GUATEMALA CITY, Dec 13, 2011 (IPS) – "At the clinic we were attended to by a woman who criticised us and only talked to us about religious questions," says Carlos Valdez of Proyecto Unidos, an NGO in Guatemala that fights for access to HIV/AIDS prevention services by homosexuals and sex workers.
Lesbian, gay, bisexual, and transgender people "face discrimination in health centres due to homophobia and transphobia, and do not receive treatment tailored to our needs. That’s why we still represent the largest number of cases of HIV," Valdez told IPS.
Among men who have sex with men in the country, 7.6 percent were HIV-positive in 2010, according to the study "Intensificación de las acciones de prevención y atención integral en VIH y sida en grupos vulnerables y áreas prioritarias de Guatemala" (The Intensification of Preventive Actions and Integral Attention to HIV/AIDS in Vulnerable Groups and Priority Areas of Guatemala), carried out by World Vision.
However, other organisations put the prevalence of HIV/AIDS among sexual minorities much higher.
A total of 22,647 cases of HIV/AIDS were officially reported in Guatemala between 1984 and 2010, according to the ministry of health and social assistance, although NGOs say that figure would grow considerably if it included the unregistered cases.
Meanwhile, the Pan-American Health Organisation (PAHO) estimates that more than 65,000 people in this Central American country of 14 million people are living with the disease, many of them without even knowing it.
Valdez said the country has taken "few steps" for preventing the spread of HIV among vulnerable groups.
But one of the advances made was the opening of five clinics catering to members of sexual minorities.
"This kind of service should be available in all hospitals, in order to eliminate homophobia, which is the biggest hurdle we face," he said.
Valdez also mentioned the special training that all medical personnel in the clinics should receive.
"Doctors only examine a man’s penis, but in the case of people of diverse sexual orientations, they should check other parts of our bodies too," he said.
He also stressed that health personnel in the specialised clinics should follow codes of conduct and standards regulating their treatment of members of sexual minorities, which prohibit discrimination.
Although public health professionals should set an example in the treatment of members of sexual minorities, the reverse is true, said Gabriela Dávila, a leader of Gente Positiva, a local NGO which works to improve the quality of life of people living with HIV.
"There is total discrimination towards people of sexual diversity," she said. "Health care workers pigeonhole them, stigmatise them, and do not keep the results of HIV tests confidential – everyone finds out later who tested positive, and the abuse begins."
Dávila told IPS that health workers need in-depth training about HIV/AIDS, because "they often believe that they will be infected through simple physical contact with a transgender person or a sex worker, which is not true."
Ana Gladys Ollas, the women’s rights defender in the office of Guatemala’s human rights ombudsman, told IPS about the case of a public health worker who tested positive for HIV, and "who was shunned by her colleagues when they found out, and had to be transferred to another area."
The government agency in charge of coordinating prevention efforts against HIV/AIDS in Guatemala is the National Programme of Prevention and Control of Sexually Transmitted Infections, HIV and AIDS, a health ministry body.
Jorge López, director of the Organisation of Support for Integral Sexuality in the face of AIDS, told IPS that as long as members of sexual minorities are considered "abnormal" and their rights as citizens are violated with impunity, it will be impossible to curtail the spread of HIV/AIDS.
"We have been steeped in social prejudice, many of it religious, imposed by churches and institutions that make people think that sexual diversity falls outside the limits of what is normal, and that it must be attacked," he said.
"Many homosexuals have had to dedicate themselves to sex work to survive because their right to education, health and family has been violated, and to put food on the table tonight they have to stand on a street corner renting out their bodies," he added.
López said it is true that there is greater access now to condoms, which help prevent HIV/AIDS and other STIs.
After overcoming a number of legal challenges from the Catholic Church, a family planning law finally went into force in Guatemala in 2009, facilitating access to condoms through the social security system and other public and private institutions.
The law also requires the Education Ministry to include sex education in the primary school curriculum.
But according to López, something very important is missing in order to improve health care for members of sexual minorities and ensure respect for their human rights: "the state must put them in the category of citizens," he said.
"Same-sex marriage is legal in many European Union countries, and in Argentina, and civil unions are legal in many other countries," he said. "That is really the only thing that in Guatemala could make people of sexual diversity real citizens."
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