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"I thought I was going to die, I thought I would die, I wanted to die, I did not see any future for myself."
A few years ago, Daniel (not his real name) collapsed in his American dream .
He had arrived in the United States from his Caribbean country in search of life that he had imagined as a child and suddenly he encountered a problem for which he believed himself protected: HIV .
"I am homobadual, I always knew and always protected me (…) It was a big surprise," he says from the other side of the phone, recalling the moment he was diagnosed with the virus.
Daniel speaks without problem to BBC Mundo, although he prefers to go to the shelter. anonymity for the stigma still hanging over those living with HIV, in the 21st century.
His family does not know his situation and many of those around him, where he has been living ever since. 13 years; that is why he asks us to keep hidden s some details to identify him.
This Latino of an average age, dedicated to the aviation sector, claims that he was infected at Miami (1945). ] tourist town in the south-east of the country known for its miles of beaches and its mix of cultures.
His case breaks with his image attractive and illuminates a hidden side of the city: its serious problem of HIV.
"Miami is not only the epicenter of this epidemic (HIV / AIDS) in the United States: it is the epicenter of the epicenter," warns Mario Stevenson, leader of research in this field to United States. and Director of the Division of Infectious Diseases at the Miller School of Medicine at the University of Miami (UM).
Miami is at the top of the ranking of new HIV diagnoses in the country, with an average of 42.9 cases per 100,000 population. in 2017, according to data from Centers for Disease Control and Prevention (CDC), which double or nearly triple compared to other major cities in the country, such as New York or Los Angeles.
Mexico : among them Campeche (17.4 per 100 000 inhabitants in 2016) or Yucatan (13.7 per 100 000 the same year).
About 60 years old. % of the new cases in Miami are citizens Latin which is not surprising considering the composition of their society: about 70% of the population is of Hispanic or Latin American origin, according to the last census published.
"There is a perception that HIV is something that is under control" There is more risk, everyone is treated, it is the United States "… Nothing n & rsquo; Is more distant from reality, "said Dr. Stevenson, who has transferred his research to a vaccine against the Mbadachusetts virus in Miami. most affected area.
Experts do not agree on a single reason for this situation and evoke an accumulation of circumstances.
On the one hand, the flow of tourists.
"Many do not know the risk in terms of HIV, so people come on vacation, they want to have fun, they are vulnerable, they do not protect themselves and they may be contaminated" , says the UM specialist.
in terms of population, the number of homeless, mental problems and addiction is high; and then there are the enormous ethnic disparities so that the messages we give to educate the population or to protect themselves sometimes do not go well in all languages, "he summarizes.
] that there is currently a treatment for HIV, called antiretroviral therapy, which can turn the virus into undetectable and prevent it from spreading itself, the problem in Florida is that until 39; 20% of people living with the virus
In 1965, the government promoted a plan to control infections and reduce the number of AIDS-related deaths, echoing some of the recommendations of the World Health Organization. team of renowned physicians.
] The government's strategy is to expand testing, to facilitate access to treatment and prevention methods such as Pre-Exposure Prophylaxis (PrEP), a drug that prevents HIV infection. r HIV, and educate the population, says Florida Department of Health in a statement sent to BBC World.
Wandering in the Hippie District of Wynwood, one of the most fashionable city, there are posters that scare you.
" Alert g onorrea", can be read in large letters at certain bus stops.
The campaign is very common in other parts of Miami, but it is more expensive to find a sign referring to HIV.
After one of these signs, one finds "Out of the Closet" at first glance, a used hippie clothing store with a pharmacy inside.
Between hangers and retro armchairs, several white doors appear at the bottom, a box with free condoms and a computer: tests for HIV and other badually transmitted diseases are offered.
"There is one thing that repeats: the stigma .This why go back to a clinic, you go to a store to buy things and you make the # 39 Review, says Oscar Medina, a social worker who has been part of this non-profit chain for three years.
"It's free. The only thing they should do is to register in the utadora composition, confidentially. Once that ends, we do not share the information with anyone, but only with the Ministry of Health, but the only case in which the ministry will follow you under the bed is if you were positive and you do not go to your doctor's appointment. "
Key to HIV and AIDS
- AIDS is not the same as HIV: AIDS is the name of the disease, the acronym HIV (Human Immunodeficiency Virus) means the virus, the cause
- You can live with the virus and never have AIDS AIDS appears in the most advanced stages of HIV infection.
- HIV can be transmitted for badual intercourse (badl, bad or oral) without protection with a person living with the virus, for the transfusion of contaminated blood and for the sharing of needles, syringes, surgical equipment or Other sharp objects
- cure HIV, but there is antiretroviral therapy said v irico which can make the virus undetectable and, therefore, prevent contagion. [19659040] Source: WHO, UNIDA, Fundéu
By the time BBC Mundo goes to the store, they Tatiana, six people: four African-Americans, a middle-aged Latino and a 22-year-old Colombian, Tatiana.
"I am tested for HIV every six months, and for me it is very serious is very normal for homobadual groups . they had the flu, "she told BBC Mundo after leaving the test, which lasts about 15 minutes and which, in her case, was negative.
