Community Organizing Around HIV Prevention in Rural Puerto Rico

Puerto Rico with a population of approximately 3.5 million people has the second highest prevalence of AIDS in the US. The most systematic data on HIV incidence and prevalence in Puerto Rico come from San Juan in which an estimated 8900 people are infected as a result of IV drug use 2800 through male homosexual behavior and 1600 through heterosexual sex. Approximately 20% of the infected IV drug users and 80% of those infected through heterosexual sex are women. The majority of HIV-related research and services are located in the cities of San Juan Ponce Mayaguez and Caguas. Little is therefore known about HIV infection in the two-thirds of the total population who live outside of these metropolitan centers. The authors discuss the changing perceptions and conflicting responses of the people of Yabucoa to the emergence of HIV infection on the island. Yabucoa is a small municipality on the south coast of Puerto Rico in which a community organization began meeting in 1991. Focus is given to aspects of social organization important to understanding the HIV epidemic how gender patterns may shape local initiatives and possible strategies for HIV/AIDS prevention in rural and semirural areas of Puerto Rico.