I've been in Mexico for almost a week. There's a growing behavior change challenge here: persuading Mexicans to change the way they eat and the way they have sex.
Why change the way they eat? Diabetes is on the rise in Mexico. Currently 9% of the population has type 2 diabetes and 18% are intolerant to carbohydrates. This is quite a challenge when the dietary staples are beans, rice and tortillas and more Coca-Cola is consumed here than anywhere on earth. It's VERY cheap.
And why change the way they have sex? One word, HIV/AIDS. The amount of HIV/AIDS in Mexico is on the rise. As in much of the rest of the world, HIV is spreading fastest among young people - especially young women.
Sitting in a sunny, apricot room - listening to passionate members of civil society groups - I was impressed by their work and their proud use of the term feminista. Their policy work aims to change laws in Mexico that discriminate against women and they also run programs to help poor women. In many of the barrios in Mexico City, that means working with HIV positive women.
Many people still picture sex workers when they think of HIV. But I was looking at Carolena- a small woman with a dark brown pony tail, a sweater that matched her brown skin buttoned to her neck. She sat quietly staring at her hands as all the formal introductions were translated and pleasantries exchanged. I was startled to see her persona transform as she began to share her story. When her husband of many years left her and their children for a younger woman, she was devastated. She heard of his death a year or so later when his girlfriend stood at her front door telling her he died of AIDS and she needed to get a test. This younger woman had just found out she was HIV positive. Carolena had wondered what was wrong. Her children had been worried about her continued weight loss and failing strength - she thought it was the depression from her divorce. She was scared. She cried for weeks. When her test came back positive - she was afraid to tell her children. It was a very hard year. "But now I am better. I have found the women here - and they helped me, supported me and I am now trained to help other positive women like me live a productive life".
This middle aged, attractive mother had found purpose and a new life. But Mexico is a big country - over 106 million. Too many people don't even have access to primary health services - let alone treatment for HIV. Then I listened to Nubella. This pretty teen wore a bright fuchsia blouse that matched her lip stick and engaged us all with her amazing smile. She was volunteering in a prevention education program in her school and in her very poor neighborhood. It was part of a comprehensive sexuality education program for young people. She was very proud to be a 'peer educator'. Nubella told us that the kids in her school were anxious to learn. They had many questions about sex and relationships, but had no one else to ask. She saw the teens they worked with become more judicious in their sexual activities; postponing, changing, using condoms and other contraceptives. They were being more thoughtful about their sexual actions. What she was doing was successful. Kids where helped, fewer were getting pregnant in school and fewer were getting infected with HIV. She was proud to be a positive force in her own community.
The professionals working in contraceptive and reproductive health programs have success stories world-wide. We have seen time and again, that healthy behavior change around sexual activity is possible regardless of religion, cultural norms, income or location. When programs are developed with the people from the communities - so they fit into the language and culture - they work. Teens and adults need information, someone to talk to that will give them clear and correct answers to their questions and concerns. They also need affordable supplies and reliable services provided within a reasonable distance - and it has to be there over time. It isn't simple but it works!
We all know that sex is a basic human drive. I have seen healthy human adaptations in sexual behaviors everywhere in the world...oh, there is one thing that can screw up these success stories - politics! Let's hold our candidates and elected officials accountable to supporting prevention of HIV/AIDS and unwanted pregnancies. It's time we support what works.
As for eating, someone else will have to write the blog on changing that behavior.