Why Chile’s New Programs To Prevent HIV Are Not Working

SANTIAGO – Last year, the Chilean government announced an ambitious set of sexual education programs due to the comparatively large numbers of people testing positive for HIV. Despite these efforts, HIV numbers continue to climb. The initial signs are that the programs are not working.

The Chilean government has been putting tens of millions of pesos into new campaigns in order to combat the growing HIV infection rate in the country, but thus far it doesn’t seem to be achieving a good return on its money. These campaigns include:

  • Youth programs in which the government allotted CLP$330,000 (US$438) per school in order to implement new strategies as well as train teachers;
  • Programs directed at certain groups, such as immigrants, because in 2018, a study by the government showed that 37% of those who tested positive for HIV/AIDS were foreigners; and
  • Other programs, such as the one sponsored by the government’s Program for Prevention and Control of HIV/AIDs and STIs (HIV/AIDs Program), more generally aimed at promoting safe sex and sexual health among other objectives nationwide.

Unlike other Latin American countries, the number of people diagnosed with HIV/AIDS continues to rise in Chile, with 5,000 new cases in 2019. In fact, since 2010, the number of people testing positive for HIV has increased by 96%. Some figures even estimate that there are up to 40,000 undiagnosed Chileans. The Chilean government concluded that some of these numbers were due to the fact that the country, despite the increase in education, still has the smallest growth in sexual education implementation in Latin America.

Earlier, CTNews made the following report on the HIV-crisis in Chile:

Why Aren’t The Programs Working?

Chile focuses a lot of its energy on the education of youth, as evidenced by the funds the government sets aside for schools. However, these funds rarely make it to the schools to which they are allotted.

Because of this, a study published June 2019 that tracked the efficacy of prevention measures from 2010-2018 concluded that most teachers still don’t have the knowledge to educate their students on sexual health. In addition, for those schools actually using their funds, the schools are able to choose their own programs, “according to their way of thinking,” and some have apparently opted for abstinence-only education rather than a curriculum that otherwise addresses disease and pregnancy prevention.

Additional proof of the programs’ ineffectiveness comes from a study by the National Youth Institute, which showed that only 20% of Chilean young people understood the differences between risky and healthy sexual behaviors and only 22-30% used condoms. The study also found that 11% of young people believed that they could catch the virus by kissing. For these reasons, the HIV/AIDs Program ultimately concluded that youth education in schools lacked effectiveness.

Universidad de Chile develops new HIV ´quick test´

Turning to programs that attempt to educate immigrant populations, the government has yet to release the data on these efforts, but both researchers and politicians suggest they might be missing the point. Though 37% of the people who tested positive for HIV in 2018 were immigrants, this number could be a “false positive” implicating immigrant populations for the wrong reasons.

First, the tests can’t prove when and where a person originally contracted the virus. The current Minister of Health, Jaime Mañalich, echoed this uncertainty, saying that there is no evidence to support a former minister’s suggestion that immigrants were “bringing” the virus with them. Especially since the government requires that many immigrants do an initial HIV screening in order to receive a visa, and has been known to reject visas those immigrants who test positive for the virus.

Second, as the head of the Immigration and HIV department of the Coordinadora Nacional de Inmigrantes, Armando Arjona, has also pointed out, it is an unfortunate reality that economically vulnerable immigrants are more likely to engage in what researchers consider risky behavior, such as prostitution, thereby increasing the chances that they might contract HIV after they immigrate.

Why is a campaign against HIV generating so much controversy in Chile?

No Effectiveness

With the national campaigns, the state has not released any related material to demonstrate their effectiveness. The most recent example, however, a commercial which aired in 2018 on public television, is strikingly similar to a program in 2016 that a national study deemed ineffective. The 2018 commercial interviewed young people about HIV/AIDS whereas the 2016 one promoted condom use while showing couples kissing. A post-campaign evaluation found that only 56.6% of the Chilean population had seen the 2016 ad and thus the research declared that it was largely a failure due to its lack of reach, impact, and viewership. 

Ultimately the national studies concluded that Chile has largely failed in its attempt because the movements lack clear objectives and don’t focus on at-risk groups,  which greatly limits their scope, though many organizations, such as Movimiento de Integración y Liberación Homosexual, consider the strategy of focusing on groups harmful because they stigmatize sex-workers and gay and bisexual men.

Some believe that the focus of these campaigns should change altogether.  Doctor Carlos Beltrán and Doctor Valeria Stuardo, who work directly in the area of infectious disease, believe that Chile’s programs should continue to make a shift towards encouraging the use of PReP, a medication designed to prevent those negative for the virus from becoming infected since only nine hospitals make it available throughout the country. Chile does, however, have a goal of making it more widely available by next year. 

No matter what strategy is taken the evidence is clear: if the government does not drastically change its strategy concerning HIV/AIDS the virus will likely continue to spread.  

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