Educating about HIV is a difficult task at this time

According to data from the United States Department of Health and Human Services (DHHS), both the country and its territories are on track to reduce the spread of human immunodeficiency virus (HIV) to zero within the next decade.

On the AIDSVu website, local data on the prevalence of the virus shows that, as of 2021, 15,801 people were living with this chronic disease. 410 new cases were also registered during the same period.

Of these new cases, more than 80% occurred in men. The highest concentration of these new cases occurs in the demographic group between the ages of 25 and 34. It should be noted that these new cases emerged after the containment of the pandemic, a situation that was also reflected in other health conditions.

Reason for new cases

In the opinion of Dr. Angelica Santiago Ruiz, there is an undeniable reality: the increase in cases coincides with a decrease in educational efforts on sexual health in the country’s education curriculum.

Santiago Ruiz, who works as coordinator of the HIV program at the Comprehensive Health Council of Loiza (CSILO), admitted that, in the twelve years she has been carrying out this aid work, she has been able to feel the change.

In addition to his degree in Medicine, Santiago Ruiz obtained two degrees in Gerontology and Health Education. With all this educational and experiential background, doctors are able to observe, analyze, and understand situations related to sexual health in Puerto Rico.

“We must recognize that HIV is a disease that affects the body at a systemic level, that is, it affects the immune system, but you still develop other conditions that begin to appear earlier in life , because it causes a kind of accelerated aging. Santiago Ruiz explained. “So, if we think about the prevalence of disease in the country’s elderly population, we are talking about a problem that is likely to compound in the future.”

The specialist admitted that, in the case of her patients, the suppression of the virus is very controlled because there are many educational efforts internally, within the organization in which she works, from the control of the patient’s health to maintaining the support of both Works for. Situation To strengthen community activities that improve the quality of life.

“In that aspect, HIV is better controlled here than diabetes or high blood pressure, because people want to go out and have fun, and at the same time they neglect their diet and develop these conditions. increases the likelihood of developing. That’s why we want (the patients), through these educational interventions, to understand their disease and prepare for their old age because, unfortunately, this is a population that is growing and many with challenges,” stressed the expert, who believes that health services for the elderly population will be a matter of importance in the coming years and should be an urgent priority for government authorities.

“Especially because we’re talking about a population that is caring for family members. We should focus on the group of people who are too old to be young, and too young to be considered old – those who have no children, or no partner… No special support from any government The project does not propose an adequate plan to develop long-term living space, as these are long-term patient (long lived, or LTS) may lead to longer survival due to the effectiveness of new treatments. For me, looking to the future these situations should be discussed now and educate, educate, educate,” he explained.

Communities are organizing through service and support centers that bring patients living with HIV together to maintain control over their co-morbidities, so that the impact of accelerated aging caused by the virus is not as severe on that population. Fell. “We also have support groups among patients, focused on educating and guiding about physical and mental health – which is also important,” said Santiago Ruiz.

stigma is prevalent

One of the primary causes that Dr. Santiago Ruiz takes seriously is the issue of stigma towards people living with HIV. “It’s not like I stand on a stage and say, for example, ‘I have cancer’ – the reaction there is ‘Oh blessed’. Even when you reveal your diagnosis of the disease, there are people who ‘stamp’ on you, not because of the disease, but because they make assumptions about how the infection occurred,” he said. Said.

Young people, on the other hand, do not consider themselves at risk. “They think it is a treatable disease, rather curable, meaning it can be solved with a little pill. Yes, treatment has evolved from requiring a cocktail of six daily medications, which is very toxic to the system, to a pill and even injection treatments (which are administered) every two months, he commented. “And to this we also have to add the development of co-morbidities, which are numerous and complicate the picture, if you do not have comprehensive care for your health.”

Gerontologists also said that the second wave population baby boomersgeneration millennium He is the one who, in his opinion, maintains that negative attitude. “What’s interesting is that according to the numbers (presented by DHHS), new diagnoses are concentrated across all of these groups, with us, those in our eighties, being the group with the lowest incidence,” he explained.

education necessary

For the expert, education on STIs – including HIV – and, by extension, healthy sexuality, has been removed from many educational curricula in the early years, which she considers dangerous. “I’ve seen how that landscape has changed,” he said. “Also, with the whole issue of technology and access to content that stimulates curiosity such as, for example, music, which is now More clearly, we should start educating (young people) already.”

“Using a protective barrier to have sex is effective, if used correctly. Manufacturers (of barriers such as condoms). dental dams) They have become creative and there are products for every taste: with taste, with design, with texture, in different sizes. Doesn’t that feel like that? Well, you have to start from the premise that, when you come into (sexual) contact with another person, you are also aware of their past sexual history,” he insisted, without first clarifying why. She agrees that every person has the right to enjoy their private life and intimacy—including sexuality—as they wish.

“Judging is one of those issues which, as I said earlier, continues to be stigmatized. In this case, it is about awareness because that moment of happiness that you enjoyed so much has passed and, when the results come, even with treatment, it adds a complication to life. Is. “This doesn’t mean going out and enjoying whatever feels best to you, but rather having conversations with yourself and your sexual partners to do it in a fun and healthy way,” she said.

On the other hand, education should also be reinforced among older adults who do not consider themselves at risk. Santiago Ruiz points to treatments for erectile dysfunction (in men) and hormone replacement (in both sexes) as ways to keep sexual desire alive, inducing a desire that, as he points out, never ends. .

“We forget that older people feel sexual desire and try to satisfy it. Therefore, we have to educate in another way, especially in the primary doctor’s office, because sexually transmitted diseases still exist. Many times this happens due to a combination between the doctor not asking (about the topic) and the patient not sharing information (about his intimate life),” he admitted.

Finally, Santiago Ruiz stressed the adequate promotion of PrEP, which has proven its effectiveness. “Not all people eligible to receive PrEP have been properly oriented,” he acknowledged. “In this, local health officials, community organizations that serve these populations and other efforts continue to be successful, but, to me, this should be an issue that is emphasized not every year, but every day,” He concluded.

The author is a contributing journalist for Puerto Rico Saludable.