Many AIDS patients, particularly the poor, are being cared for and dying at home where they have only their family members for support. But family members often are more terrified than helpful because of the stigma attached to AIDS, and a lack of medical training.

Manzanares notes that in the United States, where more statistics are available than in Mexico, two out of three adolescent suicides are caused by sexual orientation problems. After working more than seven years as a volunteer at the Funda, he noticed that many of the youths he counseled practiced sex without protection. The group workshop is a place for them to share experiences and compare notes that lead – not just to greater self-acceptance – but also to safer sex, he said.

This workshop for adolescents with different sexual orientation creates an alternate family atmosphere in which participants can ease tensions over their sexual identity and fears about HIV. It provides a supportive setting to help them overcome their shame and reticence about revealing these problems to relatives, which is the first step in enlisting their support.

Participants in the Support Workshop for Adolescents
with Different Sexual Orientation

Introductions continue around the circle. As the conversation warms, a youth puts his arm around the shoulders of another at his side. One youth jokingly refers to his male friend as his co-madre, a Spanish term used to refer to a close woman friend.

When the group learns that a couple of its members are choreographing a dance routine (above), the participants move outside for a demonstration on the tree-shaded patio. And the workshop continues.

"They like the house because it is a family-like environment," says Manzanares, dressed for the session in a sleeveless blue muscle-shirt and jeans. They affectionately call the house "the Funda," an abbreviation of the foundation's Spanish name.

To reinforce the family atmosphere, Manzanares organizes events for workshop members such as a pajama party, a Christmas Eve supper, and a camping trip in the mountains. In March, he invited author Rina Shinfer to the Funda to speak about her book Mom, Dad, I'm Gay, which attracted 120 participants.

Author Rina Shinfer (in red) talks to participants in the Workshop for Adolescents with Different Sexual Orientation. Adrián Manzanares is seated at right.

Manzanares, who launched the workshop one year ago, has established two groups of young men, with an average of nearly 30 participants in each, and is now offering a Support Workshop for Adolescent Women with Different Sexual Orientation. He plans to follow up with a Support Workshop for Parents of Children with Different Sexual Orientation, to reduce discrimination. He hopes it will help overcome the closed-mindedness of many Mexican families and increase relatives' participation in the Funda's efforts.

"We want to begin opening a space so that when a father says he has a problem, he sees that another parent also has the same problem, and he is experiencing the same thing," Manzanares said. "So, he doesn't feel guilty – he begins to accept and support. And he starts to fight to change this homophobic world into a world with more tolerance – where his son, or another's, can develop freely, without prejudice, and can be a productive person adjusted with his or her sexual orientation."

Ramos emerged from college with a degree in psychology, an interest that helped shaped his career. In 1986, when knowledge of the AIDS virus was just beginning to filter into Mexico, the government formed the National AIDS Prevention and Control Council (Consejo Nacional de Prevención y Control del SIDA) – better known as Conasida – and Ramos decided to volunteer at one of its clinics.

The government clinic provided HIV detection and counseling. But as Ramos conducted orientation courses there, he noticed there was a need to do more to "socialize people so that they would begin to see that they're not the only ones who are alone experiencing the problem," he said.

So Ramos instituted the country's first mutual self-help group at the clinic. It was such a popular concept that five more formed, and when Ramos left to create the Funda in 1987, the participants followed him.

That's when their family members began to attend group meetings. "This was a very big responsibility for me," Ramos said.

The group meetings were unprecedented forums in which people who were diagnosed with HIV gleaned perspectives from Ramos, and shared their own, in an effort to confront the sense of impotency and despair associated with the diagnosis. Ramos changed the venue – from a clinic to the park in which the Funda's first meetings took place – to provide a setting more conducive to family members' attendance.

Camping trip: participants in the Support Workshop for Adolescents with Different Sexual Orientation pitch a tent

But many family members were ignorant about the disease, fearing they would be infected if they helped their loved ones. Others were apathetic: they had a hard time overcoming a sense of hopelessness in the face of an impending death in the family, or were ashamed by the stigma attached to the disease.

