Seventeen years ago, Episcopalian Reverend, Pascual Torres, was approached by a few courageous, HIV-positive members of his local community in Honduras. Uninformed about HIV/AIDS at the time, Rev. Torres sat down to talk through end-of-life issues with them. Little did he know, this was the start of Siempre Unidos, a coalition of medical providers, counselors, pastors, business leaders and community volunteers who work together to combat HIV/AIDS with comprehensive, compassionate care, including education and employment opportunities for those living with HIV.
Last week, Rev. Torres and Siempre Unidos colleagues, Dr. Denise Main and Yolany Montufar Osorio, visited Direct Relief headquarters. For several years now, Direct Relief has been providing Siempre Unidos with medicine and nutritional supplies for their three clinics in Honduras.
Siempre Unidos has been a unique program from the beginning, fighting not only the spread of the AIDS epidemic but also the social stigma that it carries in Honduras. Siempre Unidos works with both the Honduran government and Episcopalian church to provide non-discriminatory health care to people from all walks of life.
The work they do is especially important in Honduras, where one person out of every 50 is living with HIV – the highest rate of infection of any Spanish speaking country.
People with HIV are excluded from most aspects of society in Honduras because of misunderstandings about how the disease is contracted and spread. “Many people are rejected by their families, and some are even locked in the back room of their house,” said Rev. Torres. In fact, until 2007, Siempre Unidos members had to meet underneath a tree outside, as no one would allow HIV-infected people inside their homes.
Today, Siempre Unidos runs three clinics where people with HIV can receive medicinal and social support. Meals are provided for parents and children, and community volunteers provide education on safe sex, disease prevention, HIV testing, and proper health care for those with HIV/AIDS. The clinics are a safe space where people with HIV can feel welcome to come and socialize. “It’s a place where people can keep moving forward with their lives even though they are HIV-positive,” said Rev. Torres. HIV-negative patients are also welcome to receive treatment for other medical conditions at the clinics.
“In our country, there is a bigger disease than HIV, which is the discrimination,” said Ms. Montufar Osorio, who helps with education and counseling for those recently diagnosed. “To me, Siempre Unidos is like a new home and a new family,” she said.
Siempre Unidos has undertaken the unique challenge to destigmatize HIV/AIDS in Honduras, while also providing a safe space and medical treatment for those with the disease. Ms. Montufar Osorio also works with the night outreach program among commercial sex workers in Honduras, visiting streets, nightclubs and bars on a nightly basis. The goal of the night outreach program is to prevent STDs and HIV, and has seen success since its implementation.
When the program began, Siempre Unidos reported a 14 percent infection rate among sex workers in Honduras. Now, with about 500 commercial sex workers involved, only one among them is HIV-positive. “It’s a great achievement for our program,” said Ms. Montufar Osorio.
Dr. Denise Main became involved with Siempre Unidos in 2007 through her church in the U.S., and explained how the organization has made an incredible impact in treating HIV/AIDS. “In the beginning I would visit the group about every six months,” she said, “and each time I found that one-third of the members had died since my previous visit.” Since then, AIDS healthcare has improved through increased use of antiretrovirals, but living with HIV in Honduras is still very hard.
Today, Dr. Main works with both HIV-positive and HIV-negative patients, providing support and prevention tactics for those in poor and vulnerable neighborhoods. Other medical services are also provided in the clinics, such as STD testing, pregnancy tests, and treatment for diabetes, hepatitis and malaria. Overall, the clinics regularly treat around 500 patients with HIV (not including family members and children who also frequent the clinic) and 500 HIV-negative patients.
“I think it’s important to be committed to one place for a long time,” said Dr. Main. “It’s hard to keep fundraising for one project consistently, so we appreciate Direct Relief’s support.”