Naina Dhingra is the Director of International Policy at Advocates for Youth and serves on the Developed Country NGO Board Delegation of the Global Fund.

I had thought that my visits to Global Fund projects would show me what AIDS looked like in a middle-income Latin American country. In fact, they showed me much more. In a mere one day of visiting projects, I saw not only how AIDS impacts Guatemala, but how sexual exploitation, drug abuse, violence, rape, early fertility, and lack of economic opportunity are inextricably linked to the root causes of the disease.

We started our day by visiting the Hospital Roosevelt, which is one of the largest recipients of Global Fund money in Guatemala. It is a public hospital that provides free treatment and services, with a reputation for treating patients with respect and dignity regardless of socioeconomic class. Approximately sixty percent of its resources come from the Global Fund.

There is a misconception that AIDS in Latin America is a disease of men who have sex with men. But as I stood in the waiting room of the AIDS clinic at the Hospital Roosevelt, the faces that looked up at me were young women. The face of AIDS is changing in Guatemala to be a disease of younger women. These women are at risk of contracting HIV from their male partners who often have sex with other men but do not identify as being gay.

Two months ago, the hospital started testing pregnant women for sexually transmitted diseases and HIV in the emergency room. These women are often the victims of rape, violence, and sexual abuse. Already, ten women have been identified as HIV+ and been given nevarapine treatment to reduce the chance of passing on the disease to their newborn child, demonstrating the program's success. Violence against women and sexual exploitation of girls is pervasive here in Guatemala. I spent the rest of the day with a local NGO called Casa Alianza where I saw this firsthand.

Casa Alianza runs shelters and outreach programs that work directly with street children and girls who have been raped or sexually exploited. Many of the girls are not just girls; they are young mothers. I sat with a sixteen year old girl who was already a mother of a three year old and nursing an infant; nearby was an eighteen year old girl pregnant with her second child. Often, these pregnancies and children are the result of rape and sexual abuse. The girls told me their challenges in motherhood and the difficulty in growing to love their child. Many of their friends who became pregnant in the same way ended up giving their children up for adoption. But these girls want to be good mothers and give their children a better life. Casa Alianza helps them learn how to be a mother while teaching them vocational skills, such as baking, so that they may leave the shelter and support themselves.

These young mothers made a decision to leave the streets and seek the support of Casa Alianza. But not all children are ready to leave the streets. I spent the rest of the day observing how the outreach workers work with street children. As I looked out on a group of children sprawled all over a field watching a theatre demonstration on HIV prevention, it was hard to determine what social ill they were more at risk from. The boys had visible injuries and scars all over them, representing the violent nature of living on the streets, and the girls were dressed provocatively – a result of their reliance on prostitution to survive. These children are not only at great risk of HIV infection; they suffer from drug abuse, STDs, violence, and exploitation.

An outreach worker dressed as a clown tested the children's knowledge on HIV. "It's a disease with no cure," one boy responded. "You get very sick," said another. While many joked throughout the presentation, they all were in rapt attention during the condom demonstration. The outreach workers handed out condoms, cleaned up infected wounds, and provided a safe space for children to relax for a few hours off the street.

Global Fund resources support the salaries of these critical street outreach workers. While it is a seemingly small amount of money when compared to resources going to governments, it shows how a large multi-billion dollar organization can trickle down to support community-based organizations working on the frontlines. Five years ago, the vision of the Global Fund was to make a dramatic difference in the fight against AIDS, tuberculosis, and malaria, but these programs demonstrate that the Fund isn't just impacting these diseases – it is truly an instrument of poverty reduction and social change.