“Is this the medical clinic?” asks one man, to which a middle-aged woman responds, “I think so,” pointing to a picture of an AIDS ribbon visible through an open first floor window.

The building, as well as the entire city block, is occupied by Via Libre, a non-governmental organization founded in 1990, which, at the time of its creation, operated out of a cramped office and existed only through the volunteer efforts of a small group of healthcare professionals.  Since its inception, Via Libre has provided counseling and mental health services to the HIV-positive population of Lima.  Over the past 19 years, Via Libre has grown exponentially to provide free comprehensive medical services to persons living with HIV/AIDS, create a drug bank for those who cannot afford expensive antiretroviral medication, and engage in creative educational campaigns aimed at preventing the spread of HIV among Lima´s youth and other high-risk populations.  In recent years, Via Libre has created a laboratory dedicated to the development of an HIV vaccine.

When Via Libre was founded, there were no useful statistics about the number of Peruvians living with HIV, and worse, thousands were unaware that they had been infected.  As recently as September 2007, a number of population-based surveys, including surveys by the Peruvian Ministry of Health and the United States Agency for International Development (USAID), reported that there were over 50,000 known cases of HIV or AIDS in Peru, with the capital region accounting for approximately 72% of these. Significantly, the United Nations Joint Programme on HIV/AIDS (UNAIDS) estimates that approximately 35,000 additional Peruvians are HIV positive but unaware of their status.  According to the USAID, sexual transmission accounts for 97% of HIV/AIDS cases in Peru.

In the 1990s, the AIDS epidemic quickly became a burden on Lima´s then-collapsing healthcare system, and private citizens met the challenge of raising awareness about HIV/AIDS.

“Civil society is most responsible for HIV prevention in this country,” says Marcela Coronado, a director at Via Libre. Ms. Coronado, a psychologist who works closely with at-risk youth ages 14-18, believes that there is no organized education in Peruvian schools concerning HIV/AIDS but there is a “growing recognition that [HIV/AIDS] is major public health crisis.”

Coronado explains that Via Libre has gained inroads into at-risk populations by working with community groups, sports clubs, discotecas, and other public spaces frequented by young Peruvians.

“When we work with youth, it is imperative to work with their parents and communities, otherwise parents rightfully will be suspicious of our activities,” said Coronado.

In Coronado´s view, a major challenge is “gaining the respect and friendship of the various communities we work with…our approach differs with each target community.” While Via Libre uses its mobile unit to disseminate information to large groups of people at street fairs, it utilizes a more personal approach when working with teens. “We play games with the youth and get them to loosen up,” said Coronado.

One such game involves asking teens to write anonymously on a small piece of paper the first words that come to mind when they hear certain words, such as “sexuality,” then taping their notes onto a giant ball. The facilitator then passes around the ball, and each teen reads aloud one comment for the group to discuss. “There is a lot of laughing, but the kids are really put at ease and feel comfortable talking about serious issues.” recalls Coronado with a broad smile across her face.

Via Libre´s vision and many innovative approaches to HIV prevention have gained the organization national and international attention, including much-needed funding from the European Union and other international sources.

Many of Via Libre´s youth participants have already gone on to become peer educators and form an integral part of Peru´s fight against HIV/AIDS. As part of Via Libre´s “Communidad Saludable” (Healthy Community) campaign, which is in its second year, some youth participants now work with community leaders and health professionals to organize prevention activities in and around Lima.  Ms. Coronado reports that youth have helped organize HIV awareness fairs, created HIV-prevention brochures, and are presently working with medical clinics around Lima to create spaces where the general public can obtain HIV-prevention materials and find support groups. Ultimately, Coronado explains, “Via Libre wants to create a culture of prevention. We want to start a dialogue that will continue even after our work in a particular community is complete.”