Local knowledge (or lack thereof) about HIV/AIDS

My new job working on HIV/AIDS prevention projects has not only allowed me to start carrying out prevention education in the migrant shelter where I have been assigned but has also carried with it the unintended consequence of allowing me to start educating in the community, sometimes in the most unexpected places. I'll explain what I mean: in Chiapas, although there is quite a bit of racial mixing in the cities and there are some pretty white locals, I still tend to stand out as a foreigner. Strangers often take an interest in me, wanting to know where I'm from and what I'm doing here. Lately, I've told them about my new work. After sharing this information, many of these people identify me as a source of reliable information, and start to ask me questions. In some cases, the lack of knowledge people have about HIV, AIDS, and prevention methods is quite shocking. For example, many people continue to believe that HIV can be transmitted through mosquitoes. Many others don’t understand that there is a difference between HIV and AIDS. One taxi driver even asked me, “well, I know that it can be passed from a man to a woman having “relations” [vaginal sex], but it can’t be passed from the woman to the man, right?”

Lack of knowledge of this sort has a lot to do with an overall lack of comprehensive reproductive health education in schools and other institutions in Mexico. Another factor is most likely the generally conservative nature of Mexican culture, which makes it taboo to talk about sex and sexuality (especially sex before marriage) among friends and family. Fortunately, in does seem that in recent years, reproductive health has gained footing as a “hot topic” of interest. Sex education is on the rise, particularly in the work of non-profit organizations. As a result, young people tend to have much better understanding of the issues than their parents. Nevertheless, even with this education, a number of barriers conspire to cause young people to continue to engage in risky behaviors. For example, it is very difficult to buy condoms in Mexico, and even harder to do so “anonymously.” In the pharmacies here, you have to ask for condoms from one of the clerks. These clerks are known to give judgmental looks at the customer. If the customer is a youth, clerks may lecture them on the importance of abstinence until marriage. If anyone who knows the youth or their family sees them buying condoms, they might gossip about the youth or share the information with their parents (who, influenced by the taboo of sex before marriage, might get angry with or punish their children). If a young woman is seen buying condoms, she is often labeled a “slut.” In addition to difficulties buying condoms, the cultural influence of “machismo” also creates a major barrier to safe sex, and tends to put women in a particularly vulnerable position. If a woman suggests that a condom be used, men interpret it as a sign that she has a sexually transmitted infection (STI), and not that she is trying to protect herself. If the woman tries to use a condom with her partner, she will be accused of having multiple partners. Again in this case, the woman is labeled a “slut.” Women often resort to using the morning after pill as their main contraceptive. This method, however, causes unnecessary physical stress on the woman's system and doesn't protect her against STIs. On the other hand, it is “macho” for men to have multiple partners, even if they are married or have a stable partner. This increases the chances that they will be infected with an STI, making their female partners who are pressured against suggesting the use of a condom particularly invulnerable. Machismo also influences the high prevalence and impact of homophobia in Mexican society. Because of this homophobia, men who are homosexual or bisexual often “hide” their sexual preferences from their friends and families. In many case, they never fully admit their preferences to themselves. For that reason, sexual relations they do have with men are often sporadic, unplanned, and occur in states of inebriation. These factors, combined with the guilt they experience, decrease the chances that they will be prepared with condoms and that they will use them.

As mentioned above, there are a number of encouraging signs that reproductive health education is becoming more prevalent in Mexico. Nevertheless, this education will need to be combined with policy changes and increased cultural sensitivity in order to facilitate the exercise of safe sex behaviors.