Portugal years behind in fight against HIV/AIDS


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“Sometimes I feel we are fighting a losing battle to win the hearts and minds of Portuguese public opinion in the fight against this disease,” says Cândida Alves, a counsellor at the country’s foremost HIV/AIDS charity, Abraço.

“You wouldn’t believe that, after more than 20 years, we still get phone calls from people worried that they can catch the illness from sharing a cup, a toilet seat or touching an infected person,” she says wearily. The worst of it is that there are many health professionals, including nurses, who still think that one can catch the illness from direct contact with a patient.

There are doctors within the Portuguese National Health Service who think it’s not really worth operating on HIV patients for ordinary conditions as “they will die anyway” – a conception which these days is totally untrue.

Thanks to modern anti-retroviral protease inhibitor drugs, many patients with HIV are leading perfectly normal lives, sharing relationships, bringing up children, going to work, paying their taxes and contributing towards society. Yet there is still the notion that HIV is invariably a death sentence, “something that happens to gays, drug addicts, the homeless and black people.”

“They think it can’t possibly happen to them or their children, yet increasingly it is young people from middle class backgrounds and men over 50 that are getting infected by the virus,” explains Cândida Alves. “The incidence of Viagra has put older men, in particular, in the firing line. They solve their problems of impotence, visit sex workers, get infected and then come to us in panic wondering how they are going to tell their wives.”

Yet drug addicts, sex workers and homosexuals are pretty clued up to the risks of infections and rates in this segment are not particularly rising compared to other groups. Even so, the prevalence of infection in Portugal is far from under control as the number of newly infected people continues to rise, particularly among heterosexuals.

“We actively try to go into schools and colleges and talk to teenagers about the risks and how to avoid infection, but parents very often boycott such talks not wanting their children’s heads filled with such things,” she says.

Conservative country

But according to Cândida Alves, these are the very people that need to be targeted. “A young college girl or boy goes to a party, gets drunk, smokes dope, hooks up with an attractive and apparently healthy date and HIV infection doesn’t even enter their heads.

“You just can’t tell by looking at someone if they have HIV or not since the illness can be controlled within the body for up to 10 years before symptoms start to appear,” she explains.

Now that people are living longer with the virus, some infected elderly are even being turned away from state-approved residential homes on the pretext that they haven’t got a vacancy.

“We call up and ask if they have a vacancy and they say yes, until that is, they discover the person has HIV; they make excuses and claim they made a mistake, even when, under the law, they aren’t allowed to discriminate in this way,” she adds.

Cândida Alves says that part of the problem is the conservative nature of the Portuguese and the moral hang-ups from 50 years of Salazarism and the influence of the Catholic Church.

“They can’t see that this is just an illness, like any other, caused by a virus. The common cold is, after all, caused by a virus but that doesn’t kill. To them it’s almost a moral plague; the infected to be shunned, driven out and marginalised like lepers.

“When there is a child on TV who needs an operation or a cancer ward that needs funds, the Portuguese are very charitable and say it’s shocking, but if a child has HIV no one wants to know,” she adds.

“Prevention campaigns are insufficient, there is much misinformation in society in general and people are often scared to go and have a test, which is ludicrous because if they do have the virus it stands a much better chance of being controlled early on than when a person falls ill.”

“We need more campaigns and open discussions on TV and in the media, in colleges, schools and universities, and information distributed in night spots, bars and discos where young people hang out,” she says.

Thankfully, there have been some important victories: the gay community is well aware of the risks now, while drug addicts have responded well to syringe exchange programmes. However, compared with other European Union countries, campaigns and effective policies are “still a mirage”, she concludes.

Next week: the work and services of Abraço.

If you, or someone you know, have concerns about HIV/AIDS, please contact Linha Abraço 800 225 115.

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