From reading over the document below, it seems that Cuba pretty much followed what World HIV health organizations suggests. Because of cuba's small size, social and political structure, relatively isolated nature (while many tourits visit resort areas, opportunities for sexual interaction is limited),and exphasis on health and education, detection, treztment and education initiatives was easier to deliver than in more complex situations.

However, what is interesting is when MSM rates began to rise, efforts werd made to increase social acceptance of gays, including in schools-versus Ake's approach to furtger demonize and stigmatize the gsy community.


""Since the 1990s, when the Cuban HIV epidemic became one characterized as being most prevalent among MSM, the question of public education — in particular dealing with the compound issue of homophobia in a macho Latino culture and of public stigmatization of and discrimination against HIV patients — has required greater focus. Campaigns in support of sexual diversity, considered a part of the "social inclusion" policy, are first introduced to children through the school system, which begins sex education (including sexual diversity education) at grade five. The national program, including a TV soap opera with gay and lesbian individuals as well as characters who are HIV-positive, is led by the National Center for Sex Education (CENESEX). The Federation of Cuban Women (FMC) began sex education programs in the early 1970s and set up CENESEX in 1989. Led by Mariela Castro (daughter of Raul Castro and the late Vilma Espín, a founder of the FMC), CENESEX stresses acceptance of sexual diversity and has attracted international attention in recent years for its campaigns for the rights of transgender persons, including the recognition of an individual's gender identity, regardless of birth sex, and provision of state-funded sexual reassignment surgery.61

Cuba's National Center for the Prevention of STDs and HIV/AIDS, with international support (for example, from the United Nations Development Programme [UNDP]), hosts training programs, assessment, and research in-person and helpline telephone counseling, networking, condom distribution, help for mutual support groups, nutrition education, and support for vulnerable groups. An "Afroache" program trains educators and develops specially focused educational materials for addressing the issues from that religious perspective as it is practiced in Cuba.62 Although churches appear to have no great influence on the educational campaign or the use of condoms, some of the material developed by the National Center includes the basic information that safe sex includes abstinence and that this is the only form of safe sex endorsed by the Catholic Church. Nevertheless, most materials provide an overwhelming emphasis on the use of condoms, which are distributed freely, in the millions, through the National Center.

Education programs must be periodically reviewed. The manual for groups working in HIV/AIDS prevention refers to a method developed by US academic Dr. David Kolb. This method is a teaching and learning process that emphasizes a circular relationship among concrete experience, observation and reflection, conceptualization, and practice.63 Long-term cooperation was also developed with some international agencies, in particular the World Health Organization and the UNDP. The National Center for the Prevention of STDs and HIV/AIDS, for example, was created in 1998 with support from the UNDP and Doctors without Borders (Holland) to help expand HIV education.64

Many of the health promotion pamphlets that this author observed in use during 2005–2006 were aimed at the general population, with some material aimed more directly at men who have sex with men (for example, "Siempre conmigo/Always with me" and "Hablando entre nosotros/Speaking amongst ourselves") or addressing the male responsibility for condom use (for example, "Los hombres marcan la diferencia/Men make the difference"). Another national pamphlet addressed cultural attitudes, urging, "Judge your friends by their qualities, not by their sexual orientation," and stressing acceptance of sexual diversity to counter prejudices and stigmas. This pamphlet states that lesbian, gay, bisexual, and transgender identities are all valid forms of sexuality and gender identity and that "understanding and accepting people as they are, will make you grow as a better person" (for example, a pamphlet titled, "He is also one of us"). Local music stars have been enlisted to help promote safe sex, for example in the national HIV magazine Lazo Adentro.65

Cuba