Pioneering activist Wilfredo Valencia Palacios has been dubbed the “ray of sunshine” for people with HIV in El Salvador, the Central American nation engulfed in civil war until recently. The 31-year-old (profiled in POZ, August/September 1996) spent most of his youth in San Francisco—in political exile with his family—where he tested positive in 1988. Six years later, he defied the advice of his doctor and friends by returning to San Salvador, the capital city. There, Valencia started Proyecto Girasol, an HIV-prevention and street-outreach project for gay and bisexual men, including sex workers. Last spring, the community he loves so dearly almost lost him for good. POZ caught up with the now-recovered Valencia by phone in San Salvador.

After two years on AZT, you stopped antiretrovirals in 1994, focusing instead on vitamins and good diet—until last summer. Why did you go back on meds?
I had become so ill with diarrhea, fevers and weight loss, I thought I was going to die. I went back to San Francisco last June to say goodbye to my family. My CD4 cells had dropped below 40 and my viral load was 210,000. I couldn’t eat—I’d lost 30 pounds. I was tested at the hospital and they found I was infected with four kinds of parasites—the sanitation is very bad in El Salvador.
I was put on Septra [PCP prophylaxis] and other antibiotics. Slowly I started to get my strength back. I could eat again, and gained weight. Once my body was purged of the parasites, the doctors put me on nelfinavir [Viracept], d4T [Zerit] and 3TC [Epivir]. I wasn’t going to do it at first—I had heard about the side effects. But a friend persuaded me to try the drugs. I just had a little nausea and vomiting that went away after a few weeks, and I began to feel healthy for the first time in a year. After a month, my CD4 count went up to 140, and my viral load became undetectable. It was like a miracle! That was when I knew I’d be going home to continue the most important work in my life. I’ve been back here since October.

How hard is it to get protease inhibitors in El Salvador?
It’s impossible! Even for the few who can afford them, these drugs simply aren’t available: They haven’t been approved by the health minister, and no clinic offers them. We did succeed in making AZT available from ’95 to ’96 for government employees, but then the funding was cut off. Our AIDS organizations need to get drugs donated from the United States. I have my refills brought down here by friends. Once I waited two days for my refill to arrive, and I ran out of pills. I was terrified. AIDS services are so bad here that no public clinic does viral load tests or CD4 counts. I can’t afford the private clinics, so I’m just going on faith that these drugs are working. I feel good, so they must be. But I also keep taking vitamins and eating well.

How does your activist work affect your health?
It’s what keeps me going, especially when I see how things have changed since I came here in ’94. Very few people were doing outreach then, and when the police and death squads—which are intensely homophobic and AIDSphobic—raided our meeting places, we had to hide. Now we don’t have to because the movement is bigger. These days, when we’re handing out condoms and HIV information on the street, and the police come up and ask, “Are you guys faggots?” we say, “Yes, we are militant queens!” And it’s not just gay activists—even some church workers are now handing out condoms.

How did your family react to your decision to go back to El Salvador?
When I was in San Francisco, my brother said: “Why don’t you stay and behave like a normal person? You can get better treatment and live longer.” But I see these drugs as a gift to continue the work I’m meant to do. I have so many beautiful, supportive friends here. My family is not just in San Francisco, but here too. A combination of their love and my faith keeps me going.

Every day is proof that the doctors and everyone else who said I was crazy and couldn’t do this work were wrong. Because you know what? I’m doing it, and beautiful things are happening here.