Iran's fight against the spread of HIV hinges on a delicate give-and-take
between activists who talk frankly about sex and drugs, and the ruling
ayatollahs, who fiercely protect the Islamic Republic's ultraconservative
image. The combination has made Iran the Middle East leader in preventing HIV
and AIDS.
The country's program, which melds deep-rooted religious values with
cutting-edge research, is being exported to Afghanistan, Iraq, Lebanon,
Pakistan, Sudan, Syria and other Muslim nations.
"I told my colleagues in the United Arab Emirates, 'You're not more rigid than
us. We're the only country in the world where it's the law to wear a head
scarf, where it's a pure Islamic government, where you can't drink,'" said Dr.
Arash Alaei, one of Iran's most respected AIDS researchers. "'If we have a
prevention program, why don't you?'"
In a region where other Muslim governments ignore the epidemic, quarantine
HIV-infected people or preach abstinence as the only solution, Iran's approach
is especially remarkable.
It still doles out floggings to Iranians caught with alcohol, but it 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. A state-backed magazine just began a monthly
column that profiles HIV-positive Iranians, and last year the postal service
unveiled a stamp emblazoned with a red ribbon for AIDS awareness. This year,
the government will devote about $30 million to the program.
One of Iran's most acclaimed advances comes from its notoriously secretive
network of prisons, where hundreds of drug-addicted inmates sometimes share the
same makeshift syringe to inject heroin smuggled in by guards or visiting
relatives. In a startling acknowledgment of sex and drugs even in its most
closely guarded quarters, the Tehran administration has made condoms and
needles available in detention centers across the country.
"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."
Iran's national response still faces obstacles, especially when it comes to
reducing the shame and isolation that HIV-infected Iranians endure. The
government reports 12,000 people with HIV; health workers say the real figure
is closer to 70,000. Many HIV-positive Iranians are reluctant to tell relatives
and co-workers about their diagnosis, fearful that they'll be cast out of their
homes or fired from their jobs.
But the program's architects are turning to the clergy for help in combating
the stigma of a disease that in the minds of many Muslims is inextricably
linked to sex.
A year ago, Setayesh sent questionnaires to the most influential Shiite Muslim
clerics to elicit their views on condom use, government's role in AIDS
prevention and how society should deal with HIV-infected Iranians. He received
17 handwritten responses, nearly all in favor of the government's efforts. The
U.N. AIDS office plans to compile them into a book to distribute at mosques.
Iran's first reported HIV infection was in 1987, when a hemophiliac child
tested positive.
Knight Ridder
