By Sumita Thapar Aug 8, 2008, 2:00 GMT
Mexico City - When an openly-gay, HIV-positive man leads the national AIDS agency of a predominantly-Catholic country with its machismo culture and strong undercurrents of homophobia, the message to the world is quite straight.
Mexico can be a land of extremes, especially when it comes to HIV and the sticky topic of sex, but it sent out a clear signal that it was ready to tackle its problems head-on when the government appointed Jorge Saavedra as head of the national HIV/AIDS programme, CENSIDA in 2003.
Saavedra is homosexual, was infected with HIV in 1985 and is 'married' to his current partner, through a civil union law that is applicable only in Mexico City.
AIDS is as much a health, social, public policy and economic crisis as well as a political issue. Countries that have shown poor political leadership in their response to HIV - where presidents have denied the existence of HIV or prime ministers have been too embarrassed to talk about condoms - have also seen their epidemics spiral out of control.
Mexico is frank about reporting that the main driver of its epidemic is men who have sex with men, which other countries in Latin America have been hesitant to discuss. But it also has a large problem of crimes against homosexuals.
It is a deeply religious nation. But despite severe criticism from religious groups, Saavedra managed to persuade the government to fund condom promotion campaigns.
There is still so much stigma attached to AIDS here that families abandon their relatives who have HIV. But the government launched a policy for universal access to antiretroviral drugs. Saavedra said he ensured this programme took off and it currently covers 47,000 people living with HIV/AIDS.
Saavedra is a survivor - not just of HIV, but also of the conservative politics in his country.
President Felipe Calderon, a political conservative and practising Roman Catholic, openly opposes same-sex marriage, but is quick to say that he believes in the separation of religion and politics.
Saavedra fought hard for the civil union law of 2003, which does not legalize same-sex marriage or allow gays and lesbians to adopt children, but it does give couples the right to inherit property and have joint health and life insurance policies.
This frees him to refer to his partner as his 'husband,' as he did Tuesday at the world's largest AIDS conference in Mexico City. The CENSIDA chief chose to speak about sex between men for the Jonathan Mann memorial lecture - named for the physician credited with building the World Health Organization's global AIDS programme in 1986.
He ended his speech: 'And, finally, yes, I am married, so I would like to thank my husband for his patience during all these weeks previous to the conference.'
As the audience cheered and applauded, he proclaimed, 'Yes, Mexico, I said husband. I did not make any language mistake. We got married where it is legal, almost four years now.'
In a subsequent interview with Deutsche Presse-Agentur dpa, he said: 'Condoms and testing are part of our lives. My partner is negative and I am positive. Testing is important to ensure my negative partner stays that way. We get tested twice a year.'
After earning a masters in public health and health policy at Harvard University, Saavedra returned to Mexico and joined CENSIDA in 1997.
He discovered that men who have sex with men (MSM) were the worst affected - as is true worldwide, where HIV infection rates for MSM are 19 times that of heterosexual men in poor and middle-income countries.
His efforts to combat homophobia became easier in 2001 after then president Vicente Fox, also a conservative, signed a constitutional amendment that outlawed discrimination, including any prejudice based on sexuality.
In 2004, Saavedra spearheaded an official anti-machismo education campaign, following it a year later with the first government- endorsed anti-homophobia drive.
'Machismo is very high here. I think the word was invented here. It damages women and gay men so it is very negative for a country or society,' he told dpa.
He took on homophobia through radio spots. 'It was important to do this because many gay men don't approach health services, they never get tested. They will go for health services when they are really sick, in the last stages of HIV.'
Saavedra is now working on Mexico's second anti-homophobia campaign, this time for television, despite widespread criticism that such advertisements shouldn't be funded with public money.
In 2000, he founded Mexico's largest HIV ambulatory care clinic, Clinica Condesa, which offers specialized care to HIV- infected people, many of who are gay men.
The government is setting up 51 similar clinics across the country. They're called CAPASITS, a Spanish acronym for ambulatory prevention and care services for AIDS and sexually-transmitted infections.
'The word as a whole sounds like 'capacity'. We did not want to call them AIDS clinics,' Saavedra said.
'Our mission is to offer health services to all. We want to say, 'As soon as you enter our doors feel free to be whoever you are. You can bring your boyfriend or partner and we are there to help you'.'
Saavedra's bold initiatives have been praised by the global AIDS community as well as homosexuals and AIDS activists in Mexico. His survival at the top AIDS agency continues to surprise many, as did his appointment.
'I could not believe they chose him,' said Luis Soto-Ramirez, one of Mexico's leading AIDS researchers, in an interview with Science magazine two years ago. 'It was amazing.'
Despite the challenges of coming out, coupled with the stresses of coping with his own illness, Saavedra told dpa his position demands it.
'When you are in charge of changing things, you want to be sure you're doing the right thing, and I wouldn't be sure if I was 'hiding'.'
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