A close relative lives with the virus, and that is why Tatiana claims to be her. more alert.
Oscar Medina, after her consultation, decorated with a huge and suggestive photo of Marilyn Monroe, believes that young people are now much more open to talk about their bad life, which facilitates their work, but stresses that In the community Latin-Haitian and among the most affected by HIV in the city, there is still a huge taboo.
"Latinos do not talk so much about bad at home ]; Haitians much less."
According to CDC data, the majority of HIV infections occur in men who have bad with men.
Elsewhere in the city, in a more modest neighborhood, another equipment offers a similar service: but, in his case, the facilities have four wheels.
It is a van that runs every day some points of the city to do. tests of this type and exchange of new syringes by others used.
This type of prevention program has been implemented since the end of the 80s in other major cities of the country and the world, but in Miami. It only started to work two years ago.
Before, it was not legal.
"I'm from Boston, Mbadachusetts, and elsewhere, I'm programming you and when I got here, while I was taking drugs, I looked for something similar … and I I did not find anything, I thought, what's going on? It's crazy, "recalls Meghan Machud from Brazil.
Machud's address to BBC Mundo after leaving the doctor's office after leaving the doctor's office, Hansel Tookes, promoter of the first needle exchange initiative in Florida. ("IDEA Exchange"), which has been treating you since the virus was infected with the virus in Miami with a "dirty" syringe.
"People still ask why Miami has the highest HIV rate in the country, and that's because we do not use proven HIV prevention methods ," says Specialist at the University of Miami (UM).
"This is unacceptable"
In his list of patients, there are many homeless people, but also people who live in the most exclusive areas of the city, married and with children.
UM Health System and works in coordination with the Department of Health (Florida) so that people who need it can access treatment.
This step is relatively simple: the day of the diagnosis, you can consult a specialist and leave. consulting with a drug for 30 days, comments Tookes.
But it's something they've just started doing.
Another Prevention Method Became The Authority's priority concerns the use of PrEP, a daily medication that protects from the virus and has been approved by the Food and Drug Administration in 2012.
The Venezuelan Marco Torrealba, from the Prevention 305 organization, is dedicated to promoting it to the Latin American community and doing it through the "middle street": thanks to the applications dating as a Grinder.
"PrEP began to be perceived by the Latin American community as" something I do not know, something for whores, for whom wants to have bad all the time " and it's not true, he's got a totally different angle: you want to take care of your health, "he argues in a conversation with BBC Mundo.
Critics say that PrEP prevents condoms from being used and, therefore, from other means of badual transmission – as, in his opinion, puts an end to fear of getting HIV if they have bad without a condom.
Torrealba puts doubt into doubt.
"In my case, I take PrEP and use a condom The fact that I participate in PrEP does not mean that I become imprudent in terms of HIV acquisition, what should I "I continue to protect myself with condoms because I know my pace of taking PrEP because a badually transmitted disease hurts." [19659002] One of the government's plans for this year is to "get pregnant." offer free PrEP in Florida.
"Here the Department of Health has a problem: no one knows this . Questions to anyone, and no one knows. There is no advertising campaign that say, "warns Alejandro Acosta, a Puerto Rican educator on HIV and related to the organization Egality Florida .
Acosta, who lives with HIV and tries to "become an example" for others, is very critical of the authorities and considers that they fail. "
"The CDC announced that HIV-positive people under treatment do not contaminate anyone, but question everyone. "Hey, listen, do you know that someone in treatment is not transmitting HIV?" And no, he does not know it. "
Contacted by BBC Mundo, the Florida Department of Health is limited to sending a statement regarding their plans to combat HIV infection rates / in which they emphasize their commitment to eliminate new infections and provide care for people living with HIV or AIDS, but refuse to grant an interview to this media.
figures sent by the Health Ministry to BBC World, the number of diagnosed HIV cases has decreased by 5.4% in Miami-Dade County in 2017, but the number of people diagnosed with HIV has decreased by 5.4% in Miami-Dade County in 2017; On the front line of "fighting" consider that there is still
One of the biggest hurdles is finding the best message for a society as diverse as that which resides in Miami.
That's one of the main concerns s of all conversations and she repeats herself. also Jackson Memorial
"We have a very diverse minority group, so it's a challenge ," recognizes Michael Kolber, director of the center. , which tries to offer all kinds of care to patients who arrive: psychological, educational or information on health insurance.
Years of budget cuts or lack of expansion In Florida, Medicaid, the health insurance program aimed at people with fewer resources and run by the government, is one of the world's largest health care providers. former President Barack Obama, makes things difficult.
"The reality is that we could do a lot of things, but Are you going out resources? That's the question. Because nothing is ever a panacea," says doctor.
However, Kolber is optimistic about the efforts undertaken in the last two years, such as the needle exchange.
"I think the fact that it started is very positive, it's not helpful for me to think how slow they've been." Is to think about what has been done and what is a great success [19459088].
The most urgent task at the present time is to "understand" and learn to reach people who do not listen. "
" If we do, we can test and treat them. "
For Daniel, the Caribbean man come to the United States in search of your dream, the message must be clear and concise: "This can happen to you."
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