santiago Times 7 Dec. 2001). Vivo Positivo states that discrimination is "very present in all aspects of everyday life" (en terminos concretos se discrimina ampliamente en todos los ambitos de la vida civil) (Vivo Positivo n.d.). According to a govennnent survey, in general, discrimination against people living with H1V I AIDS has diminished: in 1998, 75 per cent of the population said that they were [translation] "willing to share' social places such as the workplace and school with people living with HIV/AIDS (~Chile+4 Dec. 2001, 12). In his 2001 speech, the President of the Republic said he found worrisom e the fact that, according to a survey

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carried out by "la Fundacion Ideas," 30 per cent of the population, a "significant percentage" (un porcentaje tan significativo) thinks that people living with IllVI AIDS should be kept away from the rest of society (ibid. 4 Dec. 200 I ). According to the President, this explains why discrimination occurs and why it excludes people from the workplace (ibid.).

In a July 2002 IPS article, HIV -positive women complained of "violations of rights of employees, discrimination in schools against the children of people living with HfV, and discrimination in access to healthcare" in .. Chilea (IPS 10 July 2002). Erica Espinoza, a representative for the international community of women living with HIV, in ~Chile .. , and advisor to Vivo Positivo, said that "when it emerges that a woman tests positive for HfV, she is laid off, or she is demoted and her salary is cut, to push her into quitting" (ibid.).

According to AIDS activists' health experts, "discrimination against HIV/AIDS patients by private and public health insurance providers is a problem plaguing the Chilean health system" (Santiago Times 14 Aug. 2001). The "most common form of discrimination" appears in the denial of access to the medication needed to treat the disease, but there have also been complaints of doctors being encouraged by medical insurance providers to declare HfV -positive individuals as disabled, therefore preventing them from working and maintaining their insurance coverage (ibid.). Vivo Positivo maintains that it is difficult to obtain proper attention in the health care sector, even though CONASIDA and non-governmental organizations have made strong efforts to sensitize people about HIV/AIDS(Vivo Positivo. n.d.). The main cause of discrimination is the homosexual ~ orientation+t of some Hlv-positive people and misinformation on how l-ITV is contracted (ibid.).

According to Vivo Positivo, discrimination in the private sector is a complicated situation because laws favour employers (Vivo Positivo n.d.). A majority of employers ask their employees to undergo HIV testing in laboratories that are affiliated with the company (ibid.). Out of a fear of losing their job, the employees undergo the testing, but the results are sent to the employer first (ibid.). If the tests are positive, the employee is then fired under a different pretext such as "company necessities" (las necesidades de fa empresa) (ibid.). Employees have no legal arguments to fight such a decision since there is obligation on the part of the employer to specify what is

meant by "company necessities" (ibid.). .

In addition discrimination against people living with fllV, the transsexual president ofTraves-j+Chilea, Silvia Parada, states that "homosexuals and trans-gendered persons suffer the greatest discrimination" (IPS 11 Oct. 2002). Parada says that "there is social discrimination, including discrimination in the labour market" (ibid.). The coordinator of the Interdisciplinary Centre of Gender Studies in the social sciences department of the University of~Chile", Maria Elena Acuna, stated that "this country is discriminatory, because 'difference' is frequently transformed into inequalities that undermine the integrity of individuals, often stunting their aspirations'" (ibid.)' She believes that .. Chile+4 needs "the creation of laws and statutes that safeguard personal, social and cultural integrity" (ibid.).

With respect to the question of whether HIV test results must be reported, Csar Herrera says that the requirement that physicians report every HIV case to the Health Ministry is not strictly enforced (IPS 26 Feb. 2001). Furthermore, he added that private clinics are not required to report to the government (ibid.).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim to refugee status or asylum. Please find below thelist of additional sources consulted in researching this Information Request.

