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Paraguay: AIDS program targets prostitutes
Latinamerica Press / June 22, 1995

By Larry Luxner

ASUNCION, Paraguay -- Twenty-year-old Maria admits she's slept with 30 men this week. Her 18-year-old friend, Luisa, has been with 42 men.

Once a month, the two prostitutes reveal their sexual secrets -- not to a priest, but to Rosio Duria, a social worker employed by Paraguay's Programa Nacional de Lucha Contra SIDA (Struggle Against AIDS).

"The girls come here, often brought by their pimps," Duria said after an exhausting day at her Asunción clinic interviewing prostitutes about their activities and meticulously writing down their responses on pre-printed forms. "They have to carry certificates showing that they're AIDS-free. The HIV papers must be renewed every three months, and venereal disease papers must be renewed every month, or they'll be picked up by police and put in prison."

Duria's interviews are part of the stepped-up battle against AIDS in Paraguay, one of the world's few countries where prostitution is technically legal, but abortion is not. Until the overthrow of Gen. Alfredo Stroessner in 1989, homosexuality was also against the law -- making the detection of gay HIV carriers next to impossible.

"During the dictatorship, many subjects were considered taboo -- abortion, divorce, AIDS," says Cristina Muñoz, secretary of women's affairs under the current president, Juan Carlos Wasmosy.

It was difficult to talk about AIDS then," adds Dr. Nicolas Aguayo, director of the national anti-AIDS program in Asunción, the capital city. "The government didn't even issue monthly statistics on AIDS until September 1992."

Compared to neighboring Argentina or Brazil, Paraguay's AIDS problem is still minor. According to Aguayo, the country has had 568 cases of HIV infection, 178 cases of full-blown AIDS and 128 deaths since 1986, when the epidemic arrived here. This gives Paraguay an overall AIDS incidence of only 1.2 per 100,000 inhabitants -- one of South America's lowest.

Yet ignorance about the disease is widespread, despite the fact that AIDS in Paraguay is largely spread through sex between men and women -- not by intravenous drug addicts as is the case in Argentina, Uruguay and Chile.

"In the beginning of the epidemic, homosexuals and bisexuals were around 45% of the total, versus 10% for heterosexuals," said Aguayo, who studied medicine in Brazil. Today, homosexuals constitute 20% of Paraguay's AIDS cases, bisexuals 8% and heterosexuals 34%. Heroin addicts account for 11%, of cases, and hemophiliacs and pre-natal cases another 2%. One-fourth of Aguayo's patients acquired AIDS through unknown causes. Nearly all of them live in and around Asuncion.

To fight the epidemic, Aguayo's office has a government-funded budget of $8.4 million. About half that amount is spent on laboratory and blood-testing equipment; another $2 million goes to purchase the anti-AIDS drug AZT; the remainder is spent on awareness campaigns and educational material. equipment.

At the moment, the ambitious program counts three doctors, two biochemists, one psychologist, three secretaries, one social assistant, four auxiliary administrators, one lab technician and one driver on its full-time staff.

"This is not only the best moment we have to prevent AIDS, it's the only one," says the program's policy statement. "It is an historic responsibility of the Paraguayan state regarding the future and its children's future."

One way the program aims to halt AIDS is by educating prostitutes about the disease, and requiring them to undergo medical checkups. Duria says that while HIV tests are free, the women must bring their own disposable syringes. They must also be prepared to answer a barrage of questions about their line of work, such as the number of men they have sex with during an average week, how often they use condoms during intercourse, whether they've worked in neighboring countries, and whether they have sex with women as well.

"To do this, you need someone with a lot of confidence," says Duria. "We're dealing with very sensitive subjects."

She said Paraguayan prostitutes generally work for pimps, keeping half the proceeds for themselves. Near the Asunción bus terminal, poorer girls charge 10,000 or 12,000 guaranies (around $5), while women working in swank downtown clubs like the Playboy earn up to $100 per customer. The prostitutes usually take their clients not to hotels, but to special places called reservados, which often charge a small fee of their own.

Besides asking questions, Duria also gives each girl who visits her clinic a large box of condoms. Getting the girls to use prophylactics, however, isn't that simple. In addition to battling long-standing opposition to condoms from the Catholic Church -- which is quite powerful in Paraguay -- there's also a strong economic disincentive. "Many guys will offer girls an extra 10,000 guaranies if they don't insist on using a condom," she said.

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