From: rastern@sol.racsa.co.cr
Date: Mon, 8 Apr 1996 19:39:01 +0600
Subject: AIDS in Costa Rica

>                              Sexuality and Death in Costa Rica
>
>by Richard Stern, Ph.D.
>
>San Jos=E9, because of Internet, cable TV, and the new mall round the=
 corner, now
>seems closer to back home than ever.  In 20 or so years, differences
between countries
>may be more or less nothing more than geographical. =20
>
>But Costa Rica is changing. The drivers have to slow down because of the
traffic.=20
>McDonalds delivers right to your house,  trying to compete with Pizza Hut
and Burger
>King.  In the mall,  I can see the same movies that   you see back in=
 Chicago.
>
>The "Defensoria de los Habitantes" (Defender of the Inhabitants), the
government's
>human rights  watchdog organization even made a pro-gay ruling two weeks
ago, when
>it said that groups such as the Triangulo Rosa gay group  cannot be denied
the right to
>form a legally chartered association.   So things are changing and
Triangulo Rosa has
>its legal charter and has paved the way for future minority groups to be
able to become
>chartered as well.   Illinois, my home state, was actually the first state
in the US to
>legalize homosexuality way back in 1961.   But cultural change comes way
after legal
>change.
>
>
>In Costa Rica gay people and women are now fighting the same battles  as
were fought
>on US territory  30 years ago.  In the USA, they have already found that
gays and
>women are no better and no worse than anyone else, and that if they are
just treated
>equal that they will act equal.  =20
>
>In Costa Rica,  this fact of life is still to be discovered so we must
reteach here what
>has already been learned in the North.  International human rights
organizations help a
>lot because groups like Amnesty International  have now accepted that the
gay cause is
>part of their agenda.  And Costa Rica wants to maintain its reputation as a
bastion of=20
>human rights.  (Even though it really isn't,  it somehow has acquired this
reputation, so
>now it must make changes  in order to actually not be found out to be
violating the
>rights that it is famous for.)
>=20
>
>In truth, the culture here is a veritable hell for women and gays.
"Machismo" refers to
>a male dominated culture where masculinity  is carefully defined by a=
 series of
>expected roles and behaviors.   Men always make decisions about women and=
 men
>have the right to do sexually with women what they want. Even if they don't
want to,
>they  had better pretend that they do.  To be "playo" the local equivalent
of "faggot," is
>the worst thing that can happen to someone.  Even though educated people
now  feel
>that sexual preference may be genetically determined  a person born with=
 this
>microscopic difference in some part of their genetic structure is condemned
to  subsist=20
>as sub-human in  a rigidly enforced  virtual caste system of gender.
>
>The machista men even drive their cars faster to somehow prove their
masculinity.
>They park where they want,  and they have to slow down, not for traffic
signals, but to=20
>look hard at any woman who is under 30. To fail to show this degree of
sexual interest
>could indeed make someone suspect that you are "playo."
>
>A woman who is sexually abused, theoretically has the legal rights that she
needs. But
>in reality she files her report with a  male middle aged policeman, who may
be a
>"compinche" (pal) of the alleged perpetrator and/or simply believes, that
the abuse  is a
>probably a good sign that the abuser is sufficiently masculine.    The
attitude might be
>described as "what's all the fuss? She wasn't a virgin anyway."=20
>
>So as time passes and differences between cultures disappear,  it is for
better as well as
>for worse.  Their may be more McDonalds and shopping malls, and less  of=
 the
>charming individual Tico pueblos and neighborhoods. But I suspect that
machismo has
>also outlived its usefulness and that  the communications revolution, which=
 is
>"shrinking" the world, will have a beneficial effect on women and sexual
minorities
>here.=20
>
>Consider the situation of AIDS in Costa Rica.  Several years ago the =
 Catholic
>Archdiocese here vetoed the "Guides to Sex Education" that were to be
presented to all
>public school students here. The program included frank and open
information about
>AIDS  including the use of condoms. But this was  to  threatening for the
high Priests
>(presumably, as chaste men, they are not at risk for AIDS, so maybe they
feel that it is
>not their problem) So the program about Prevention of  AIDS has remained
largely
>non-existent in the schools which would have been the easiest and most
logical space to
>reach  the majority of adolescent Costa Ricans, who as a result of  the
machista culture,
>are supposed to be as sexually active as possible, although the church says
that they are
>all virgins until they marry.