References

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__ . 4 December2001 a. Gobiemo de.»Chilefl. "Ceremonia de promulgacion de la Ley sobre el Virus de Inmunodeficiencia Humana y beneficio fiscal para enfermedades catastroficas, Discurso del Presidente de.la Republica." <http://www.conasida.cl/docs/legallley/leypresi.htm> [Accessed 1 May 2003]

--:-::-~. 4- December 2001b. Ministry of Health. Ley N 19.779. <http://www.cQnasida.cI>[Accessedl May 2003]

Inter Press Service (IPS).l1 October 2002. Gustavo Gonzales. "~Chilefl: Gays Advocate Legal Reforms to Fight Discrimination." (NEXIS)

__ . 10 July 2002. Gustavo Gonzales. It~Chilefl: Women with AIDS Complain of Pervasive Discrimination. It (NEXIS)

. 13 June 2002. Gustavo Gonzales. "Health-j+Chilea: Aids Prevention Key Focus of First Gay

--

Newspaper. fr (NEXIS)

__ . 26 February 2001. Tamara Vidaurrzaga. r'Health-~Chiiefl: AIDS Funding Falls Short." (NEXlS)

International Gay and Lesbian Human Rights Commission (lGLHRC). May 1998. "Chilean HIV -Positive Prisoners Die While the State Continues to Deny Them Medical Care." <httpz'www.iglhrc.org/php/ section.php?id=5&detail=279> [Accessed 6 May 2003]

Santiago Times. 7 December 2001. "Vina Del Mar School Expells Student Sick with AIDS .» Chile~ Grapples to Deal with Health Epidemic." (Global News WireINEXlS)

__ . 6 December 200 1. "»-Chilefl to Develop Generic AIDS Medication. The Government Adopts New Measures to Uphold HIV/AIDS Legislation." (Global News WireINEXIS)

__ . 14 August 200 1. "Questions About Insurance Companies and Discrimination." (Global News ! WirelNEXlS)

United Press International (UPI). 18 August 2001. Jennifer Pribble. "AIDS Spreading in»-Chile~.rt (NEXIS)

__ . 1 December 2000. "AIDS Programs Get OK." (NEXIS)

VIHSIDA en .. Chile". 19 July 2001 "Hospitales publicos." <http://www.vihsida.cl/paginas/045.html> [Accessed 7 May 2003]

Vivo Positivo. n.d. "Discriminacion por vivir con VIHlSIDA." <httpz'www.vivcpositivo.cl/ derechosCiudadanos/discriminacion.htm> [Accessed 7 May 2003]

World Markets Analysis. 26 November 2002. Tanja Sturm, "Black Market for Medicines Burgeons in ~ Chile~. If (NEXlS)

Additional Sources Consulted

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Unsuccesful atempts to contactthe non-governmental organizations Vivo Positivo and MOVILH (Movimiento de Integration y Liberacion Homosexual)

Internet sites, including:

BBCnews

Bureau of Citizenship and Immigration Services

Centro nacional para la prevencion y control del VIHlSIDA

Country Reports on Human Rights Practices 2002,2001, 2000

Gay »Chi1e~

Gay Today

Global Gayz

Human Rights Internet

Human Rights Watch

International Lesbian and Gay Association (ILGA)

Las Ultimas Noticias [Santiago]

Movimiento de Integracion y Liberacion Homosexual.(MOVILH)

Opusgay

UNAIDS

Search engines:

CHL41400.EF

16 avril 2003

Objet:

Chili: organisme voue it la protection de l'environnement appele Movimiento Ecologista Universitario (Mouvement ecologiste universitaire) (1998-2000)

Bureau regional: 4

Exp. :

Direction des recherches, Commission de l'immigration et du statut de refugie, Ottawa

Les seules 'sources documentaires mentionnant un Movimiento Ecologista Universitario (Mouvement ecologiste universitaire) qui ont ete' trouvees par la Direction des recherches datent de 1999 et associent ce

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Page 5 of 40

Notas del Dia

4(5(2005 2: 16 PM

3 de Enero 2003

Noticias del dla ..; Notas completas

1.Siete+73 deenero Titular de portada

SIDA EN. CHILE: LA DISCRIMINACION MATA ANTES QUE EL VIRUS SOBREVIVIR ALA EXCLUSION. Paqinas 30,31,32 y 33

SOLOS POR EL SIDA

A un ana de promulgarse la ley del Sida el panorama publico ha mejorado para quienes sufren esta enfermedad. Sin embargo, el virussigue mostrando una arista muy dura: el acoso de la discriminaci6n en la vida cotidiana. Pequeiios gests, frases, actos diaries frente a los cuales hay legislaci6n 'que valqa.

