March 26, 2006
The Little Red Riding Hood syndrome (I)
Mileyda Menéndez, Julio Martínez and Mayte María Jiménez
A CubaNews translation. Edited by Walter Lippmann.
Unlike other pandemics, HIV/AIDS affects those who welcome it of their own free will. Many diagnosed as having the disease in the last few years were fully aware of how to avoid infection, but never believed they would have “such bad luck”.
Little Red Riding Hood is carelessly waking. Her mama had warned her time and again of the Big Bad Wolf, but she has no intention to give up the pleasure of going through the woods. After all, her “destination” is grandma’s home.
Is there a safer way to get there? Yeah, fine, but not as nice and exciting as this one, nor does it have the undeniable attraction of a forbidden thing that triggers a rush of adrenaline through her impulsive adolescent body.
Besides, with so many square kilometers of forest, can the wolf be expected to be around here now? It’s quite foolish of her mom to think she wouldn’t recognize that horrible beast long before it comes near, and then whoa!, I will jump aside with great skill to stay clear of its lethal bite and leave it right there, gaping in disbelief…
The traditional sweeping dialogue between Little Red Riding Hood and the wolf has been plagiarized in hundreds of jokes, plays or cartoons in which without exception the girl escapes from her (pursuer?) by a stroke of luck.
Perhaps that is why the attempt to convey to new generations the moral of this story –none other than avoiding unnecessary risks and distrusting appearances– is sadly marred by the untimely predator, come “out of nowhere” to undo a mess that anyone with half a brain knows is irreversible.
In real life, a new virus-wolf, cunning and voracious, cajoles its victims with pleasure while hiding its ugly head under the guise of close or desirable persons who are supposed to be as innocent as a granny... Then, who can save the unsuspecting from HIV/AIDS?
NOT ENOUGH INTERNALIZATION
Over 95% of those of us living on this Island are aware that unsafe sex practices are the main way of infection for Cubans, according to several studies conducted in the last five years.
Also known is that a safe sexual activity with the use of a condom and having only one, faithful partner, as well as voluntary abstinence, are the best way to keep away from infection. However, such knowledge is yet to be sufficiently internalized, as reflected in the behavior of the sexually active, not always responsible population (15 to 49 years old).
In a recent interview by JR, Doctor María Isela Lantero, Head of the National STD-HIV-AIDS Program implemented by the Ministry of Public Health, said that even if the HIV/AIDS global rate of prevalence falls short of 0,1%, more than half of the 6,975 cases detected between 1986 (when the program started) and last December got infected after 1999.
Prevalence between 15 and 24 years old is 0,05%, a population sector that has kept growing without rocketing in the last five years. Such “plateau” in the curve tells us that so many campaigns did not go unheeded: they just have to be redirected.
But knowledge is not a vaccine. Reality proves that HIV/AIDS-related risk perception is still very low, mainly among teenagers, most of whom see it as “other people’s business” and are in no fear of their lives.
Those taking their first steps in sexual activity give priority to pleasure over health. Males in particular believe to be “safe” from contagion, since they say to have “a good eye” for healthy sex partners.
Males are more exposed, but females are more vulnerable: machismo standards make us
look down our nose at a woman who suggest using a condom during foreplay, mainly in the case of steady couples, lest she be taken as transgressive or “frivolous”, and therefore many prefer to cross their fingers and commend themselves to chance rather than finishing a relationship.
BOLDNESS OR NAIVETE?
Of added significance, beyond the number of people who dare that experts across the country have estimated, were the answers given during this research, because they prove the existence of gaps, both informative and instructive, as to how to relate with other people.
Random high school and technical students between 13 and 16 years of age in the city of Cienfuegos were asked whether they considered themselves to be in danger of getting HIV/AIDS:
Paula: “I don’t think so, I don’t even have a boyfriend, and I’m not ashamed to say I’m still a virgin”.
Alina: “Not likely… I’ve only had sex with my boyfriend, who is 16, my elder by two years, but he’s had sex with no one else since we met three years ago”.
Juan Carlos: “There’s only been two women in my life; one was a señorita, as old people say, and the other is my current girlfriend, who wasn’t a virgin but has had only two other partners years ago”.
Pedro: “Look, journalist, I enjoy my youth, and I’ll go for a score with any girl who looks like a go. I take precautions, though. My dad taught me, for I’m not embarrassed to sharing these things with him. I always have a condom in my pocket, just in case anything comes up”.
