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International LGBT researchers come to Pitt to battle HIV-related stigma back home 

"They're working in circumstances that as Americans, we just can't imagine."

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Eric Castellanos remembers with a disarming smile the period in her life when she contracted HIV.

She was 20 years old, just a couple years after she'd fled the small, heavily Catholic Belizean town she grew up in, a place where no one seemed to understand — let alone accept — her gender identity. (Though Castellanos sometimes identifies as a man, she says she is comfortable with female pronouns for this story.)

She'd hitchhiked to Mexico City and fallen for a man whom she'd met while volunteering at a hospice care center. But they were growing apart, partly because he was HIV-positive and Castellanos wasn't. "This was my first love," Castellanos recalls, "he was so fearful of infecting [me] with HIV."

Castellanos gave him an ultimatum: "We either have to go our own way or I have to get HIV as well." He eventually agreed to start having unprotected sex, and eight months later, on Dec. 24, 1995, she tested positive.

"It was a conscious act on my part to be HIV-positive," she says. "Love makes you do crazy things."

It's not a story she often shares — "I don't want to encourage anyone to be HIV-positive" — but she says it helps explain how in the seven years since her partner died, she became one of the most prominent activists in Belize and the first to talk openly about her sexuality and HIV status in the media.

Castellanos hadn't planned to leave Mexico. She had mostly bad memories of a childhood in Belize, where her gender nonconformity lead her parents to insist on testosterone injections and took her to a clinic that promised to "cure" her homosexuality. But she'd lost the healthcare she'd gotten through her partner and had little choice.

When she arrived, she began noticing how marginalized the LGBT community was compared with Mexico. There was nothing like the gay clubs she'd experienced there, and "The [HIV] medication I was taking in Mexico didn't even exist in Belize."

The stigma associated with HIV-positive people was immense. "The image people had of HIV was someone in bed dying, which contributed so much to discrimination," Castellanos says. Belize has the highest rate of HIV in Central America, with a prevalence rate of 2.3 percent, and the rate is thought to be much higher among gay and transgender populations, according to amfAR.

Castellanos began devoting herself to reducing the stigma of HIV, laying the groundwork for an organization that would advocate on behalf of the positive population. She started work on a degree in social work (still in progress) and eventually founded the Collaborative Network for Persons Living with HIV in Belize (CNET+).

Though it started mainly as a support group, over the past four years the organization has grown to include everything from condom distribution to a text-message system to remind people to take their medications.

And now, armed with some of the research methods she's learning at Pitt, she's hoping to tap back into CNET+ and survey hundreds of people to better understand what the barriers are to HIV testing in Belize. "It will give us so many tools to work from and design projects to work with the population and make recommendations to the government," she says.

Still, Castellanos isn't expecting progress to be easy. Since she's appeared in Belizean media as an advocate for HIV-positive people, she's received numerous death threats. She doesn't walk the streets alone in Belize — and after pressure from the U.S. embassy, Belizean authorities offer some security.

"As much as I love my country and am so committed to change things there, in the days I've been here, I've had dreams of never going back," she says.

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