More indigenous Guatemalans turn to sex work, stoking HIV fears

BY EZRA FIESER

http://www.miamiherald.com

Like other Kaqchikel Maya women in her village, Fabiola Sánchez rises at daybreak, feeds her children fresh tortillas and boards a bus for Guatemala City.
But while most are bound for sewing factories or jobs as nannies and housekeepers, Sánchez gets off at the central bus terminal and walks a few blocks to a nameless two-story brothel where she works as a prostitute.

The sex industry has long attracted the poor and marginalized, including some indigenous women working in small brothels on the outskirts of Guatemalan towns. But lately health workers have seen a marked increased in the number of Maya women traveling to Guatemala City to work in a notorious red light district known as La Terminal for its proximity to the bus terminal.

''They've come here more and more because they can earn four, five, even 10 times what they could make in other jobs,'' said Dr. Marco García, who runs a nearby clinic offering free HIV/AIDS tests and treatment.

The clinic is treating more indigenous women than ever, he said. In the waiting room, a handful of Maya women, small children in tow, waited for medical treatment on a recent morning. ``They realize the risks of contracting diseases, but prostitution pays.''

Sánchez, 26, turned to prostitution six months ago. ''There was no work in my town. I have three children and the cost of everything is so high now,'' she said.

In a country where more than half the population lives in poverty and a third earn $2 a day or less, Sánchez can make $30 on her busiest days, having sex with eight to 10 men.

The government, which permits but does not legally recognize prostitution, does not track the number of women working in the sex industry. But organizations working in the field estimate there are thousands.

''The demand in the sex industry is enormous in this country,'' said Maria Tallarico, who oversees the Joint United Nations Programme on HIV/AIDS in Guatemala. ``Many come from indigenous communities and many of them had been deported. They have no jobs, there is no social system to support them, so they go into prostitution.''

DANGEROUS `BRIDGE'

Health workers such as Tallarico fear the women will carry HIV/AIDS back to their villages, where government services are sparse.

''They act as a bridge for the disease and related diseases, bringing it back to the general population,'' Tallarico said. ``We don't yet have firm numbers, but hospitals are seeing more cases of tuberculosis and sexually transmitted infections, as well as more AIDS cases.''

Guatemala accounts for a small slice of the world's HIV/AIDS cases. As World AIDS Day is observed Monday, the United Nations counts 40 million people worldwide living with the disease. The U.N. estimates 65,000 Guatemalans are living with the disease, mostly prostitutes and gay and bisexual men.

But the disease is starting to spread. By 2015, the U.N. estimates 128,000 citizens will be infected, meaning the country will face an epidemic. In that case, Guatemala, which spends less of its gross domestic product on health than any other Central American country, would be forced to open new hospitals and buy more expensive anti-retroviral drugs.

SERVICES SUFFER

The increase is stretching thin the budgets of clinics that serve the poor. García's clinic, which is run by the Fundación Marco Antonio, can only accept 715 patients and its nearby 27-bed hospital is nearly always full.

''Our largest issue is always money. We are funded by the government and the Ministry of Health receives budget cuts regularly,'' said Ana Castillo, the foundation's Executive Director. ``We couldn't possibly expand our services.''

The Guatemalan government's 2007 HIV/AIDS monitoring report said 1,812 indigenous people had the disease.

In a small, mainly indigenous city in the steep mountains of Guatemala's Western Highlands, Delia Smith, a Catholic nun, opened a clinic to treat poor people suffering from HIV/AIDS. Only seven patients came at first. In recent years, demand has skyrocketed. The clinic sees 40 to 50 people a day. Most seek nutritional advice, but many are presenting HIV symptoms and in need of testing and counseling.

''We are overstretched in trying to meet the socio-economic demands of the very poor HIV-positive people in our area,'' Smith said. ``We don't have the financial resources to respond to all [their] immediate needs.''

Smith said the increase in deportations of Guatemalans back to their country is exacerbating the problem. The United States has deported more than 25,000 Guatemalans so far this year, according to Guatemalan migration authorities, putting the country on pace to receive a record 27,000 returnees.

''People who are HIV-positive who were getting treatment for free in the U.S. are returning to Guatemala and waiting in line,'' Smith said.

Dressed in a colorful hand-sewn skirt and blouse and sitting in front of the brothel on a narrow side street, Sánchez said she knew nothing about AIDS until a friend told her when she started working. Now she visits the nearby clinic to test for the disease every three months. And although she carries a handful of condoms in her skirt, she admitted she doesn't always use them. ''I try to use them all the time,'' she said. 'But some men don't like it and I don't want to tell them `no,' '' she said.

Johanna, another Kaqchikel woman who would not give her last name, laughed.

''If she won't have them,'' Johanna said, referring to men who won't wear condoms, ``I will.''