The two girls and the first boy couldn’t or wouldn’t answer how someone can be said to be carrying the virus. The fourth one said: “I expect that person, if he/she knows it, would say so”.
As to what it means to have a steady, protected relationship, the girls said: “To stay with someone and be faithful”, and “not to change partners too often… and if you do, everytime you have sex with the new one make him wear a condom until you make sure he’s not infected”.
Juan Carlos remarks that “if you’re not steady, for the time being or fow a while, you have to be more careful, not only with vaginal but also with anal penetration, for as far as I know you can get AIDS either way, not to mention other diseases like gonorrhea, syphilis, herpes or hepatitis”.
Pedro thinks oral sex is even more dangerous “because there’s no way you can protect yourself… When your girl swallows your infected semen it goes to her blood and she gets it. And I guess the other way around is risky too, but I’m not so sure”.
AN ATHLETIC CONDOM
We requested professor Magalys Carvajal and some of her colleagues at the Physical Culture School of Manzanillo, in Granma province, to make a survey among students and athletes between 18 and 26.
In general, all 84 answers linked HIV to irresponsible sexual behavior or exchanging contaminated blood, and labeled condoms and steady partners as allied in protecting health.
A young woman mentioned the need to have regular blood tests, whereas another urged to watch all AIDS-related TV programs to be up to date, and one of her classmates stated that “there are ways of enjoying yourself without going all the way to penetration”.
Among the answers given by males outstands that of a young man who defined HIV as a way of “disgracing and killing another person”. Another stands for “a faithful relationship and honest conversations” as preventive measures, and a third one underscored that “knowing how to think helps avoid infection”.
Nonetheless, we were in for a few surprises too, like a 19-year-old male who thinks that birth-control pills protect us against HIV; a 20-year-old student who advises to disinfect any object used by AIDS sufferers; and a third young man, 26, who defines the virus as a disease that can “come down” on anyone. There are a few who even take it for granted that “some people transmit it and others don’t, since they’re just carriers”.
Catchy phrases like “a safe hit”, “no to promiscuity”, “live your life”, “abstinence”, “foreplay without intercourse”, and “if it is with Vive, so much the better” bear witness to the success of AIDS campaigns in Cuba.
Still, more personal commitment is needed. In fact, only six male respondents and two females answered in first person: “I always wear it”, “I could” or “We could” get infected, protect ourselves, take precautions… The rest referred to it as something rather alien, in some cases as a “homosexual” or “African” thing.
Several JR readers join our research by e-mail. Although living in different provinces, they sent messages having a common factor: our youths have a certain image of HIV, but they don’t lose any sleep over it. Not yet.
That is why our mediators heard opinions by boys and girls who admitted to have unprotected sex with someone they just met simply because “they were carried away by impulse”, though they would later look back on it with a sense of unease. C.E., a 25-year-old university student in Holguín province, wrote the following: “A girl from a boarding high-school girl told me she’s very frightened of the disease, given the countless horrible things people say about it, so she demands her partner to wear a condom.
“However, she also says to find it uncomfortable because the magic of caressing and genital contact is lost in the process, thus the idea of not using condoms has crossed her mind, knowing full well that she can also get other diseases.
“A couple told me they use a condom the first time, but not if they make love again in the same day. They acknowledge it’s senseless, and a risky habit at that.
“Another flabbergasting opinion which I never thought anyone could even entertain”, remarks C.E. about a 24-year-old man who dismissed any worries about AIDS because, should he ever get it, “there are special healthcare centers in Cuba with the proper conditions to take care of it. No sweat! One can even get married there”, he said.
This young man finishes his message saying, “I believe STDs are just around the corner, lying in wait for a misstep. Unfortunately, the decision to wear a condom, maybe the best protection so far, is still out of many youths’ minds. I found it very difficult to adapt myself to it, but I overcome that barrier as soon as I realized how different the outcome is when you make it a part of having sex”.
Junior and senior high-school students answered to our collaborators that “you can’t give much thought to protecting yourself when you have a lasting relationship”.
They eventually stop using condoms and only worry about not having to deal with unplanned pregnancy, even if they’re aware that they had partners in the past who might have been infected or think that being faithful “is not highly regarded nowadays”.
TO EACH HIS/HER OWN
Cuba is not the only country where teenagers behave erratically when it comes to sex. Experts around the world and particularly in Spanish America have joined forces as a function of launching more efficient campaigns and further stressing on couple-oriented education so that the new generations can finally realize that they are responsible for their bodies and must learn to take care of them.
