Spain's Aids Problem

Spain is a relatively healthy and productive country. There is a total population of 41,060,000 people. The life expectancy at birth is about 76 years for males and 83 years for females. The child mortality is .5% for males, and .4% for females. As you can see, Spain is a fairly healthy country. Their total health expenditure is $1,640 per capita, and this is 7.6% of the Gross Domestic Product (GDP). Spain's economy supports a GDP that, on a per capita basis is 80% that of the four leading Western European Countries. The actual GDP was $23,300 in 2004, with a real growth rate of 1.6% and a reported unemployment rate of approximately 10.4%.

In 1986, Spain passed the General Law of Public Health Care. This was a change in philosophy from insurance based health care to a system, which declared health care as a public service open to anyone. This allowed 98.9% of the population the right to receive health care free of charge, regardless of the amount of contribution.

According to the CIA's World Factbook, the adult prevalence rate of HIV/AIDS in 2001 was estimated at .7%. At that time, there were nearly 140,000 people living with HIV/AIDS, and 1,000 people died from the virus/syndrome in 2003. By June 30, 2003, 66,344 cases of AIDS had been notified, and 34,871 had died. Of the reported cases, 63% were injecting drug users. Additionally, 15% more were heterosexual and 14% bi/homosexual. According to the Epidemiological Fact Sheet from The Joint United Nations Programme on HIV/AIDS (UNAIDS), The United Nations Children's Fund (UNICEF), and World Health Organization (WHO), "Spain has the largest cumulative total of AIDS cases, and ... injection drug users amongst AIDS cases, of any other European country."

A report from Medical News Today states that "about 200 fewer people were diagnosed with AIDS in Spain in 2004 than were diagnosed in the country in 2003, a decline of 10.7%..." The article continues to reaffirm that this is the fifth consecutive decline in the number of new AIDS diagnoses. Furthermore, Medical News Today mentions that this is an indication of "...intensification of HIV/AIDS public awareness campaigns and more HIV testing in the country."

With the statistics of HIV/AIDS prevalence and its impact on Spain in mind, it is imperative that one shed light on the barriers that are hindering policy and prevention efforts. As stated in the article "AIDS threat growing throughout Europe" "AIDS is rapidly spreading in Eastern Europe and is on the rise again in Western Europe because integrated prevention and treatment programs have not been sustained or do not exist." Lack of knowledge, education, and adequate resources all contribute to the spread of this widespread epidemic. Carlos Ortega, a former heroin addict, states that "before no one knew about AIDS, no one worried about it. It wasn't something we talked about, and we didn't take any precautions" ("Needle exchange key to AIDS..."). Like countless other Spaniards, Carlos had never heard of AIDS until a doctor told him he had it.

In the past, barriers to prevention were not combated with adverse opinions and reluctance from the general public, but we unheard of. There was little known knowledge of the syndrome and efforts that were enforced were not available to individuals with the greatest risk. According to Kalman Mizsei, Assistant United Nations Development Programme (UNDP) Administrator and Regional Director for Europe and the Commonwealth of Independent States (CIS) "members of at-risk groups [have] often [been] subject to social exclusion, poverty, stigmatization, or incarceration factors which [have heightened] the spread of the disease" ("AIDS threat growing throughout Europe"). Education in schools was not something actively pursued to deliver HIV prevention information or efficient sexual health and contraception instruction.

Within the substantial issue of AIDS lies the past and present barrier of unsafe sex. The article, "AIDS threat growing throughout Europe", mentions that "there is...evidence that people are having sex at a much younger age without protection. [Also], the percentage of people reporting premarital sexual relations more than doubled between 1993 and 1999..." Unsafe premarital sex is alarmingly common among young people. This issue itself is a barrier as most adolescents and young adults need to be further educated on the importance of contraception and the consequences of unprotected sexual relations. Additionally, adolescents need more insight into sexual transmitted diseases and infection, but more importantly in the prevention of HIV/AIDS.

Beyond the dimensions of education and knowledge, one of the greatest barriers that have prevented the use of contraception and adequate HIV/AIDS prevention techniques has been the influence of the Roman Catholic Church in Spain. Traditional Roman Catholic teachings ban condoms because they are a form of contraception ("Spain Church cautious on condoms"). The reluctance of the church presents a barrier as most people want to hold true to their religious believes and dare to go against the wishes of the church, even if that means jeopardizing their health. "The Roman Catholic Church remains a powerful voice in Spain" ("Spain Church cautious on condoms"). The battle between the socialist government and the Catholic Church has been a longtime barrier and continues to damper the thought of combined global strategies in preventing the spread of such a catastrophic epidemic as AIDS.

Although, numerous barriers still exist as the pandemic continues to rise in Western Europe, efforts are being made to overcome past challenges in prevention. As more and more people are being diagnosed the government, relief agencies, and even the Catholic Church are fulfilling their obligation to attempt to sustain treatment efforts. With the support of other Western countries and the European Union efforts are steadily beginning to emerge.