>
>This is not true.    As a result of my work as a Psychologist with people
affected by
>AIDS, I  now know of more than 50  Costa Ricans under the age of 25 who are
HIV+.  =20
>90 percent of them report having initiated their sexual careers while still
in high school
>and they universally report that they were not informed about AIDS by=
 anyone.
>
>Yet AIDS is one of the most preventable contagious diseases in the world.
The use of a
>condom or simply modifying one's sexual practices is enough to  prevent the
virus
>from spreading.   Yet the same machista culture delivers the message that a
masculine
>man doesn't need a condom, or, in the case of heterosexual relationships,
it is the male
>partner who makes the decisions as to what  sexual behavior  will occur.
The woman
>is a second class partner.  Among gays as well as heterosexuals the belief
prevails that=20
>a  person with the AIDS appears weak and emaciated, ergo  if your potential
partner
>looks  physically fit, you can do whatever you want.
>
>
>Of course any one of my 50 or more clients would be able to tell you that
this isn't so.
>But they wont.  Because an HIV+ person in this culture is absolutely
terrified to tell
>anyone that he or she is HIV+. They are afraid of rejection on a massive
scale, loss of
>friends, jobs, and even family support.  It happens all the time.  Until
the same
>"Defensoria de los Habitantes." makes a legally binding decision about the
rights of
>HIV positive people, they will not speak  up and warn the others about what
they
>know.
>
>Costa Ricans have always had a strong faith in their government taking good
care of
>them. In the case of AIDS and its terrible consequences, this faith is
misguided and  is
>proving fatal in many cases.
>
>I recently attend a Conference for representatives of  NGO=B4s=
 (non-governmental
>organizations) working in the field of AIDS were in San Jos=E9.  Over 200
persons,
>mostly from Central America, attended.  The conference was excellent and
the cause of
>the spread of AIDS were analyzed in great detail.  =20
>
>The sad conclusion is that there have been as many new cases of  AIDS
reported in the
>last three years in Costa Rica, as in all of the previous 15 years of the
epidemic. The
>total number of deaths will soon surpass 1,000. Even more discouraging is
that between
>ten and fifteen thousand persons in Costa Rica are now infected with the
AIDS virus.=20
>And the majority of these people probably don't even know that they are
infected.  The
>average length of time for an HIV infected person to be asymptomatic is
around 8
>years. So during these 8 years, these people, probably unaware of their HIV
status,
>will continue to have sexual relationships and spread the virus to their
equally unaware
>sexual partners.   =20
>
>If these statistics are true, how is the government of Costa Rica going to
be able to pay
>for medical care for the future victims of  the  AIDS virus?   Is the
Catholic church
>going to provide the funds?
>
>
>In the meantime the Triangulo Rosa group struggles on to  try to provide=
 AIDS
>education in the gay community, where 70 percent of the cases have
occurred.  What is
>annual budget of our Association?  $10,000 yearly is what we have and this
comes
>from  the government of Holland, not from Costa Rica. This just about pays
the rent
>and light bill for our small community center in Alajuela We are all
volunteers. We
>know that there is nobody in the country who knows more  than us about how=
 to
>develop educational programs in the area of AIDS.
>
>But we  are  20-25 persons and we don't have nearly the time available to
do what is
>needed.  We get tired.  We go to work in our other jobs to earn the money
we need,
>but our secret passion is to try to save lives and we find that we are
fighting a losing
>battle against other institutions.
>
>
>Richard Stern is a Psychologist living in San Pedro.  Triangulo  Rosa can
be reached
>by phone at 442-7375 (Spanish) or 234-2411 (English)
>