Ramos decided the Funda must provide attention to family members, as well as to the carriers of HIV-AIDS. He set up a project where psychologists counsel victims' relatives to abate their prejudices and misconceptions, and to teach family members how to extend emotional support to an infected person.

The project also includes home visits from nurses, who show family members how to take a patient's vital signs; administer medications; apply injections; treat wounds, hemorrhages and ulcers; clean and move a patient, and provide for proper nutrition. The Funda's hospice provides services that offer spiritual guidance and solace for those confronting the death of a loved one.

Its thanatology program provides specialists' counseling on death and dying to the terminally ill and their families. Lawyers provide legal assistance.

The Funda staff and volunteers support relatives by accompanying them on visits to overcrowded and ill-equipped hospitals, where they set examples of how to insist on timely and dignified treatment. The Funda even intervenes with financial aid for families that can't afford food, medicine, housing or transportation.

Ramos remembers one of the Funda's first clients, a woman in her late teens whose father was gay and sick in the hospital with AIDS. She attended one of the Funda's orientation meetings about 10 years ago.

"She was living in anguish and with severe desperation when it came to the nurses' shift changes, because she didn't know whether the nurses were going to want to attend to her father," Ramos recalls. "The doctors were causing a lot of problems. She began to ask how to handle the nurses to assure they would attend the man. Little by little, she started integrating into the foundation, and she stayed working with it for a long time."

The Funda has reaches up to 70 families per year with home training and motivation visits. It reaches some 2,000 people annually with individual and group psychological therapy. Some 150 people per year receive counseling on death and dying. Its talks, conferences, training sessions, expositions and media outreach efforts number in the hundreds annually, affecting an estimated 7,000 to 10,000 people annually.

None of these benefits was available in Mexico City when the Funda began its work. Today, a handful of other non-governmental groups have entered an arena that was established by the project. What sets the Funda apart is that it also serves as a platform for family members to join the battle against the AIDS virus and associated discrimination in the community, not just at home.

When Ramos started the Funda, he established its credibility by recruiting respected doctors. This led to community confidence that helped produce donations of everything from the Funda's building to furniture to coffins to mirrors.

Ramos said he especially appreciates the mirrors, and has built up a collection of small ones with elaborate frames. "Some say it's because gays are narcissistic," he jokes. But he adds, Funda uses the metaphor of the mirror to inspire family members to get involved. To diminish a relatives' hesitancy, a Funda counselor admonishes "that the best way to see [the HIV carrier] is as if you are looking in a mirror – see the person as someone like ourselves, who is infected."

But mirrors don't pay the bills. Grants, such as one Ramos received from the Levi Strauss and Co. Foundation in 1992 and another from Ashoka in 1993, have helped Funda expand. Collaborations with government institutes have been another major contributor.

Yet funding is inadequate for the Funda's needs. Manzanares underwrites all the costs of his workshops with money he earns as a schoolteacher. Ramos gave up his paycheck from the foundation a year and a half ago. The eight other employees' wages were reduced in March. One of the employees supports herself and children with income from a corner store she opened in order stay at the Funda.

Thanks to some 60 volunteers like Manzanares, the foundation's work remains steady, but is limited. "We'll get a call saying that somebody needs a psychologist and we can't provide one," Manzanares said. "We have people but we're not working full time because there's no economic underpinning here," he says.

Despite the struggle for resources, the Funda is making an impact and has a vision to expand its influence. Through the Funda, Ramos has achieved one of the significant goals for family leadership building that he set ten years ago: establishing a master's program in family psychology, with emphasis on different sexual orientation and HIV-AIDS, in Mexico's university system.

The Funda also has inspired a half-dozen other non-profit groups to form in different Mexican states, such as Chiapas, Oaxaca and the state of Mexico. Manzanares is planning to replicate the youth workshops in these and other locales. He wants to train his workshop participants so that they can start sessions on their own, as a way to broaden community leadership. He envisions creation of regional and national encounters between the groups, as a way to develop a sense of community.