'Although aware the deceased had the ‘gringo’ illness the family was too ashamed to recognise or officially register it.'

More than one in every 100 adults in Guatemala is infected with the HIV/AIDS virus. The country falls only slightly behind Honduras with the highest infection rate in the whole of Central America. (UNAIDS, 2004).

But despite the growing national crisis, the HIV/AIDS situation is very much in denial throughout the rural highlands, where the vast majority of Guatemala’s population lives.

In my local town of San Pedro Jocopilas, hidden away in the mountains, HIV/AIDS is still whispered about as a ‘gringo’ disease brought upon themselves (the gringos) through the promiscuity of Western life. Earlier this year a local family registered the cause of death of a relative at the village Medical Centre as ‘cough and high fever’. Although aware the deceased had the ‘gringo’ illness the family was too ashamed to recognise or officially register it.

The irony lies in that as the ‘shameful, promiscuous’ disease is dismissed in rural areas as a western immorality, it is the young men travelling to the coast or the city in search of work who are exposed to Guatemala’s easily accessible and all pervasive sex industry, and later return to their communities unwittingly increasing the rate of infection.

Machismo Customs

Whilst talk of HIV/AIDS remains socially unacceptable, in contrast the acceptability of the machismo lifestyle in Guatemala is something I have struggled to come to terms with. For a dedicated family man to speak openly about his ‘other’ children out of wedlock is the norm; to visit a brothel is expected; men generally reject the use of contraception due to the belief it will encourage infidelity in their partner, and there continues to be pressure on prostitutes not to use condoms.

A local Doctor clarified that this machismo attitude is indeed a serious link to the spread of HIV/AIDS in Guatemala. 'It’s very important to reassess our values in relation to sexual activity and monogamy. The immoral customs of this country are a danger to the future generations', she explained.

To illustrate her point she described the traditional custom for a man to take his son, upon turning 12, to a brothel for his ‘initiation’ to manhood. My appalled reaction was somewhat overshadowed by the astonishment of a young teenager also present as she asked incredulously ‘You didn’t know that?’

These shocking customs are spoken about in a matter of fact way on a regular basis. It is a reality in which they live. Sadly, in many communities the HIV/AIDS reality still cannot be publicly addressed. Needless to say, if the acceptability of Guatemala’s machismo customs and iniquitous sex industry continues, then the acceptability of safe sex and the prevention of HIV/AIDS must be promoted alongside this precarious culture.

Raising Public Awareness

In the local Health Centre the paramedic Gustavo Villegas assured that in line with the Ministry of Health’s HIV/AIDS public awareness objectives of 2005, the Centre provides daily talks and distributes flyers. But when asked if the villagers of San Pedro were aware of the six current HIV/AIDS cases registered in the community the answer was no.

It is clear the HIV/AIDS epidemic is not going to be recognised by the majority of the country’s people until first hand accounts are experienced at a community level. An understanding of how the disease is reaching diverse regions of society must be achieved. Recognition and acceptance of HIV carriers in the community needs to be established, as well as the ability to register the true cause of death of an AIDS victim with the local Health Authority.

This can only be achieved through community level participation and awareness raising. If addressed now, an outbreak of the epidemic in the poorest regions of the country may be prevented. At present infection rates in the highlands remain low. But as is the case with the fatal spread of the HIV/AIDS virus in all corners of the globe, it may only be a matter of time.

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