Source: theguardian.com<\/p>\n
on a hill overlooking a middle-class neighbourhood and a hospital lies one of S\u00e3o Paulo\u2019s slums \u2013 home to about 300 families trying to eke out a living in the largest city in Brazil. Here in Boi Malhado, ramshackle dwellings built with planks of wood and corrugated iron are perched precariously on the hillside. Only recently, one house belonging to a mother and her newborn baby collapsed. Both survived but the remains are there for everyone to see.<\/p>\n
Children run up and down narrow passageways between laundry lines and live electric wires; sewers are a hole in the ground covered by a piece of wood; and water access is sporadic \u2013 it\u2019s common for the community to go without for days. \u201cOur government is very unfair,\u201d says resident Mariangela Ferreira, 35. \u201cWe pay our taxes and we don\u2019t even have the basics.\u201d<\/p>\n
Inhabitants face all manner of health problems, including HIV. It is this that has brought Sandra Santos, a healthcare professional who specialises in educating young people about the virus, here on a Saturday afternoon. Santos, who works at Emilio Ribas hospital is convinced that it\u2019s areas like this where she must work.<\/p>\n
But it\u2019s challenging. The poverty is breathtaking and Santos had to go through an intermediary to ask the drug dealers that rule this area to allow her into the slum. \u201cHealthcare professionals won\u2019t enter because they\u2019re too scared,\u201d she says. \u201cBut these are the people who we can\u2019t reach and who need our help.\u201d<\/p>\n
In the past hour, she has spoken to a 20-year-old mother who is living with a diagnosis of HIV. The new mother is taking antiretroviral drugs \u2013 she started when she found out she was pregnant \u2013 but Santos fears for the future. \u201cIf [health services] don\u2019t give her the support she needs, she will lose motivation and not take her medication.\u201d<\/p>\n
The number of young people with HIV in Brazil is on the rise.\u00a0Figures from 2019\u00a0show that from 2007 to June 2019, 300,496 cases of HIV were reported in Brazil. The majority (52.7%) were found among those aged 20-34. While rates among the white population are falling,\u00a0more black people are becoming infected. In S\u00e3o Paulo, young men account for the most accentuated spread of the epidemic. In the 10 years up until 2018, male 15- to 19-year-olds, 20- to 24-year-olds and 25- to 29-year-olds showed an increase in detection of 3.8 times, 2.9 and 2.3 times respectively.<\/p>\n
Santos\u2019s work has never been more important. Traditionally her role has been to welcome young people who contracted HIV from their mothers to the hospital, and work with other healthcare professionals to educate them around the importance of taking their medication, as well as helping them to deal with prejudice and stigma in society.<\/p>\n
Now she is focusing on prevention. She works with a team of young people with the virus to give lectures in schools and youth centres about what living with HIV is like, and how to avoid getting it in the first place.<\/p>\n
Renata Ferreira, 21, is a patient at Emilio Ribas and recently helped to set up an\u00a0organisation\u00a0that supports other young people with HIV. She also goes out with Santos and others to talk about her life with the virus.<\/p>\n
She was the only one of three siblings to contract HIV from her mother and now lives in Parais\u00f3polis, one of the largest favelas in Brazil, with her adoptive parents. She takes antiretrovirals and is undetectable \u2013 she cannot pass on HIV through sex and can have children without giving them the virus. \u201cNo one knows about HIV around here. We know it exists but that\u2019s it,\u201d says Ferreira. \u201cWe are taught very little about sex and prevention. Even doctors don\u2019t know much.\u201d At her local health centre, she has found herself explaining aspects of living with HIV to doctors.<\/p>\n
Life hasn\u2019t always been easy for Ferreira. \u201cUntil the age of 14 I thought I was going to die,\u201d she says. \u201cI didn\u2019t have other people with HIV in my life.\u201d There were times when she gave up taking her medication and struggled with stigma at school. Along with Santos and her friend and colleague Thiago Martins, who also lives with HIV, Ferreira has seen lots of people die. Santos remembers one year when 17 people she was working with died. \u201cWe\u2019d go from a funeral to a birthday party. It was very hard,\u201d she says.<\/p>\n
Back in Boi Malhado, Maria dos Anjos, a community leader, sits at a table with Santos talking about ways they can work together. \u201cIt\u2019s so important to talk about HIV. And first we must talk about prevention,\u201d says Anjos. \u201cI know 11- and 12-year-old girls who have to prostitute themselves to survive. We have a problem with sexually transmitted infections and pregnancy because children don\u2019t receive any sex education.\u201d<\/p>\n
The future may be fraught with challenges and Santos and her colleagues have to work in a difficult political climate: the president of Brazil, Jair Bolsonaro, recently labelled\u00a0people with HIV \u201can expense for everyone\u201d. But today has been productive and, at least on the ground, there is hope and appetite for change.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":5053,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[273,52],"class_list":["post-5052","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aids-hiv","tag-health","tag-hiv"],"yoast_head":"\n