Por Juan Andres Guzman

EI articulo comienza descrtibiendoel caso del cabo Alex cea cocinero del casono de oficiales de la Fc ha en Cerrillos, quien fue notificado como portador del VIH a los 25 arios, y dado de baja, "pr padecer una enfermedad invalidante de caracter permanente". Alex no sabia entonces, que hace cinco meses estaba vigente la ley de Sida, destinada a garantizar los derechos de las personas infectadas can este virus. En su articulo 7 hay una menci6n especlfica para los uniforrnados: "Ia permanencia en el servicio, la renovaci6n de los empleos y la promoci6n no podran ser condicionadas a los resultados de los

exarnenes" .. EI anuncia querella contra la Fach para marzo, porquetampoco sabia que en el nivel que el tenia el Sida, no es una enfermedad invalid ante. Vasil! Deliyanis es el encargado del area de derechos ciudadanos de Vivo Positive. Por experiencia sabe que si la ley no se ha usado hastaahora no es por falta de casos. Varios de ellos aparecieron en el libra "Situaciones de discriminaci6n", pub licado en noviembre pasado por Vivo Positivo: profesores que pierden su empleo y su indemnizaci6n; artistas cuyas exposiciones son cercenadas para que no aparezca la palabra Sida ni nada relacionado con esa enfermedad; trabajadores que optan por decir a sus empleadores la verdad y que son despedidos con escandalo, y otros que son presionados para que renuncien. EI caso de Elizabeth se ex pone como ejemplo de matrimonios que no viven con la verdad. Ella y sus dos hijos son portadores, porque a fuerza de presiones su marido xconfes6 su bisexualidad: - A mi me cagaron y yo cago-dijo el, Jorge rarnirez, presidente de "Vida Optima"una organizaci6n que reune a mas de 500 personas contagiadas con VIH de la zona norte de Santiago, tiene muchas anecdotas de discriminaci6n. Cuando el se infect6 , tenerVIH era muy similar a tener lepra, incluso para los medicos, que 10 atendian al final, y con guantes y mascarilla, gorros, como si se peqara por tocarlos. La que mas Ie duee, la vivi6 dentro del grupo catolico al que asistia regularmente. Uno de los feligreses Ie dijo al cura que el tenia Sida. EI sacerdote escogi6 la misa para predicar con el ejemplo. C uando toco la comuni6n simplemente 10 salt6 ... Pero Jorge tiene un caracter alegre y fuerte. Pelear por sus derechos y el de sus asociados 10 mantiene en pie. En su historia se condensa la de cientos de personas que durante estos afios se han organizado para hacerse respetar y conseguir remedios. Es la historia de medio centenar de colectivos, .esparcidos por todo elpais, que

. bautizan siempre con la palabra Vida y que a traves de Vivo Positive fueron claves para que se promulgara la ley del sida. Los discriminados como los contagiados con el virus, pueden desarrollar anticuerpos y revertir sus situaci6n.

