See also an interview to Harry Douglas, III, DPA, Member MEDICC Academic Council. Executive Vice President, Charles R. Drew University of Medicine and Science

Epidemiologist
Director, Sexually Transmitted Diseases and HIV-AIDS Prevention Centerr

	Dr. Rosaida Ochoa

Dr. Rosaida Ochoa is easy to find, but hard to catch:  she spends long hours at the STD/HIV-AIDS Prevention Center she directs in the Vedado neighborhood of Havana, but there she’s involved in a whirlwind of activity with center staff and volunteers, and barely has time to talk with journalists.  It’s the price of success:  the Center was opened with support from Doctors Without Borders of Holland in 1996, the result of increasing emphasis on prevention in the Cuban HIV/AIDS program.  Since then, its programs have mushroomed to meet the demand from all of Cuba’s 14 provinces for educational seminars and materials for health personnel, individual and group counseling, workshops for hotline (or “helpline” as the Center calls it) volunteers, risk group sessions, and scheduling of the HIV/AIDS mobile unit throughout the country. 

MR:  How do you organize work at the center?  What are the priorities?

RO:  We have several basic programs:  first and foremost, training of both health personnel and activitists who promote safe sexual practices in their communities. Right now, we have a one-week course in session for activists at the University of Havana.  Second, we carry out research in communities, bringing a socio-cultural focus to our epidemiological analysis of various population groups (such as young people, women, men who have sex with men, etc.).  Third, we offer counseling services through the helpline, face-to-face sessions for walk-ins to the center, and psychological counseling pre- and post-HIV testing. 

MR:  Tell me more about the helpline.  How does it work, and what kinds of calls are most frequent?

RO:  The helpline is available 12 hours a day, and we staff the phones with volunteers who have gone through our training program.  Most of them are university students, or people living with HIV.  We receive about 45 calls a day from all over the country, and the number is rising.  The subjects of callers’ concerns range quite a bit, from general questions about sex to STD prevention and treatment, to the symptoms of HIV/AIDS and so on.  Most of the callers are between 15 and 39 years of age.

Volunteers staff the Center’s “helpline” 12 hours a day.

MR:  And counseling for persons diagnosed with HIV?

RO:  This is a very sensitive and very important aspect of our work.  We are involved in training counselors—family doctors and epidemiologists at the centers where people receive the results of their HIV tests.  We train them to give psychological support both before and after people are tested.  Now that there is not massive screening in Cuba, we find that most of the people who come in to be tested do so on the recommendation of their physician—whether the patient may be a hemophiliac, a pregnant woman, or a teen frequently changing sexual partners.

MR:  How common is it for people living with HIV/AIDS to become involved in your programs?

RO:  Very.  We now have people living with HIV/AIDS involved in all of our programs—in Havana, this means 60 people active with the center.  There are more men than women in the group.  These collaborators are very forceful and very committed, and so they are key to the success of programs like our mobile unit, which is taken into communities, onto the beaches, sporting events, and so on.  They also participate in the other programs, such as “Men Having Sex with Men” and “Women and AIDS”.  And they lead three of them:  “HIV/AIDS and Nutrition”; “Religion and AIDS” (involving the protestants and the Abacua); and the “Persons Living with AIDS” program for out-patient attention.  In this last case, they have also set up their own mutual assistance groups, to provide psychological support for each other. 

These volunteers have also published important literature:  one pamphlet in particular “Living with HIV:  A Manual for Persons Living with HIV/AIDS in Cuba”, which carries useful advice and information on clinical aspects of the disease, treatment protocols, psychological and social dilemmas, and the laws that protect people living with HIV/AIDS.

MR:  What about social prejudice against those with HIV/AIDS?

RO:  These are barriers that we are taking down, one by one.  We have the good fortune that in Cuba today, people don’t lose their jobs or their place in the community because they have been diagnosed with HIV.  Once HIV/AIDS patients no longer lived in the sanatorium, and were able to return to their homes, we faced some social taboos, especially in the interior of the country.  We have worked with focus groups in their communities, and with their families. Interestingly, we haven’t had cases of families rejecting members with HIV/AIDS:  rather, they have had a tendency to be overprotective.

 In some cases, we’ve been asked to offer seminars in workplaces where HIV/AIDS persons are working.  Once the first barriers come down, it’s much easier.  We’ve found that informing people about the infection and teaching them how to protect themselves and their partners is a big step against lingering prejudices.

MR:  And what about social and cultural prejudices against homosexuality, and especially against men having sex with men?

RO:  In general this is still a problem, but less so than a few years ago.  Today, there is more respect for a person’s sexual orientation than before, greater tendency to afford space to homosexuals in society.  But from a public health point of view, we are still very concerned, especially since 70% of our HIV/AIDS cases are among men who have sex with men.  And if these men are not in the open, but are still in the closet or marginalized, it is harder to find them and provide them with the information they need to protect themselves.  This year, we have a stronger program to reach such people, organized by volunteers with our center who are men living with HIV/AIDS.  They are reaching people who are homosexual, bisexual and transvestite.  We’re committed to prioritizing this program, and to conveying the respect that people of all sexual orientations deserve—respect that means offering them the means to protect their health.