An interesting viewpoint was provided by Colombian psychologist Gloria Pedraza, who asserts the notion of risk develops as early as when you are still in your mother’s uterus: every step forward in human life entails new, circumstantial hazards and spreading your living space or “area of protection” to other family members as well as to your home, school, neighborhood, nation…
This is how emotional, highly subjective growths are established, to the extreme that what is known, what satisfies “my” parameters, is usually deemed undangerous. As she describes it, “I represent no risk to myself, or my boyfriend, my friend, my friend’s cousing... so I take no precautions”.
Dr. Susana Guijarro, president of the Asociación Latinoamericana de Atención a la Adolescencia (ALAPE) is in favor of setting limits at those ages, albeit accepting that sexual relations go hand in hand with their psychosocial development, and it is therefore important that they not only know what they are exposed to but also how to say no, keep their composure and cast an adult eye over an event which can compromise their future.
Family is a protective factor, something even its youngest members acknowledge taking into account that home is their preferred source of information and necessary model.
“Before you teach them to ‘take care’ you have to foster decision-taking abilities, self-esteem improvement techniques and the proper use of tools to weigh opportunities and risks”, emphasizes Dr. Rosaida Ochoa, director of the National Center for STD/HIV/AIDS.
Likewise, Spanish sexologist Félix López warns that youths and teenagers are not always vulnerable to the same extent: they’re not even alike, nor are they what they were months before or will be months later, a fact to bear in mind when the time comes to design programs.
In this connection, Dr. Natividad Guerrero, director of Centro de Estudios sobre la Juventud (CESJ) appraises sexual education for adolescents as a scientific challenge that involves both proposing a conduct and teaching about sex and reproduction rights. And the sooner the better, since concepts like couple steadiness, love, faithfulness and pleasure are quite relative at an early age, as we saw while covering this report.
According to studies conducted in her center, a high percentage of teenagers feel unqualified to face sexual relations and hence more vulnerable to STDs, despite this being the sex-related subject they know best, followed by the risk of undesired pregnancy.
They have also stumbled upon wrong views about HIV in their surveys, to wit: any contraceptive can prevent it, even if not a barrier method; and, those who have the virus must carry an identification so that we can stop the epidemic.
In like manner, Argentinean professor Lucía Weiner turns the spotlight on the fact that both teenagers and youths have real information about the virus but not on the kind of life the infected lead, a knowledge that might make them think things over and become more reliable from their sexual behavior standpoint.
These inquiries revealed that most get their first notions about sexual issues through communication products foreign to their sociocultural environment (like Saturday night movies, in the case of Cuba) and thus ineffective in prevention or to promote healthy lifestyles within the context of each country, city or age bracket.
One way or another, every specialist refers to the so-called “magic thinking” in adolescence, that is: the conviction that nothing will happen to them and that living “here and now” is what counts, for death and disease are adulthood stuff.
The degree of subjective immunity they believe to enjoy is so high that sometimes they have even learned to give the “right” answers to get any grownup off their case while in practice they adopt perilous, devil-may-care attitudes.
They live in the firm belief that there’s no reason to be “afraid of the big bad wolf”, since if they ever find themselves in a tight spot a hunter-vaccine will eventually turn up that may avert any danger facing them as many times as necessary.
The Little Red Riding Hood syndrome (II)
Yahily Hernández, Zenia Regalado, Mileyda Menéndez, María Bárbara Hernández, Hugo García and Cinthia Oviedo
Sometimes it’s already too late by the time the consequences of a hardly responsible conduct at an early age come to the surface. Low self-esteem, lack of knowledge and a shallow commitment to one’s own life could lead straight to HIV, sexual preference notwithstanding.
Her faltering words, choked by the pain coming from deep within, make us focus our attention on the eyes of this fifteen-year-old girl from Camagüey province as she looks at her little boy.
The minutes become centuries until in a gesture of resignation she reveals the reason of so much uncertainty. She reaches out, takes a blue inflatable doll lying by the sleeping child, and whispers in a very low voice so as not to wake him up:
“They say dolphins watch over children and protect them when they are in danger, as if they were theirs… that’s why he’s got his own. Perhaps I won’t be able to be by his side tomorrow. If it were up to me, I’d have my baby live many, many years more than I. That’s the only way for him to be happy.
Who can tell me for sure that I’ll live to take care of him? I spend hours and hours on end watching over his sleep, trying to imagine his future, asking life to give him the chance I didn’t have and let him live in peace, without this fear that kills you from inside”.