LA LEY A PRUEBA

En recuadro se detalla 10 que estipula la ley, que asegura que el examen para detectar el virus es voluntario, que sus resultados son confidenciales y que la presencia del virus no puede serusado para despedir 0 afectar la carrera de ninguna persona. La misma ley hace unasalvedad respecto de los uniformados, en cuanto ala voluntariedad del examen para detectar el VIH.Sida. la ley los autoriza a aplicarlos a todo su personal. Sin embargo, tarnbien dice que debe ser informado a Ja persona y que se debe hacer una consejerfa previa para decirle que es el VIH y 10 que implica. Si el examen es positivo se Ie debe decir a la persona cual es su tratamiento, que debe y no debe hacer. .. El abogado Patricio Contesse, de la clinica juridica de la Universidad Diego Portales serialo que siendo una enfermedad permanente no es invalidante. Deliyanis dijo que algo que dificultara la aplicaci6n de la ley es que aun no existe su reglamente que debierq haber sidopublicado en los 60 dlas despues de la promulgaci6n de la ley.

VOLVER RESUMEN

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N013S del Dia

4/5/20052:16 PM

2.Mujeramujer latercera.cl 3 de enero

50 MUJERES DETRAs DEL PODER Por Loreto Aravena y Ana Marfa Barra

Hay mujeres que, por su trabajo, estan directamente ligadas al poder. Porque son la cara visible de un ministerio, porque dirigen empresas, porque estan en el parlamento, porque son intelectuales publicarnente reconocidas 0 porque ejercen su influencia como rostros de la television. Sin embargo, Mujer a Mujer quiso, pol' primera vez, buscar este ario nuevos nombres. Nombres de mujeres que estan lejos de los titulares y ocultas de los flashes. Mujeres que, pese a ser desconocidas para ta gran mayoria, tambien cumpten un ral clave.

Negocian contratos millonarios, lIevan la delantera en la investigaci6n, lideran gremios y organizaciones beneficas, toman decisiones tras las carnaras de televisi6n, dictan la moda de las chilenas 0 las ultirnas tendencias del disefio. Son el "Pepe grillo" que estaen el hombro de empresarios, autoridades, partamentarios, animadorese, incluso, del Presidente de la Republica. Cad a una con historias muy dislmiles y desernperiando roles trascendentes. Estas son las 50 mujeres que estanen la primera linea . detras del poder en Chile.

ANABELLA ARREDONDO: EL SIDA CON TODAS SUS tETRAS

Que la camparia del Sida del 2003 vaya a hablar las cosas por su nombre, restando palabras decoradas y entregando mensajes directos, se debe en gran parte a la doctora Anabella Arredondo, Secretaria Ejecutiva de la Comisi6n Nacional del Sida (Conasida).

Porque a pesar de que estas no handejado de ser un aporte sequn ella, todavia falta unlenguaje mas explicito en el tema de las relaciones sexuales entre hombres y entre quienes ejercen la prostituci6n. Adernas, aun queda apelar a la "no discriminaci6n", ya que si bien los VIH positivos estan gozando de buenas condiciones de sa Iud gracias a la triterapia, la marginaci6n social y laboral de estes esta impidiendo su estabilidad tanto econ6mica como sicol6gica.

Su ultimo gran logro fue acercar a lossectares civiles, vale decir, a todas la ONG's que trabajan con el tema del V1H y comprometer su participaci6n con el gobierno en un tema que sigue infectando a los chilenos. Porque era mucho 10 que estas organizaciones podian hacer en materia de apayo sicol6gico y en cuanto a revelar las investigaciones mas recientes.

Anabella ha trabajado toda su vida en salud publica yen epidemiologia. Su primer acercamiento al tema del Sida fue cuando trabaj6 en el Departamento de Epidemiologla del Ministerio de Satud, donde hacia un rastreo para saber a cuanto Uegaba la cantidad de infectados yd6nde se centraba la pandemia en el pais. Despues de eso, su carrera se fue encaminando hacia acciones mas concretas: primero en el departamento de estudios del Conasida y en el 2001 en el puesto maximo de este organismo que depende del Ministerio de Salud.

Los actuales deberes de Arredondo no s610 selimitan a las carnparias, pues ella es la que se encarga de recordarle alMinisterio de Hacienda acerca de la necesidad de ir incrementando los recursos para atender a los afectados. Yes asl como los $3.800 millones que se destinaron en el2001 para los pacientes infectados, aumentaron a $6 mil mlilones durante este ano. Para el proximo, se estiman en $9 mil millones.

