People living with HIV/SIDA receive support from CESE during the pandemic

Around the world, the COVID-19 pandemic continues to spread at a catastrophic rate, although some countries have managed to control it.  Brazil currently ranks fourth in global death rates, behind only the United States, the United Kingdom and Italy.  There is a general propensity for epidemics to expose and aggravate social inequalities, with a greater impact on marginalized and vulnerable groups.  And we know, the poorest individuals, black people, residents in peripheries, the indigenous and more vulnerable populations will suffer the most from the spread of the virus and the collapse of the health system.

Included in these vulnerable populations are people living with HIV and SIDA, who, like those who do not live with the disease, must follow prevention measures to minimize exposure and risk of contracting SARS-CoV-2, the causative agent for COVID-19.  According to the Joint United Nations Programme on HIV/SIDA (UNAIDS), although significant progress has been made in recent years in the treatment of HIV, 15 million people who live with the disease do not have access to antiretroviral therapies, which could compromise their immune systems.

In order to continue to preserve this population’s health, CESE, through its Match Funding Methodology, has supported the project “POSITHIVE SOLIDARITY – Assistance and prevention in combatting COVID-19” from the Caririense Association for the Fight Against SIDA, located in Juazerio do North, in the state of Ceará.  The proposal aims to minimize the possible socio-economic and negative impacts of the pandemic on this population in the city, as well as to provide guidance about measures recommended by the health authorities aimed at social distancing, individual protection, and individual and collective hygiene.


Stigma and health issues

In a report published on its website, Winnie Byanyima, Executive Director of UNAIDS declared that “To get through this, we need to make the most of our valuable experience in responding to other global epidemics, such as that of HIV: to base the response on human rights, to involve communities and not to leave anybody behind.”  However, the Brazilian government has learnt little from this experience and from other epidemic diseases such as smallpox, meningitis and yellow fever.  As well as positioning himself against medical and scientific recommendations, weeks before the pandemic President Jair Bolsonaro publically declared that “Anyone with HIV, as well as being a serious problem for them, is an expense for everyone here in Brazil”, reinforcing stigma and contradicting the reality of government health expenditure.


Ronildo Oliveira, Coordinator of the Caririense Association for the Fight Against SIDA, explains that prejudiced and stigmatizing discourse such as this hinders the treatment and prevention process, particularly in small communities: “The coronavirus creates the same feelings, fear and prejudice we saw at the beginning of the global HIV/SIDA epidemic and this is even worse in smaller places without access to clear information.  With the pandemic, we have seen this hard reality in our communities, for HIV seropositive people, poor people, LGBTQI+ people, black people and those from the peripheries, where the virus is really present.  Unfortunately, so far, segregation has occurred with the pandemic”.

According to data published by the Ministry of Health in November 2019, approximately 900 thousand individuals live with HIV in Brazil, 766 thousand have been diagnosed, 594 thousand have undergone antiretroviral treatment and 554 thousand do not transmit the virus.  The number of people living with HIV in 2018  was lower – 866 thousand.

For Ana Pereira, the association’s legal adviser, prejudice and discrimination only lead to negative impacts and social exclusion, further intensifying the existing social vulnerabilities in society: “This makes people afraid of seeking out information, services and methods that reduce the risk of infection or adopting safer behaviour, fearing that this will make people suspect their HIV status.  Lack of preparation in some health professionals and the prejudice ingrained in society also alienates the LGBTQI+ population from health services.  The stigma around COVID-19 will lead to similar difficulties, which is why we need more empathy and less discrimination.”

Ana considers the government action, at both federal and state level, has been timid and negligent. People who live with HIV/SIDA are already stigmatized and have difficulties remaining in the informal labour market: “In our region, Cariri, most of this population is in informal labour, principally in sales, and now, in the midst of the pandemic, these people have no means of guaranteeing their subsistence with dignity,” Ana explained.  She also talked about the problem of accessing treatment.  Public transport is not circulating and consultations have been partially suspended: “There are only emergency appointments.  People who live with HIV, principally those who do not have their own transport, have suffered even more from the impacts caused by the pandemic.  There are difficulties accessing medication, which is the minimum required, and this situation is aggravated by a lack of telephone contact for patients/services.”

In relation to this, Ronildo Oliveira also denounced the absence of state action, declaring “Here in Ceará, the reference hospital for SIDA/AIDs – São José and the state infectious diseases service, historically run down, have become reference centres for COVID-19.  Access to treatment for people living with HIV has become even more precarious.  And a lack of PPE [Personal Protective Equipment] leaves patients even more vulnerable.”

There is a series of social determinants related to sexually transmitted diseases and populations vulnerable to infections, such as LGBTQI+ communities, the association’s target audience, which experiences a greater impact from the pandemic.  “We have seen the intensification and synergy of vulnerabilities in a much more acute way at this time of pandemic, most are black, poor, from peripheral neighbourhoods, and semi-literate.  Many are not registered with any government benefit agencies, such as the Federal Government’s Single Registry for Social Programmes (Cadastro Único para Programas Sociais do Governo Federal: CadÚnico). With no possibility of working and no support from social programmes or local governments, the LGBTQI+ population, which already faces prejudice and discrimination in other situations, is experiencing a deepening of the vulnerable conditions they already suffer,” describes Ana Pereira, referring to the transvestites and transsexuals served by the organization.


Partnership with CESE

Asserting its commitment to the guarantee of human rights and to overcoming the inequalities faced by HIV positive people and LGBTQI+ communities, CESE supports the measures of the Caririense Association for the Fight Against SIDA to continue guaranteeing the rights of these populations, through: Home delivery of medication for people living with HIV/SIDA; Distributing staple food baskets, as well as cleaning and personal hygiene materials, facemasks, 70% alcohol hand sanitizer and cooking gas to this group; and legal and social support via telephone contact, messaging apps and e-mail to respond to questions about CadÚnico (social benefit), the times of medication deliveries, emergency government aid and the location of services for suspected COVID-19 cases.

Ronildo talked about the importance of CESE’s support through the match funding methodology: “CESE was and will be a great partner, both in local fundraising training and in support through the match funding project.  We are grateful for its sensitivity in supporting life projects for populations that suffer the most within our local context.”

Ana, who is also the institution’s fundraiser, added her thanks for the support received during such a difficult period: “I send to CESE all the gratitude of those whose lives have been impacted and improved through this connection of confidence and willingness to see a more egalitarian and fair world.  This partnership has been of fundamental importance to help our beneficiaries during such a difficult time of pandemic.  Through CESE, we have been able to minimize the negative impact the COVID-19 pandemic has had on the lives of so many people.  In delivering medication and providing information about health services, in being a link between the reference centre and patients living with HIV, and by saying YES to requests for food aid and other basic needs.”


Match Funding Methodology

During the pandemic period, CESE is making funds available through the Action for Children Programme to support social movements and partner organizations in their emergency aid activities to combat the impacts of SARS-CoV-2, the COVID-19 causative agent.  Through this support, CESE is encouraging groups to raise half of the funds required to run their project and then doubles the amount.

The Caririense Association for the Fight Against AIDS ran two fundraising activities, the sale of a feijoada bean stew via delivery and a campaign for online donations through virtual fundraising platforms.  The organization raised BRL 8,382.00 and CESE matched the amount, leading to a total of BRL 16,522.00.


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