June 25, 2001 12:28am
Brazil Uses Porn to Fight AIDS
(SAO PAULO, BRAZIL) -- A villa outside Sao Paulo has been turned into a set for a pornographic movie by the Brazilian company, Sexxxy videos [http://www.sexxxy.com.br]. But the company is also the latest recruit in the fight against AIDS. In these films, condoms are standard props. The company is also shooting a special message about AIDS to put at the start of each of its videos -- something that the Brazilian congress will soon make compulsory for all adult movies.
Co-opting and regulating the pornographic industry is just the most explicit example of Brazil's aggressive anti-AIDS programme, which is making many experts point to the country as a model for elsewhere in the world. Certainly Brazil, which has cut deaths from the disease by 60%, is way ahead in both the controversial issues likely to dominate the world AIDS summit in New York, which starts Monday. The first is how and whether to provide universal treatment. The second is coming up with prevention campaigns in which sex, homosexuality, relations between the sexes and drug use can be discussed publicly - subjects still taboo in many places.
Brazil is the only developing country to provide free treatment, making cheap generic copies of anti-AIDS drugs. Officials say cutting AIDS deaths makes the $300m it spends on free treatment a sound economic, as well as ethical, investment. "We do not have our hospitals filled with people dying of AIDS," says Dr. Fabio Mesquito, who runs Sao Paulo's city AIDS programme. One of the fears of providing universal treatment is that it will create resistance, because people in the third world will not take the medicines properly. But studies in Brazil have shown uneducated slum dwellers or rural workers are just as good at keeping to complicated drug regimes as people in the developed world. Brazilian clinics use charts with little stickers for the different pills -- the sun, the moon and meals -- to explain complicated drug regimes. Thanks to free treatment, doctors say, the epidemic has spread at half the speed predicted a decade ago. However with more than half a million Brazilians estimated to be infected with the virus, experts say they need whatever treatment is available to fight the disease.
Brazil's laws allow it to break international patents to produce copies of the latest drugs. This has brought conflict with the United States, which has gone to the WTO [http://www.WTO.org] and is threatening sanctions. Some U.S. officials have argued that treatment is only a small part of an anti-AIDS programme and that Brazil should look more to prevention. This has produced an angry response from Brazilian doctors. "Ethically and practically I cannot see how we can run an AIDS programme choosing between prevention or treatment. We have to do both because one enhances the other," said Dr. Arturo Kalichman, head of the Sao Paulo state AIDS programme. Doctors here say that without treatment, people do not want to get tested, making the disease spread much faster. Treatment also reduces stigma against those with the disease, making it easier to include them in prevention campaigns.
Brazil does have an aggressive prevention campaign. It has used its open attitude to sex, which is sometimes blamed in other countries for the spread of AIDS, to full advantage. Brazilian media campaigns, talking about condoms and sex, would be much too explicit elsewhere in Latin America, let alone the rest of the world. In many Sao Paulo schools, teenagers practice putting condoms onto a clay model, as well as discussing the importance of honesty in relationships as part of their sex education. Brazilian doctors are now looking at ways of expanding this because, despite the successes, the disease continues to spread into the population at large.
The latest statistics show a steady increase in the numbers of women testing positive, often after taking the test during pregnancy. Many are married, from poor households, and have only had relations with their husbands -- who have not been so faithful. Doctors admit changing this will be tough. "The potential of the epidemic among the heterosexual population is very worrying because it is the vast population of Brazil," said Dr. Kalichman. "We still have a cultural challenge to deal with the sexist and double morals, that a man can do something that a woman cannot do." He added that fighting AIDS also means fighting poverty and social exclusion. Here Brazil, which has one of the biggest wealth gaps in the world between rich and poor, still has a long way to go. "If we rest on our laurels," warns Dr. Kalichman, "the disease could still get out of control." -- Tom Gibb in Sao Paulo