MEXICO CITY — MEXICO CITY -- Fernando Rodriguez Hernandez almost died at home two weeks ago at the age of 31.
He has been sick for several months, suffering from constant vomiting and diarrhea. His cheeks are sunken, and there is no visible muscle between his skin and bones. When his body first began to deteriorate, Mr. Rodriguez sought doctors' help.
But hospitals turned him away.
"They all told me, 'No,' " he said, frowning. "They would not accept me at any hospital, so I went home and tried to take care of myself."
Mr. Rodriguez has AIDS, a disease, he says, Mexico would rather ignore than fight. Ignorance about the disease is widespread -- strong Roman Catholic traditions make sex a forbidden topic of discussion in homes, schools and churches. And there is almost no help for AIDS victims, leaving thousands of people like Mr. Rodriguez to die painfully at home or on the streets.
"It's absurd," says Alfredo Hernandez, director of one of three AIDS hospices in Mexico City run with private donations. Mexico has an agency that deals with AIDS, known as CONASIDA (SIDA being the Spanish acronym for the disease).
But Mr. Hernandez complains, CONASIDA "doesn't have a hospice. CONASIDA doesn't have an effective education campaign. They do almost nothing to stop the disease from spreading."
AIDS was first reported in Mexico 10 years ago. Since then, according to CONASIDA, more than 25,000 people have come down with the disease and as many as 250,000 people are believed to be infected with the human immunodeficiency virus, which causes AIDS.
Still, most hospitals have never treated AIDS patients, so nervous nurses and doctors often offer them over-the-counter pain-killers and send them on their way. Families still throw sick loved ones out on the street, afraid that they can get AIDS by breathing the same air. And all too many people fail to practice safe sex, thinking they are safe from AIDS because they are not gay.
The disease is spreading most rapidly among women. In 1985, one out of every 24 AIDS victims was a woman. That number has risen to one out of six.
Close to half of the women are infected through sexual contact with their boyfriends or husbands, a trend that doctors and psychologists attribute to intense fear gay men have of admitting their sexual orientation. In Mexico, where homosexuals rural towns have been killed because of their lifestyle, gay men will often lead double lives.
"A man will have a wife and child, but they also have homosexual relations with men," says Dr. Patricia Uribe, who directs the government's AIDS outreach programs. "They deny that they are gay, so they don't see themselves at risk for AIDS, and they infect their wives."
In the last few months, Mr. Hernandez said, about 120 families with AIDS, or who are HIV positive, have visited Ser Humano, a center that provides confidential testing and psychological services to AIDS patients. Its name means "human being."
But government efforts to combat the spread of AIDS are shallow. While it is estimated that the number of AIDS victims will double over the next three years, public expenditures will likely fall, officials at CONASIDA acknowledge.
Last year, the Mexican government spent a low $2.5 million for AIDS education campaigns and to distribute 5 million condoms, mostly to nongovernmental AIDS groups. Condoms are not distributed in schools.
"That's asking for trouble," says Dr. Javier Baez Villasenor, a director at CONASIDA. "The parents will get torches and axes and come after you, saying that you are trying to pervert their children."
With its coffers virtually bare, CONASIDA has not been able to afford slick media campaigns, and those that it has initiated are sorely criticized as ineffective. AIDS activists say that, instead of urging safe sex, the campaigns often stress abstinence and marital fidelity, morals that are increasingly unrealistic in modern Mexican society.
"The message of the government has not been very clear because they do not want to have problems with the conservative sectors of the country, especially the Catholic Church," said Francisco Javier Lagunes, of Mexicans Against AIDS. "They do not promote the use of condoms because the Catholic Church is opposed to that."
Other campaigns, he says, terrify instead of educate. Sitting in a sparsely decorated office, Mr. Lagunes holds up a poster printed by a church-based organization that shows the view of a youth wearing sneakers looking straight down while standing on the ledge of a skyscraper. On the street far below stand a circle of firefighters holding a white net to catch him.
"Do you want to jump into the wind?" the poster says. "Think about it. You can prevent AIDS."
Mr. Lagunes says, "People react to these campaigns with denial. They think, 'This is so terrible that it couldn't happen to me.' So they do not protect themselves."
Case of denial
That is how a night club dancer named Gustavo contracted HIV. He will not give his full name. He is a 26-year-old gay man, but he is so thin and fragile that he looks like a boy.
A couple of years ago, Gustavo said that he met and had sex with a man in El Paso, Texas. As was his custom, he did not use a condom, even though the man appeared thin and sickly.
"I thought he just had a bad cold or something," Gustavo says.
Posters and ads about AIDS, he says, seem to attack his lifestyle more than they advise about the importance of safe sex. So he rejected the messages.
"The ads for AIDS all seemed to sensationalize the problem," he says. "I reacted by becoming defensive. I thought the ads were only trying to create more homophobia, and so I didn't listen to them."
Last spring, Gustavo began to feel weary after the shortest walk or dance rehearsal. A test at Ser Humano in August confirmed his fear that he had HIV.
He has told very few people that the results were positive, not even his parents, out of fear of being rejected. His former lover has already abandoned him, and it seems the only person he can share his fears with is the therapist at Ser Humano.
Support for the ill
Showing compassion for victims of AIDS is the main service provided by Ser Humano, lodged in a white two-story house in a quiet middle-class neighborhood on the north side of Mexico City.
The center runs two hospices, each with 10 beds for patients and one doctor and four nurses. Mr. Hernandez, a psychologist, also organizes support groups for people in early stages of the disease. Neighbors are less than pleased to have dying people living on the block, Mr. Hernandez says. Bodies of those who die are removed from the hospices late at night.
Ser Humano has never received support from the government, although workers at CONASIDA often refer AIDS patients to the hospices for help.
"We are not endorsing hospices," says Dr. Baez, of CONASIDA. "This council thinks it's not the solution. AIDS patients should be seen in all hospitals around the country. They should not be sent to special hospitals."
But the wealthy often panic when asked to donate money to AIDS charities.
Fear of disease
Last month, a benefit concert was held to raise money for the construction of an AIDS hospice at the southern edge of Mexico City. The concert featured Celia Cruz, a widely adored singer known as the "Queen of Salsa," and the hospice is being built in memory of Tina Chow, an internationally renowned model who died of AIDS in 1992 at the age of 41.
Organizers of the concert said they sent out 10,000 tickets, targeting Mexico's wealthiest businessmen and celebrities. Only 1 percent of those invited bought tickets.
"We got some calls from people who said, 'How dare you invite me to some concert for AIDS,' " said Elena Lopez, a Mexican who nursed Ms. Chow until her death and who will manage the new hospice. "We sent invitations to performers and people in the fashion industry who we know have friends who have died from AIDS, but they don't want to admit it."
In a popular new Mexico City newspaper, a column on sexuality is printed each week in which a local sex therapist responds to readers' questions about sex or sexually transmitted diseases.
A letter printed Dec. 5 shows just how little Mexicans have learned about AIDS over the last 10 years. It was signed, "Doubtful."
"For some time I read that AIDS was a disease of homosexuals and drug addicts," it read. "But recently in the preventive campaigns they talk about everyone being at risk. Are they just trying to make the campaign more intimidating . . . or what?"