Monday , May 29 2023

HIV: how Miami became the hottest spot in the US


"I thought I was dying, I thought I was going to die, I wanted to kill myself, I did not see myself as a future."

A few years ago Daniel (fictional name) fell American dream

He came to the United States of America in the Caribbean Sea to find a life that he imagined a child's image and found a problem that he suddenly believed was protected: HIV.

"I am homosexual, I always know and always protect me, it has been a big surprise," he explains, on the other hand, remembering the moment when he diagnosed the virus.

Daniel definitely speaks of BBC World, but he still has no anonymity because of the stigma weighing those who suffer from HIV. XXI. century.

His family does not know about his situation and does not have many of them living in Florida, where he lived for 13 years. That's why he asks us hiddens Some details you can identify yourself.

This latin Latin Latin-American dedicated to the aviation sector certifies that it was infected Miami, a tourist city located in the south-east of the country, known for its beach mileage and mixing cultures.

His case illuminates the hidden face of the city: a serious problem in his liver.

"Miami epicenter is the epicenter of the epidemic in the United States (HIV / AIDS)," warns Mario Stevenson, leader in research in the United States. and director of the distribution of infectious diseases of medicine at Miami Miller School of Medicine (UM).

The metropolitan area of ​​Miami (along with Miami, along with Fort Lauderdale and West Palm Beach), diagnoses new HIV in relation to the same country, according to the latest study by the control and prevention centers of the disease. CDC), preliminary data for 2017.

It has an average of 35,3 cases, approximately 100,000 people, that duplicate or increase almost three times as large as other American metropolitan areas, such as New York or Los Angeles.

Nearly 45% of the new diagnoses recorded in the metropolitan area of ​​Miami 2016 were Hispanics / Latinos, this is not surprising, 45% of the population of the area corresponds to this community (and this percentage is greater than 70%, it is only a city of Miami).

"It's the perception that controlling HIV is under control." There is no risk, the treatment is for everyone, that is the United States. "Nothing is far from reality," says Dr. Stevenson, he has researched his research on the Massachusetts vaccine to work on the most affected area in the Miami vaccine.

Experts do not accept a single reason for explaining and explaining this situation accumulation of circumstances

On the one hand, tourist flow.

"Many of them do not know about the risk of HIV, so the holidays come, they must be fun and vulnerable, they do not have to be protected and infected," explains UM specialist.

"Then, according to the population, homeless people, mental problems, excessive substances, and then they are enormous. ethnic differencesTherefore, the messages we provide for the education or protection of the population are sometimes not well-used languages, "he said.

Although currently undergoing treatment with HIV, although it is called antiretroviral treatment, the virus is rotated undetectable And to avoid transmitting, the Florida problem is that 20% of people living with the virus do not know, Stevenson emphasizes.

In 2016, the government promoted a plan to reduce infections and reduce the number of deaths associated with AIDS, with some recommendations from the doctor's team.

It is expanding the government's strategy, facilitating access to treatment and prevention methods, such as Pre-Exposite Prophylaxis (PrEP), a drug that prevents HIV infection and awareness, specifies the Florida Department of Health. A statement sent to BBC World.

About the neighborhood hipster Wynwood, one of the oldest ways in the city, is afraid.

"G alerthonor ", It can be read in large letters at some bus stops.

The campaign is very common in other parts of Miami, but it is harder to refer to HIV.

After one of those posters he finds it "Out of the closet"At first glance, a clothing store hippie Second hand, within the pharmacy.

Amongst the stitches and armchairs, there are some white backgrounds, condoms and a free computer box: HIV and other sexually transmitted diseases are offered.

"One thing is repeated: stigma. That is why the concept is: you do not go to the clinic, go to the shop you shop, and go through the process, "explains Oscar Medina, a three-year nonprofit, non-profit chain.

"It's free, everything you need to do is registered on your computer, confidentially, once you have finished, we do not share information with anyone, only with the Department of Health, but the only case it will be the department. if you are positive and you will not go to your medical appointment. "

Keys to HIV and AIDS

  • AIDS is not HIV itself: AIDS is the name of the disease. The acronym refers to a virus that causes HIV (a human immunodeficiency virus).
  • You can live the virus and never suffer AIDS. AIDS appears in advanced HIV infection infections.
  • HIV can not be transmitted sexual intercourse (vaginal, anal, or oral) with a person living with the virus; blood transfusion transfusion; and to share needles, syringes, surgical equipment or other sharp objects.
  • For the time being, there is no cure for HIV, but there is a call antiretroviral treatmentIRICO, the virus can not be detected and, therefore, to prevent infection.

At the time the BBC Worlds store visits, six people have arrived: four American, middle male and a 22-year-old girl named Tatiana.

"I tested for six months (HIV), because I am very serious for me, for gay groups, It's very common. They speak as if they were false, "he said, leaving the test for the BBC World for about 15 minutes and, if necessary, negative.