“Why don’t you live in peace?”
“Maybe some other HIV sufferers can, but not me. Merely thinking that he might go through the same things I have… all the scorn and mistreatment, and this fear of death that never ends… Who can live peacefully? Can’t you imagine how much my boy would suffer?
Then I compare: I have my mother, my father, my sister, my family who love me and look after me... but what about him? His father hasn’t even acknowledged him, he wants to have nothing to do with his son. And I, his mother, the one who could protect him, don’t know what fate has in store for me.
I’ve suffered very much, and still suffer for what could happen. It’s the only thing I have in my mind: he’s being tested. If it turns out that he’s ill… how will our lives be?”.
ONE YEAR BEFORE
Caridad was fourteen and learning tae kwon do in EIDE when she met her first boyfriend and started to have sexual relations.
“Things didn’t work out and we split. Some time after that I had sex with another boy I met in a party. I still don’t know who he is, nor do I remember what happened between us. Later on I met my child’s father-to-be”.
“And when you were diagnosed as having the disease …"
“It seemed like a dream, a mistake. I still don’t understand why it had to be me. The thought never crossed my mind that I could get HIV-infected, let alone giving birth at 14 with possibilities of transmitting my disease to him.
I always thought that thing on TV only happened in other countries and not in Cuba. I would hear things about AIDS, but it was so alien to me… it was about people who had nothing to do with me. Now and then I remember how unconcerned my girl friends and I were about those programs, which most times we didn’t even watch”.
“Why did you decide to see a doctor?”
“I never took any precautions and ended up pregnant. I was in seventh grade, and didn’t know, didn’t realize, what was going on. When my belly started to swell I was afraid of losing my school, of being backbitten… until I told mom and we went to the hospital, but it was already too late, I was five months pregnant and couldn’t have an abortion”.
SCORN, MISTREATMENT AND LONELINESS
“When they told me I was a seropositive they sent me to the Sanitarium to keep me from doing a stupid thing. I stayed there until the ninth month.
Life seemed to be returning to normal, but just as I was beginning to adapt to the new situation reality came around and I was crushed by this thing that is still tearing me apart. A new school year began and I went back to my classroom, but then I decided to drop out for good”.
“What made you take that decision?”
“Whatever I tell you is not enough… there was so much scorn and pain… as if you were living in another planet.
“Never in my face… My classmates got on more or less well with me and gradually got used to it, and my teachers helped me. But those parents…! They did their utmost to try and keep me out of school.
They even wrote several times to the municipal councils of Health and of Hygiene and Epidemiology. Many of them signed letters demanding my dismissal from EIDE, others hinted at it… But the school principals stood their ground and called to a number of meetings to explain every detail of this illness.
What marked me the most were my mother’s never-ending tears. Did she cry! So I decided to leave over my professors’ objection. I felt I was no longer the same. You could cut some people’s phony attitude with a knife. And a lot of water has passed under the bridge since then!
I guess a person gets used to anything, even scorn... By now I take notice of nothing. And the things they’ve done to me! I was walking down the street once and saw a bunch of kids spinning tops. When I tried to go on my way they wouldn’t let me… and shouted so many things at me that passers-by stopped to watch. Nobody did a thing… and right then and there I realized that no matter where I could go I would have to bear humiliation.
My mother visited those children’s school and talked to the principal… which helps but solves nothing, because unpleasant situations you’re your way when you least expect it”.
BEYOND ANY PAST EXPERIENCE
“If I could revisit my past I would be a much more cautious girl: I would do nothing without protection. I guess I’d change about everything… except my son!
I love him more than I do myself. I’d have him again, only as a healthier woman, and with more love. Not from me, but from his father, who he hasn’t known since he was born 11 months ago.
For instance, I’d like to open my eyes and see that it was all a bad dream… If those children humiliated me, what will everything be like for my baby? Will he have friends like the others? Will he be accepted with a mother like me?
There is so much in my mind… If it were up to me, I’d gladly sacrifice my life in return for keep this disease away from him”.
“He has a checkup every three months, and so far so good. We have to be patient, for it’s still too soon, but there’s still hope, and I pray endlessly…”
It’s too much for her. Tear roll down her face. Her son starts crying in the bedroom and she comes back to the disturbing realities she has shared for almost one hour with JR. She caresses him. She kisses him. She speaks to him about dreams of the future.
One, for starters –she points at a beautiful photograph–, was already fulfilled: her 15 summers didn’t go unnoticed.
