Because all these methods fall short, most patients go without the medicines and eventually waste away. As in the United States and Europe, AIDS in Latin America first appeared in the gay population and has since spread to women. The infection rates in the United States and Latin America are roughly the same, but without widespread access to the cocktail, Latin Americans are dying faster. The clinic tests 2,000 people a year, with 17 percent turning up positive. Several patients' groups have formed in the last two years, hoping to persuade the government to follow the example of Brazil and Costa Rica, which now provide the medicines to nearly all AIDS patients.
Similar campaigns are also underway in El Salvador and Honduras.
Guatemala does offer some drugs, through its Social Security system. But the system covers just 13 percent of the total population. So the clinic tries to take up the slack for example, by enlisting its patients in drug studies. A major victory came in 1997, when the U.S. drug company Merck was looking for places to test whether its drug Crixivan was more effective when taken two or three times a day. The clinic was chosen as a study site, and doctors there began the search for 50 suitable patients.