La doctora ha estado, adernas, en las negociaciones con los grandes laboratoriostarmaceuticos para fijar rebajas en los medicamentos necesarios para la triterapia. S610a traves deeste tratamiento, los enfermos pueden aspirar a tener una mejor calidad de vida e, incluso, a prolongarla. Si bien este anono le fue muy bien, hoy forma parte de las negociaciones colectivas que realiza el Pacto Andino: al comprar mayor cantidad de medicamentos es posible obtener mayores descuentos.

VOLVER RESUMEN

3.0rgullogay.cI 3 de enero ;-

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Page 2 of 5

N etas del Dia

4/5/2005 2: J 6 PM

"LAS VARIANTES DEL 0010 Y DEL TEMOR" por Warren J. Blumenfeld.

(*) Fuente: articulo de Revista Letra S

Tomado de la introducci6n de Warren J. Blumenfeld a su compilaci6n Homophobia: how we all pay the price. Beacon Press, Boston, 1992.

Traducci6n de Carlos Bonfil

Las minorias sexuales --Iesbianas, gays, bisexuales y transexuales- figuran hoy entre los grupos mas despreciados. Se ha escrito mucho acerca de las formas en que en numerosas sociedades la homofobia sefiala a las rninorlas sexuales, desde las creencias negativas acerca de estos grupos (mismos que pueden 0 no expresarse) hasta la exclusion, conculcaci6n de garantias legales y civiles, y, en ciertos casos, los aetos de violencia abierta. Cuando miembros de estos grupos internalizan estas actitudes negativas, se produce un dane espiritual y el crecimiento ernocional se reprime.

La homofobia opera en cuatro niveles distintos perc interrelacionadcs: el personal, el interpersonal, el institucional y el cultural (tambien llarnado colectivo 0 social).

HOMOFOBIA PERSONAL

Se refiere a un sistema personal de creencias (un prejuicio) sequn el cuallas minorias sexuales inspiran compasi6n por su incapacidad de controlar sus deseos, 0 sencillamente odio por estar psicol6gicamente trastornadas, geneticamente defectuosas, 0 por tratarse de tristes inadaptados cuya existencia contradice las" leyes" de la naturaleza, 0 por ser espiritualmente in morales, parias infectados, asquerosos, 0 para ponerlo amablemente, inferiores, por regia general, a los heterosexuales.

HOMOFOBIA INTERPERSONAL

Se manifiesta cuando una indisposici6n 0 prejuicio personal afecta las relaciones entre los individuos, transformando al prejuicio en su ingrediente activo, la discriminaci6n. Algunos ejemplos de la homofobia interpersonal son los apodoso .. chistes" cuyo prop6sito es insultar 0 difamar a personas 0 a grupos; la

.. agresi6n fisica 0 verbal y otras formas extremas de violencia; el retiro de apoyo, el rechazo, el abandono por amigos y otros comparieros, colegas de trabajo, familiares; la negativa de arrendadores a rentar departamentos, de comerciantes a prestar servicios, de asequradoras a ampliar su cobertura, y de patrones a contratar con base en una identidad sexual real 0 atribuida. Y la lista continua.

Sequn un estudio de fa Asociaci6n Nacional de Gays y Lesbianas, mas del 90 por ciento de los interrogados habia experimentado alqun tipo de victimizad6n por su identidad sexual, y mas del 33 por ciento habra sido agredido directamente con violencia: mas de uno de cada cinco hombres y casi una de cada diez mujeres seiialan haber sido "golpeados, maltratados 0 pateados", y aproximadamente los mismos porcentajes padecieron alguna forma de abuso policiaco. Cerca de un tercio de los interrogados sufrieron agresiones verbates, y mas de uno de cadaquince padecieron maltrato flsico por parte de miembros de su propia familia.

