CUBA's plans to rehabilitate its hiv patients within the community rather than locking them up in hospitals has not met with much success. "Uptill now, only 170 people have joined the out-patients scheme, and I have already received several letters requesting readmission," says Jorge Perez Avila, director of the Santiago de Las Vegas hospital.

The out-patients scheme, approved by the health ministry in 1994, was aimed at Hiv-positive patients who were symptom-free and -capable of looking after themselves and others". The hospital itself could be seen as a camp to take hiv patients off the streets; but to the patients, who often find life outside tougher, it is an oasis untouched by the killing effects of the Cuban economic crisis.

The 'hospital system'of the national aids preven@ion programme has been strongly diticised internationally, although experts acknowledge Cuba's success in controlling the spread of the disease. This, success is attributed to the national blood screening programmes, combined with measures to follow up the sexual pakners of all new cases.