Bolivia's Traditions, Diversity Impede AIDS Fight Bolivia has the lowest HIV/AIDS prevalence in South America, but the epidemic in the country is growing rapidly. Bolivia's macho culture and its indigenous and cultural diversity make it difficult to reach many at-risk groups.
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Bolivia's Traditions, Diversity Impede AIDS Fight

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Bolivia's Traditions, Diversity Impede AIDS Fight

Bolivia's Traditions, Diversity Impede AIDS Fight

Bolivia's Traditions, Diversity Impede AIDS Fight

  • Download
  • <iframe src="https://www.npr.org/player/embed/101665214/101986477" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

Fernandita Quipildor works on her homework with her cousins at her grandmother's house in Santa Cruz, Bolivia. The 12-year-old was born HIV-positive after the disease was passed to her by her mother. Roberto Guerra hide caption

Battling AIDS, HIV In Bolivia
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Roberto Guerra

Juan Carlos Quipildor is HIV-positive. He and his daughter, Fernandita, were among the first people in Bolivia to go public about having the disease. He shows a video of his wife, Maria Luisa, in the Santa Cruz hospital before she passed away from AIDS-related complications in 2003. Roberto Guerra hide caption

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Roberto Guerra

Juan Carlos Quipildor is HIV-positive. He and his daughter, Fernandita, were among the first people in Bolivia to go public about having the disease. He shows a video of his wife, Maria Luisa, in the Santa Cruz hospital before she passed away from AIDS-related complications in 2003.

Roberto Guerra

Quipildor plays with his kitten in the bedroom of his Santa Cruz home. He says he faces discrimination in his neighborhood and at work, and recently lost his job. Roberto Guerra hide caption

toggle caption
Roberto Guerra

Quipildor plays with his kitten in the bedroom of his Santa Cruz home. He says he faces discrimination in his neighborhood and at work, and recently lost his job.

Roberto Guerra

Bolivia has the lowest HIV/AIDS prevalence in South America — but the epidemic is growing rapidly in the country.

The country faced its AIDS problem later than many of its neighbors. Only in the last three years has the Bolivian government made a concerted effort to educate the public about the disease and provide free AIDS drugs who those who need it.

But Bolivia's mix of tradition and cultural diversity are proving to be major challenges when it comes to fighting AIDS there.

Bolivia's AIDS Epicenter

The only public AIDS clinic in Santa Cruz, Bolivia's largest city, often keeps its doors closed. Doctors, nurses, technicians and receptionists go on strike when they run out of gauze and needles and many other basics.

Eventually, they will get their supplies from the government, but not until after strikes that can last as long as two weeks.

In the meantime, hundreds of patients will miss their appointments and prescriptions. An interruption in HIV drug treatment increases the likelihood that patients will develop resistance to the drugs.

The clinic's director, Gonzalo Borda, says that 46 percent of all HIV-positive people in Bolivia are treated there.

"If we can't control HIV in Santa Cruz, we won't be able to control it in Bolivia," he says.

Santa Cruz is a growing city made up of immigrants — from other cities, from the countryside, and from neighboring Brazil, Argentina and Paraguay. Because of this, it's where most new cases of HIV in the country are diagnosed and where most treatments are given.

Making HIV A Priority

With a population of 9 million, Bolivia had an estimated 1,500 cases of HIV in 2005. But that number doubled within just a year, forcing the government to acknowledge it had a potential crisis in its hands.

"We've made HIV a priority and passed the so-called AIDS law, where we define the government's responsibility toward HIV-positive patients, providing free care and drugs for anyone who needs it," says Ronny Rossel, the national coordinator for the country's first government AIDS program, based in Bolivia's capital, La Paz.

Rossel estimates there are about 8,000 HIV cases in Bolivia now. The law passed last year makes generic drugs from Brazil and India available to anyone free of cost.

But Bolivia's macho culture and its indigenous and cultural diversity make it difficult to reach many at-risk groups. The country has an estimated 40 different ethnic groups, many of them with unique languages and social and family traditions. As well, the government has barely made any efforts to increase HIV awareness and to dispel the myth that it's an illness affecting only prostitutes and gays.

Speaking Out, Dispelling Myths

Juan Carlos Quipildor is from Santa Cruz. He became infected with HIV while he worked abroad in Argentina and has been living with the virus for more than 10 years. He and his 12-year-old daughter, Fernandita, were the first Bolivians to go public about having the disease.

Quipildor says he faces discrimination in his neighborhood and at work, and that even though he is happy to get free generic medicines from Brazil, the help hasn't been there when he most needed it.

"From Brazil, the drugs get to customs, and then they travel a long way before they get to the regional offices. This is such a huge bureaucracy, and our lives depend on these treatments," he says.

"I live with my dad and I'm doing well," Fernandita says. "We always help each other during the bad days, because when my mom was sick, we also stuck together and took care of her until she died."

On this day, Quipildor and his daughter are at his mother's house. Quipildor has just found out that he lost his job, and that he, Fernandita and his healthy 3-year-old son, Andres, may have to move in here for the time being.

He says his mother has come a long way since she first found out he was HIV-positive.

"Our old mentality here in Bolivia was that only prostitutes and homosexuals could get infected — so when they told us that my exam came out positive, my mother fainted. When she woke up, the first thing she asked me was, 'Are you going to die?'" he says.

Quipildor and his daughter both seem to be doing well, more than a decade since they were diagnosed. But, Quipildor says, they still have a long way to go to get the support and care they really need.