HOMOFOBIA INSTITUCIONAL

Se refiere a las formas en que orqanisrnos gubernamentales, empresariales, educativos 0 religiosos discriminan slstematlcarnente por la orientaci6n 0 identidad sexual. En ocasiones las leyes, los c6digos 0 los reglamentos se encargande aplicar dicha discriminaci6n. Son pocas las instituciones que cuentan con politicas a favor de las minorfas sexuales; muchas trabajan activamente no s610 contra esas minorias, sino tambien contra los heterosexuales que los apoyan.

Hasta 1973, las asociaciones psiquiatrlcas consideraban la hornosexualidad como un desorden mental. A menudo se internaba a la gente en contra de su voluntad y se les sornetla a una -'terapia de aversi6n" a la vez peligrosa y humillante; en ocasiones incluso se les aplicaba la lobotornla para alterar sus deseos sexuales. Frecuentemente seles sigue negandoa amantes del mismo sexo y a sus amigos el acceso a la visita de sus amados en unidades hospitalarias de terapia intensiva porque las politicas de los sanatorios s610 autonzan derechos de visita para parientes consanguineos 0 para la esposa legitima. Aunque hoy muchos profesionales, en el medio psiquiatrlco y en el de la medicina, sostienen actitudes genuinamente positives en relaci6n con las realidades de la homosexualidad y la bisexualidad, desafortunadamente algunos siguen atrincherados en sus percepciones negativas de la atracci6n entre gente del mismo sexo, y estas percepciones afectan a menudo la forma en que responden a sus pacientes.

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HOMOFOBIA CULTURAL

Se refiere a normas sociales a c6digos de conducta que sin estar expresamente inscritos en una ley a un reglamento, funcionan en la sociedad para legitimar la opresi6n. Se manifiestan a traves de intentos por excluir de los medias a de la historia las irnaqenes de lesbianas, gays, bisexuales y transexuales, 0 de representar a estos grupos mediante estereetipos negativos. EI te61ogo James S. Tinner (1983) propone siete categorias superpuestas per las que se manifiesta la homofobia cultural.

1 y 2. Conspiraci6n para el silencio y negaci6n de la cultura. Estas primeras dos categorias estan estrechamente vinculadas. Aunque sin una expresi6n formal en la ley, las sociedades intentan, de manera informal, evitar que grupos numerosos de individuos de una minoria particular 0 de un grupo especiflco se congreguen en un lugar cualquiera (un bar u otros centres sociales), 0 negarles espacio para realizar eventos sociales 0 politicos, negarles tarnbien el acceso a material de trabajo, 0 intentar restringirles toda representaci6n en una instituci6n de docencia 0 empleo en alqun negocio, y desalentar una discusi6n franca, abierta, honesta sobre topicos que interesen 0 conciernan a estos grupos.

En las sociedades en que esta presente la homofobia, ha habido intentos muy evidentes de falsificar testimonios hist6ricos del amor entre personas del mismo sexo --a traves de la censura, el oscurecimiento, las verdades a medias y la alteraci6n de pronombres personales que sefialan el genero--, 10 cual vuelve extremadamente diffcil una reconstrucci6n adecuada. Como consecuencia, muchos miembras de las minorias sexuales crecen sin paradigmas culturales propios, realmente significativos.

En Cristianismo, tolerancia social y homosexualidad, John Boswell cita como ejemplo de censura un manuscrito de EI arte de amar. La frase que originalmente decla "Hoc est quod pueri tanger amore minus" (EI amor de un joven me apetecia todavia menos) qued6 alterada por un mora1ista medieval yapareci6 como" Hoc est quod pueri tanger amore nihil" (EI amor de unjoven no me apetecfa para nada). Una nota del editor en los marqenes Ie informaba allector: "Ex hoc nota quod Ovidius non frerit Sodomita" (Con esto queda claro que Ovidio no era un sodomita).