Relative life lives with the virus and that's why Tatiana is more alert.

As Marilyn Monroe is adorned with a horrible and suggestive photo, Oscar Medina believes that young people are now far more open to talking about their sexual life. This facilitates his work, but emphasizes that between Latin and Haitian communities, in the cities affected by HIV, it is still very large "Taboo".

"Latinos do not speak about sex at home; Haitians are much less. "

According to CDC data, most HIV infections occur between males.

At another point in the city, in a more marginal area, another group offers a similar service, but when appropriate, four wheels have the installation.

This is go to exchange types and exchanges that travel daily to different points of the city new syringes others use it.

At the end of the 80s, this type of prevention program in other countries and around the world was carried out, but in Miami two years ago it began working.

Previously, it was not legal.

"I came from Boston from Massachusetts, where they had this program, and when I came there, when I came for drugs, I searched for something similar and I did not find anything." I thought. "What's happening?" It's wonderful, "remembers Meghan Machude, originally from Brazil.

While walking, Machude talks to BBC World after leaving the doctor's office after leaving Hansel Tookes. Syringe exchange initiative in Florida ("IDEA exchange"), who has been infected with the Miami virus by treating it with a "dirty" syringe.

"People have always wondered why they have the highest HIV in the country in Miami, and that's why We do not use proven prevention methods HIV, "says specialists at the University of Miami (UM).

"It's unacceptable".

In the list of people, there are homeless people, but those who live in the most exclusive neighborhoods of the city, are married and have children.

The UM program is part of the healthcare system and works with the Department of Health (Florida), so that people in need have access to treatment.

Now this step is pretty straightforward: the same day you diagnosed, you can see a specialist and leave it for 30 days after a medical consultation, says Tookes.

But they started doing that.

It has become another preventive aspect priority The authorities are using PrEP, a daily drug that protects against the virus and is approved by Food and Drug Administration in 2012.

Venezuelan Marco Torrealba, 305 Preventative Organizations, is a member of the Latin community and is called "middle-class", such as applications such as Grinder.

"He has begun to look at the PrEP Latino community" I do not know anything, something for prostitutes, for whom " Want sex all the time& Is not true. It's a completely different angle: you want to take care of your health, "he defends with the BBC World.

Critics say that PrEP prevents condoms from interfering and therefore increases the spread of other sexually transmitted diseases, which, in their opinion, end up fearing to contract sexual intercourse without sex.

He doubts Torrealba.

"In my case, I take PrEP and use the condom." When I'm done I'm not saying daredevil again To get HIV What to do I continue to defend myself with my pamphlets, because I know what the rate of my PrEP is, because of the sexually transmitted illness. "

During this year's government plans, Prep offers Florida at no cost.

"Here the Health Department has a problem: no one he is aware. He asks anyone, and nobody knows. It's not that advertising campaign, "says Alejandro Acosta, a Florida-based organization on education and equality in HIV in Puerto Rico..

Acosta, who is living with HIV, and others are trying to "make an example", believe that the authorities are critical and rotten.

"CDC does not infect anyone with HIV in the treatment, but everyone who can ask about the street." Check, do you know that a person in the treatment does not spread HIV? "And no, he does not know".

Contacted the BBC World, with the Florida Department of Health, sent a statement about plans To combat HIV /sgo This has emphasized the commitment to eliminate new infections and ensure the care of people living with HIV or AIDS, but it is not an interview.

According to data provided by CDC, the number of diagnosed cases of HIV decreased by 7% in the metropolitan area of ​​Miami in 2017 than in the previous year.

As regards the data sent by the BBC World Health Department, the number of cases diagnosed by HIV decreased by 5.4% in Miami-Dade County in 2017, the most vulnerable to the metropolitan area.

To get "zero", people in front of "battle" must be taken into account the main obstacles The best message for the whole society living in South Florida is needed.

This is one of the main concerns in all the interviews, as well as in the Jackson Memorial clinic in the public city of Jackson Memorial.

"We have a very diverse group of minorities challenge"Michael Kolber, the director of this center, acknowledges that when they receive care from all types of care: psychological education or medical insurance information.

The annual budget cuts or lack of expansion of Medicaid Florida, the insurmountable program for people with little resources promoted by former President Barack Obama is difficult.

"The reality is that there may be many, though Where do you get the resources? It's a question. Why nothing is ever a panacea, "says the doctor.

However, Kolber is optimistic for the efforts begun in these two years, for example, to exchange syringes.

"I think it's a very positive thing from the beginning, thinking about how slow it was for me, what's useful to think about and what it is great success".

Today, in his opinion, the most pressing need is "to reach populations that do not learn to learn and learn."

"If we get them we can try and treat themors ".

Daniel, a man from the Caribbean who came to the United States, should have a clear and precise message: "You will happen to me."

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