Iran's Progressive Approach Toward AIDS

In a region where other Muslim governments ignore the AIDS epidemic, quarantine HIV-infected people or preach abstinence as the only solution, Iran's approach is fairly progressive. Iran's AIDS program melds up-to-date programs and research with deep-rooted religious values.
The country still doles out floggings to Iranians caught with alcohol, but it also gives clean syringes and methadone treatment to heroin addicts. Health workers pass out condoms to prostitutes. Government clinics in every region offer free HIV testing, counseling and treatment.
In 2005 the postal service unveiled a stamp emblazoned with a red ribbon for AIDS awareness. In 2006 there was an AIDS awareness concert in Tehran. This year, school children in Mashad created a 150 foot long painting to promote AIDS prevention and awareness. And in 2008, the government is due to earmark an estimated $30 million to AIDS programs.
Reuters
A man stands next to a piece of artwork at a conceptual art exhibition about HIV/AIDS in Tehran on World AIDS Day, Dec. 2.
"Iran now has one of the best prison programs for HIV in not just the region, but in the world," said Dr. Hamid Setayesh, the coordinator for the U.N. AIDS office in Tehran. "They're passing out condoms and syringes in prisons. This is unbelievable. In the whole world, there aren't more than six or seven countries doing that."
Shame, drug addictionIran's HIV infections rates may be low for a country of about 69 million people, but AIDS experts note that the country is confronting some major obstacles in controlling the disease's spread from growing intravenous drug use and prostitution.
According to World Health Organization estimates, the number of people living with HIV in Iran is approximately 22,000 to 30,000. The government reports 12,000 people with HIV, although health workers say the real figure is closer to 70,000. Across the Middle East and North Africa, the number of HIV cases has risen to 460,000, with 68,000 new cases in 2006 alone.
Many HIV-positive Iranians face shame and isolation. They're reluctant to tell relatives and co-workers about their diagnosis, fearful they'll be cast out of their homes, fired from their jobs, or ostracized by society. Those infected may remain hidden and not go to medical centers for treatment, raising another challenge to stopping the spread of HIV.
"My husband gave me HIV. He is a drug addict and he uses needles. He got the disease and did not know himself," said a 28 year-old cleaning lady who asked not to identified. "One day I was at work and the lady of the house noticed I was not looking well for some time. She sent me to her husband's clinic. [The doctors] did some tests and then told me I have HIV. Without [my employers] I don’t know what we would have done, because we can’t tell anyone in the family. They would never look at us again," the young woman said.
VIDEO: Doctor takes on HIV/AIDS in Iran
Because Iran is located on a major narcotics transit route (neighboring Afghanistan is the biggest narcotics producer in the world), the country's addiction rate has been growing, particularly intravenous drug use. Iran has the highest levels of opiate-based drug addiction in the world, according to the U.N. World Drug Report for 2005. The drug addiction problem used to be confined to people smoking opium but now the use of heroin is widespread.
In addition, to the north of Iran there are the newly independent countries such as Kazakhstan and Moldova formed after the dissolution of the Soviet Union, which are suffering from one of the fastest-growing HIV/AIDS epidemics in the world. The rapid spread of HIV in neighboring countries from narcotics smuggling has caused the increase of AIDS infection among Iran's injecting drug users.
Risky sexual behaviorThe increase of prostitution is also causing concern among Iran's medical community.
"The trend of transmission has changed from intravenous drug users to high-risk sexual behavior," said Dr. Minoo Mohraz, Iran’s leading AIDS specialist. "People cannot afford to get married so young, and are getting married older. The gap is being filled by more prostitution...In our culture we have a problem with high-risk behavior and extra-marital sexual activity," she said.
Only three years ago Mohraz was the first person to have mentioned the word "condom" on national television — and that only came after she overcame stiff opposition from some officials.
"I told them that if they won't let me talk about condoms and sexual behavior, I won't go on TV. So, finally they relented."