3. Negaci6n de la fuerza popular. Muchos estudios han descubierto que un porcentaje significativo de la poblaci6n experimenta deseos hacia personas de su mismo sexo y que dichos individuos definen a menudo su identidad con base en esos deseos. Existe sin embargo la suposici6n cultural de que alguien es heterosexual hasta que "se Ie encuentre culpable de 10 contrario". Sequn Tinner, "Ia sociedad se niega a creer cuantos negros hay que 'pasan' par blancos y cuantos gays y lesbianas (y bisexuales) hay que 'pasan' par heterosexuales''.

4. Miedo a fa visibilidad excesiva. Una forma de homofobia se manifiesta cada vez que a miembros de una minoria sexual se les dice que no deberian definirse a si mismos por su sexualidad 0 identidad sexual, 0 cuando se les acusa de ser muy "Ilamativos" al expresar en publico signos de afecto, comportamientos que las parejas heterosexuales practican con toda naturalidad. Se les transmite el mensaje de que hay algo intrinsecamente errado en su deseo homoer6tico y que los individuos con dicha indinaci6n deberian mantener ese deseo para sl mismos, bien escondido.

5. Creaci6n deespacios publicos definldos. La sociedad tiende a encerrar en ghettos a los individuos y grupos a los que ha privado de sus derechos, y en ellos existe poca posibilidad de integrarse completamente a la vida de la comunidad. Hay barrios, comercios, e incluso oficios reservados a las rnlnorlas sexuales; algo similar sucede con otros grupos minoritarios. Los individuosingresan a estas areas esperando encontrar alivio temporal al clirna externo de homofobia.

6. Negaci6n del autoetiquetamiento. A los grupos minoritarios se les reservan tambien epttetos y otras etiquetas peyorativas. Las minorias sexuales hanescogido terminos de autodefinici6n (gay y lesbiana) para manifestar de manera mas adecuada los aspectos positivos de sus vidas y de sus amores. Recientemente, un nurnero creciente de lesbianas, gays, bisexuales y transexuafes se han reapropiado de terminos como marica, loca y marimacho para transformar esos venenosos slrnbolos de vejaci6n y fanatismo en herramientas de apoderamiento.

7. Simbolismo negativo (estereotipos). Se utiliza el estereotipar a grupos como una forma de control y como un obstaculo mas para el entendimiento de un cambio social significativo. Abundan los estereotipos acerca de las minorias sexuales, y van desde los supuestos apetitos insaciables hasta su apariencia flsica y la busqueda de las posibles " causas" de sus deseos.

VOL VER RESUMEN

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EURODIPUTADO SE SOL TO LAS TRENZAS

MADRID, (DPA).- EI eurodiputado espariol y candidato a la alcaldla de Madrid por Los Verdes, Jose Mafia Mendiluce, anunci6 su homosexualidad en una entrevista que publico ayer la revista espanola "Zero", dirigida al publico homosexual.

EI politico, nacido en Madrid en abril 1951 en el seno de una familia vasca, asegura que hasta el momenta no habladecidido salir del armaria "par cobardia". Mendiluce ingres6 en 1980 en el Alto Comisariado de Naciones Unidas para los Refugiados (ACNUR), donde desempefi6 cargos importantes, entre ellos el de enviado especial en los Balcanes y Coordinador Humanitario de Naciones Unidas, desde donde dirigi6 por dos aries la mayor operaci6n humanitaria de la historia de NacionesUnidas. "Si yo me hubiera confesado homosexual en la ONU nadie me hubiera perseguido, pero no hubiera side responsable de la mayor operaci6n humanitaria de las Naciones Unidas", asegura.

Respectoa la decision de anunciar su homosexualidad en fa precampafia electoral de las elecciones de mayo, Mendiluce sefial6: "No me gustarla ser s610 el candidate de los gays". Y afirma que Ie llama la antenci6n que los partidos traten de induir "unos cuantos gays" en sus listas y el encabece una.

La revista "Zero" se ha hecho conocida porque en ella han confesado su homosexualidad un militar de alta graduaei6n, un curay un guardia eivi

VOLVER RESUMEN

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