“I don’t want to die of COVID-19, but I’m starving, and I don’t know if I’ll be able to keep on taking my ARVs for HIV”

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Michela and Luis live in Tegucigalpa, Honduras. They are trying to survive on what Luis earns by selling bottled water and sweets amid the lockdown measures related to COVID-19 pandemic. “I’m living with HIV since I was born. I am 29 years old; I have a 9-year-old son and I live with my partner, who is also living with HIV. We feel we are at a standstill, sitting on our hands. I do not have a job; I take care of my son. We are trying to figure it out. I do not have enough food for everyday meals”, says Michela. Quite desperate, they turn to the Latin American and the Caribbean Movement of Positive Women (MLCM+) to seek help.

Marcela Alcina, from the MLCM+ in Buenos Aires, Argentina, receives more than 20 calls for help daily from people with realities like that of Michela and Luis since the start of the pandemic. Mostly related to the lack of medicines, food, and containment. Despite using all its social activism resources to respond to and assist the coming requests, the needs generated by the pandemic are extreme and far beyond her.

This is how the Americas Volunteer Strategy was born in the days of COVID-19. An initiative launched by Marcela and her colleagues from the MLCM+ with the support of the UNAIDS office for the Southern Cone, which to date is present in 17 countries in the region, with 850 volunteers, and more than 3,000 requests for help.

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What have you been eating lately?

“The Women Movement lets us know if there is a food package for us, but it’s not a sure thing. Usually, we decide not to have breakfast. We have lunch and a little snack. In Honduras, lockdown depends on the final number of your ID, so if your ID ends on 1 and 2, you’re allowed to go out on Mondays, if it ends on 3 and 4, you’re allowed to go out on Tuesdays, and so on. No one can go out on Saturdays and Sundays. You have only one day a week. It is also forbidden to go to work. My partner tries to sell bottled water on Wednesdays, when he can go out, and that way he manages to bring home some money, but it’s not enough. We are starving. He could earn from 300 to 400 lempiras a day (12 USD) depending on how many customers he gets” says Michela.

 

Have you received any messages regarding your antiretroviral medicines?

“No. No one has helped me, but I have enough medicines. I went to the hospital and they gave me 2 months’ worth of treatment. I will have to go on June the 1 st again, but I do not know if I will be able to. I cannot be left without my medicines, but no one tells us what to do. We are a vulnerable group, I am scared. We’ve lost our livelihood, it’s maddening”.

Another aid applicant is Yesenia, Colombian by birth, she lived for more than 24 years in Venezuela and due to the humanitarian crisis in that country, she had to return to Colombia 6 months ago to access her treatment for HIV.

She does not have a job and needs help to feed her family and to move to withdraw antiretroviral drugs. “Kids can’t put up with hunger the way we grown-ups do”, Yesenia says. Fortunately, she managed to connect with Yani Valencia of the Lila Mujeres Organization of the MLCM+ network, they provided her with a food package for her and her family, and they are going to look for someone who is able to go get her antiretroviral medicines. “I was about to pass out when they brought me these groceries, I was extremely happy”. They will keep working on weaving networks and connecting people’s goodwill around the region with one goal: to help each other.

Considering the current situation, we are living across the world, the WHO advised people living with HIV to have a large supply of antiretroviral medicines. Therefore, HIV care centers are asked to adopt the Multi Month Prescription and Multi Month Dispensing systems for 3 to 6 months and, particularly, for those who live with HIV and adhere to antiretroviral therapy.

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“I came back to Cali 6 months ago only to find myself living another crisis. My biggest concern is to get my antiretroviral medicines, but I don’t have access to health care in Colombia”, Yesenia says. “It’s been extremely tough for me and my partner since we’re both living with HIV. My children and my husband are unemployed. I am desperate. It is a very depressing and frustrating situation for us”, she states.

 

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What would you advise decision-makers to do? According to you, what is a specific solution to face this pandemic?

“If I were to talk to a politician, I would ask them to think more about poor and sick people, because we’re going through some very hard situations. They have not provided us with food.

