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Cuba Health News

The True Stories of HIV/AIDS in Cuba

By Conner Gorry

December 2, 2006 -- Since the first case of Cuban HIV was diagnosed in 1985, Dr Jorge Pérez has kept a journal. “We’ve lost Juanita – a special patient. Her passing brings me great sadness,” reads an entry from 1997. Another, from 1990 declares: “This patient was the biggest liar I’ve ever met.” Such personal and frank observations from a pioneer of one of the world’s most polemic epidemiological programs make SIDA: Confesiones a un Médico (AIDS: Confessions to a Doctor), a must read.   

Dr Pérez – who is to Cuba’s AIDS program what Mother Marianne Cope was to the hospice movement – weaves 20 years of journal entries, conversations with patients, their personal correspondence, and clinical observations into a poignant and readable public health history. The 190-page monograph, skillfully edited by Jacqueline Teillagorry, marks the publishing debut of Havana’s National Center for Prevention of STI’s and HIV/AIDS.

“I had been thinking about writing this book for a long time, taking notes and keeping a journal,” Dr Perez told Cuba Health Reports. “I actually started writing it in mid-2005 – stealing time between 11 at night and 2 in the morning - after a friend told me, ‘you have to start writing down your experiences. They shouldn’t be lost.’” 

And what experiences.  From 1989 to 2000 as head of Cuba´s first AIDS sanitorium (compulsory for serpopositive patients before 1993, when Cuba switched to an ambulatory care policy) and as current Director of the Hospital at the Pedro Kourí Institute of Tropical Medicine, Pérez has lived the emotionally-charged histories alongside his patients. The result is an authoritative accounting of their lives, as told to him, providing readers both an historical and contemporary account of AIDS in Cuba, replete with data through December, 2005 (see table).

By the Numbers: Cuba HIV/AIDS Picture through December 2005

*This includes children who have lost their mother or both parents.
Source: Confesiones a un Médico

From the young girl who loses her virginity and becomes infected, to the seropositive patients infected through rape, blood transfusions, deliberately or through sheer carelessness, these moving stories narrate the medical, ethical, and social tale of the disease on the island, mistakes and all.

Writing the book was “very emotional,” says Pérez. “It brought back many difficult memories. I’ve tried to be as objective as possible.” To help get the stories right, some of the patients who inspire Pérez’s daily struggle against the disease and appear in the pages of Confesiones a un Médico, provided feedback and clarifications (and complaints when they didn't like the pseudonyms chosen for them).     

Dr Jorge Pérez signs copy of his new book at launch party

Despite strides the national program has made – HIV prevalence in Cuba is 0.2%, lower than the 0.6% average for Latin America and much lower than the Caribbean average of 1.6%[1] – Dr Pérez sees room for improvement, especially in prevention among men who have sex with men, and prostitutes of both sexes.  Furthermore, to achieve still lower infection rates, he recommends decentralization of medical services dealing with the disease, so HIV prevention strategies reach every corner, with each individual in society playing a role.

The Cuban edition of Confesiones a un Médico, with a print run of 4,000 copies, was financed in part by the United Nations Development Programme (UNDP) and was generating a buzz even before its official release on November 10th. Indeed, talks are already underway with various international collaborators to publish the English and Portuguese-language editions. Making Confesiones a un Médico available in translation is key to realizing Dr Pérez’s goal: to ease suffering and make discrimination against people living with HIV/AIDS a thing of the past by changing attitudes, one human being at a time.  

You can read an English translation of Chapter 7 “The First Children” from Jorge Pérez’s new book here. (http://www.medicc.org/publications/medicc_review/0406/mr-features.html)

To learn about Cuba’s national program, see “Approaches to the Management of HIV/AIDS in Cuba: A Case Study,” published as part of the World Health Organization’s Perspective and Practice in Antiretroviral Treatment (2004), available here (http://www.who.int/hiv/pub/prev_care/cuba/en/)

Notes & References

1. UNAIDS/WHO. AIDS Epidemic Update: December 2005.

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