Others: studying comes first, though something as ordinary as enrolling Camagüey province’s Vocational Preuniversity School “Máximo Gómez Báez” could make her story start all over again.
How will she be received in that or any other school? She still has no answer to this and many other questions she’s been forced to cope with along her very young, if shattered, life.
However, she doesn’t give up, regardless of her fear to undergo once again so many bitter moments. And as she struggles with so much uncertainty, her dreams remain unchanged.
“HIV? AIDS!!! Me??? It can’t be... it’s impossible, doctor¡”. Alain still remembers his cries and once again wishes the earth to open and swallow him up.
“I just can’t believe it!”, he said as a tear rolled down on his face. As if from a faraway place he heard someone asking him who he had had sex with.
“There are so many… I don’t know at this very instant”, he answered then in a voice choked with grief, and made ready to tell his story, the same one he now recounts to this newspaper in his eagerness to help other teenagers just like him.
It all started when I went to a party where I joined a group of friends from school who were talking about how many times they had got laid. My turn came and I said that only once and with a condom, and they all started to laugh, teasing me until I got pissed off and left. They called me a fool, a coward… arguing that condoms reduce pleasure and create mistrust.
From that day, and under the influence of those comments, I decided to ‘score’ with any girl I would run into: pretty or ugly, thin or fat, white or black… I didn’t mind as long as I could prove my manhood to my friends.
I had binges with older women –who already had children– and even a couple of times with a guy who let me play games in his computer…
Hey, listen, I’m not gay! I like women, but he told me he would teach me a lot about sex to drive a woman crazy and wipe the floor with all my friends”.
Alain crumples a tip of his shirt and looks out the window, as if trying to find in Havana’s landscape a way out of his embarrassment.
“If I had known then what I know now… Believe it or not, I met people at the Sanitarium who knew a great deal about this topic, but went overconfident and there you have…
One of them who is now my friend says his mistake was not that he believed other people: his worst blunder was that he believed in himself and thought of himself as a cool, easy-going man who had great luck at picking up ‘chicks’, and what he picked up instead was this disgrace that takes neither age nor gender into account and can’t be put down like a cigarette when you finally want to take life seriously”.
A LIGHT IN THE OFFING
“My name’s Joel. I’ve been a health promoter for four years, since I got HIV. My family, mainly on my mother’s side, has just started to accept me. They bear with me, albeit out of pity because I’m infected.
I’m studying and eager to keep studying. Many, even within my own family, used to tell me that it was pointless because I was already ill... but I was adamant, so I enrolled for the integrated upgrading course for young people.
They helped me very much at school, where I studied for four years. Now I want to move on to the university.
I’ve got neighbors who always see to it that I take my medicines in due course, that I eat well, and so forth... that’s another reason why I’m a health promotor and do my job in communities around Pinar del Río province”.
“Better understanding from my family, practice my profession of choice, and more tolerance of homosexuals by other people”.
“A message to the young…”
“Not only to the young, but to people of all ages, for I got the virus from a 47-year-old person who knew he had it but had sex with me nonetheless.
For seven years I had had a steady partner. I cheated on him, and see what happened… didn’t wear a condom and got infected. So I’d advice everyone to read, learn and think of themselves before having a sexual relation”.
“Half a year after I found out I was ill I had a diarrhea disorder for some months. Now I’m taking several anti-retroviral drugs that have strengthen my defenses…
“Anything you would like to change about your life?”
“Had I been faithful, I wouldn’t be ill now. Casual sex is a mistake. Further, I reckon homosexuality shouldn’t exist. I wish it were like when Adam and Eve, all people are heterosexual: a man for a woman… but that’s out of anybody’s power.
Who knows what I could have studied! Back when I was in sixth grade I was asked to become a ballet dancer but my mother didn’t let me. Then in ninth grade they wanted me to practice fencing in a sports school and she said no again. It seems that, after noticing my sexual leanings, she was afraid of having me far from home, and that was worst.
She always tried to control me more than she did my sister. She likes me to be at home around the clock. If she only knew how much I’ve suffered because of that!”.
“How do you feel in your workplace?”
“I work at the Center for STD/HIV/AIDS Prevention. They’re all wonderful there and fight for the same purpose: stop the epidemic. Working makes me feel fine, clear-headed, useful...
I’m not the
let’s-eat-and-sleep-because-we-die-tomorrow kind of person. That’s not the
way I look at things: I’m not a vegetable, therefore I study and work. Thus
I have no time to think of death”.