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Iran's growing AIDS crisis shifts from the needle to the bed

Agence France-Presse - December 1, 2004
Hiedeh Farmani

TEHRAN, Dec 1 (AFP) - Health experts warned Wednesday that Iran's growing AIDS problem was moving away from drug users and into the bedroom, and appealed to Islamic authorities to go further in breaking a taboo over all things sexual.

"The trend of transmission has changed from intravenous drug users to high risk sexual behaviour," said Minoo Mohraz, a doctor and specialist in Iran's official AIDS Association.

"People cannot afford to get married so young, and are getting married older. The gap is being filled by more prostitution," she said.

According to official figures, just 7,510 people in Iran carry HIV, the virus that can lead to AIDS.

But experts point to a likely figure of at least 40,000, saying this is disguised by a lack of testing facilities and the unwillingness of sufferers to come forward.

"AIDS is still largely a taboo, and policy makers have for a long time been in denial," Mohraz told AFP in an interview.

"And people who are infected or fear to have been infected do not come forward because of the social stigma associated with AIDS. In our culture we have a problem with high risk behaviour and extra-marital sexual activity."

As an example of the stigma, she claims that only two years ago she 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 behaviour, I won't go on TV. So finally they relented."

There are signs that attitudes in the Islamic republic are adapting to the threat of AIDS -- even if public discussion of what goes on under the sheets is still considered to be at best vulgar, at worst criminal.

World AIDS Day has been marked with a fresh barrage of information being broadcast over the conservative-controlled radio and television frequencies in the Islamic republic.

Some officials have even gone on air to call for the state to distribute condoms free of charge.

But Mohraz, whose AIDS Association is attached to the health ministry, said Iran still has a long way to go in accepting that HIV/AIDS is not a problem that remains confined to the country's injecting heroin addicts.

"Policy makers think that if you talk about something, it will encourage the activity," she said.

"So public awareness and education is by no means consistent. They talk about it on TV for World AIDS Day and that's the end of it until next year."

This view is backed up by another AIDS worker, Mahmood Reza Moussavi, a psychologist working at one of Tehran's handful of dedicated clinics.

"The general public is extremely ignorent. Some families lock the infected member in the cellar and cut all contact with them," he said, warning that women in particular were reluctant to come forward for testing and support.

"Most of the patients who seek help are heroin users who come here for methadone therapy," he said -- adding that the rest of the sufferers do so in silence.

"What we need is consistent therapy and psychiatric help," Moussavi said, explaining that a particularly discreet form of health structure needed to be built up.

"People just cannot cry out loud in public: 'I am HIV positive'."

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