The answer would be to act in the health care context. In Colombia, HIV still exists, HIV is not over, particularly when it comes to women. They established a curfew at night so people will not go on the streets, but some do out of need, because they have nothing left to eat. How can you stop someone from going out if they have nothing to eat?”.

How many people live in your home?

“There’s 8 of us: my 4 children, my husband, my 2 grandchildren and me. It’s a small house, it’s uncomfortable. One of my sons sleeps on a mattress on the floor, my daughter sleeps with both her kids in one room and I sleep with my 2 other kids and my husband. On sunny days, it feels like living inside an oven. The sewage system does not work properly either and that’s also one of our daily problems. I don’t want to die of COVID-19, but I’m starving, and I have no idea if I’ll be able to keep taking my ARVs for HIV”.

Needs of the communities

According to the last survey conducted by UNAIDS for Latin America and the Caribbean regarding the community needs of people living with HIV in the context of the COVID-19 pandemic, only 1 in 10 people (6-11%) reported to having a 3 month supply of ARVs. In addition to that, only 27% of the 1245 people who took the survey claimed they had enough protection equipment such as masks, gloves, and soap, compared to the 73% who did not.

Solutions from the communities: volunteer strategy

The Latin American and Caribbean Movement of Positive Women (MLCM +) connects with the community through an online form that has allowed them to receive more than 3,000 cases of real people who need support of all kinds.

“One of our colleagues in El Salvador had to use her neighbor’s Wi-Fi to be able to work with us, but she needs help too. She has no Internet connection at her place, nor food”, Marcela Alsina explains.

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That’s how, through their own network, they have coordinated a great volunteering force whose aim is to spread solidarity in this difficult situation the whole world and the region are experiencing, but keeping the focus on people living with HIV, a population that needs to be a part of the global and national responses to COVID-19, in compliance with the commitment undertaken by all the countries in the 2030 Agenda of the UN to “leave no one behind”.

“We have met people living with HIV who have no food at all and have been starving during lockdown; we have also met people who have no access to health care. A colleague of ours in Colombia borrowed a neighbor’s motorcycle to distribute medicines. We notice communities are overlooked quite often, but we must be a part of the answer. We couldn’t wait any longer, we had to do something”.

What are you doing specifically?

"We are giving food and cleaning products away, we are making masks that will later be distributed along with ARV medicines, we are teaching people some prevention methods, we are giving condoms away and helping people find shelter in domestic violence situations. For us, “Estrategia de voluntariado de las Américas” is part of an initiative that can go further than any other”, but more support is needed.

In Argentina and Paraguay, they work with UNAIDS, UN Women and UNFPA, all of which offer them technical and financial support in an interagency approach. In Brazil, they are helped by UNAIDS and UNESCO and they count on the UNAIDS regional team in Latin America and the Caribbean, but we need to get this strategy to more countries with local and national partners.

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“UNAIDS provides us with resources, specialists, and training webinars. UNESCO, on the other hand, also helps us financially. That way, we are putting together a mechanism that intends to support the government’s actions, not replace them. However, we need to ensure people living with HIV, those who are starving, transgender people, and working and stay-at-home mothers are considered. We have experience and we have partners, come, and support us”, Marcela described.

For his part, the UNAIDS Regional Director for Latin America and the Caribbean, César Núñez, said: “For UNAIDS, it is essential that concrete actions be taken that allow us to close the gaps and achieve the goals that we have set for ourselves as an organization, but also accompany States to achieve the goals they have set for themselves; such as the 2030 Agenda for Sustainable Development or the Political Declaration on HIV and AIDS. Now, we see how inequalities have become more evident with this COVID-19 pandemic.

For this reason, supporting this initiative is an action in that sense; inequality, and especially gender inequality, is exacerbated in times of crisis. Women living with HIV must be in the responses of the countries, and mechanisms must be used to avoid leaving them behind”.

UNAIDS recognizes the fundamental role that communities have played and continue to play in the AIDS response at local, national, and international levels. Communities contribute to the AIDS response in very different ways. Their leadership and the defense they carry out help to ensure that the response remains relevant and well-founded, that people remain at the center and that no one is left behind.

 

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