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New struggles with HIV in Timor-Leste

Did Church stance on red-light districts contribute to today's problem?
New struggles with HIV in Timor-Leste

A rest house managed by the Holy Spirit sisters in Dili, Timor-Leste's dusty seaside capital, provides care and support for people with HIV. (Photo by Ryan Dagur)

Published: September 03, 2015 05:25 AM GMT
Updated: September 02, 2015 07:08 PM GMT

While most of the world is seeing a declining or contained number of newly diagnosed people living with HIV, Timor-Leste is seeing an alarming rise, advocates and health officials say.

The rate of infection remains low — less than one percent of the population — however, a host of factors including, poverty, illiteracy and possibly even the country's influential Catholic Church, are inhibiting efforts to control the spread of the virus.

Since 2011, government statistics show a 33 percent rise in the HIV infection rate. There have been 509 known people with HIV reported since 2003, with 326 of them reported after 2011, according to the National Commission to Combat HIV and AIDS in Timor-Leste.

Father Adrian Ola Duli, director of Caritas Dili, said it's difficult for the country to get a grasp of the true numbers because most Timorese are afraid to get tested.

"In Timor-Leste, a person who is infected is considered to have poor morals. So many do not want a blood test," he told ucanews.com. But many of the victims are innocent — wives who contract the disease from their husbands and children who get it from their mothers, he added.

Father Duli said he is certain that the rate of infection is much higher than being reported. "It's like an iceberg, visible only at the surface."

 

Despondent

When Yolanda, a mother of five, was diagnosed with HIV in 2003, her neighbors told her she did not deserve to live in their neighborhood. Her husband, who died in 2007, had tested positive for HIV.

"I asked him why [he became infected] but he said he did not know, he was confused. I do not know whether he was seeing prostitutes," she told ucanews.com.

The husband became despondent, refusing to take his medication or discuss the illness.

"I too thought I would die quickly, but I tried to be stronger," she said.

She started taking her antiretroviral drug therapy and got a job with a local nongovernmental organization counseling other people with HIV.

"Through sharing, I learned more about the disease and that I could survive as long as I took the drugs," she said.

Timor-Leste was occupied by Indonesia from 1975-1999. During the occupation, sex work was relegated to certain red-light districts that made it easier to regulate the health of commercial sex workers.

Following independence, the country's powerful Catholic Church led a campaign to dismantle commercial sex districts, forcing the industry to go underground.

It was then that HIV began to proliferate. The first reported case of HIV/AIDS in Timor-Leste wasn't until 2001.

But Father Duli said the HIV/AIDS issue was too complicated to just blame the Church for opposing red-light districts.

"We are aware that it made it difficult to control sex workers; we believe the best solution is to strengthen people’s morality — to provide formation. It is also the same with condoms. We don’t promote it because we believe it is not the right solution (to combat HIV). In our opinion, fostering individual morality is the correct response," he said.

But Eladio de Jesus Faculto, who works for parliament's health desk, said the Church's official stance was shortsighted.

"The absence of a red-light district made it difficult to contain HIV. If we can't help control people's health, HIV will continue to spread," he said.

 

Economic pressures

Holy Spirit Sister Christina Wolla, who has been providing care and support to people with HIV, estimates that there are thousands of commercial sex workers in underground establishments, including many university-aged students, dozens of whom have been diagnosed with HIV.

"They go to school during the day, and in the afternoon and night they become sex workers, serving up to five men a night," the nun said.

Economic pressures serve as the trigger, Sister Wolla said. "They want to help the family and go to school. They see sex work as a quick way to get money. They tell me, 'If we stop, what can we do?'" she said.

"But imagine that these girls are serving five men a day and those five men are going home to their wives. We’re looking at a much more dangerous problem," she told ucanews.com.

Government and civil society groups are working together to contain the virus with the government allocating US$1 million a year to HIV prevention programs.

The Church also has undertaken preventive measures, counseling couples on HIV during marriage preparation courses and educating students through its vast network of Catholic schools.

It also provides direct care to families living with HIV.

"We must walk with the families in order to save their future," Father Duli said.

Franciscan Father Sebastian Gaguk, rector of St. Francis Assisi College, said the church provides sex education and HIV counseling as part of its curriculum, but cultural mores limit its effectiveness.

"Talking about sex is still taboo for Timorese people so many do not understand the adverse effects of promiscuity and sexual diseases like HIV. We are working hard to overcome that," he said.

 

Care and Support

For those already affected, support and, in many cases, the will to continue living is found in the strength of their relationships with others living with HIV. Many of them have never disclosed their medical status to their families.

"We support each other so that those who are infected do not lose hope," said Patricio, 35, who was diagnosed with HIV in 2006.

"At first I could not accept the situation. I was sick continuously and twice tried to commit suicide. But God, it seems, still gave me a chance to live," he said.

Like Yolanda, Patricio refocused his energy to helping others, travelling across the country to counsel others living with HIV. "They are more receptive to help from someone else with HIV. We understand each other," Patricio said.

UNAIDS estimates new HIV infections around the world have dropped by 38 percent since 2001. However, the number of newly reported cases in Timor-Leste has risen.

Thirteen years after achieving independence from Indonesia, Timor-Leste now faces a new struggle.

HIV and AIDS "are the new occupiers of Timor-Leste," said Faculto, the parliamentary health official.

 

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