Associated Press - November 27, 2006
Donna Abu-Nasr

She never will, she said. "Can you imagine what their reaction will be? We'll be treated like pariahs," said Umm Muhammad, a Jiddah resident who declined to use her full name to protect her privacy.

Saudi Arabia's government has become more open about AIDS in recent years, publishing statistics about the number of infected Saudis, providing them with free medical care and urging compassion.

But in this deeply conservative kingdom, social stigma is still attached to the disease - which most people link, correctly or not, to acts forbidden by their religion and sometimes punishable by death: premarital or gay sex and adultery.

That complicates the job of health workers and activists who advocate spreading awareness about protective measures. How, they ask, can an activist educate people about safe sex in a culture that demands men and women abstain from premarital sex?

The dilemma is that many Saudis, mostly men, do have sex before marriage as well as extramarital affairs - especially on trips to other countries, activists say. Some contract HIV and infect their wives. According to Health Ministry statistics, 78 percent of HIV/AIDS cases in the kingdom are a result of sexual contact.

"If we were to say 'Use condoms' to everybody, it's like giving them carte blanche to go out and have sex," said Rami al-Harithi, a 30-year-old activist who contracted HIV during a blood transfusion at age 8.

Al-Harithi, from the holy city of Mecca, is one of the first Saudi HIV-positive patients to come out in the open and says people are sympathetic because of the way he got the disease. He says he will speak frankly at a seminar for male high school students this week to mark World AIDS Day.

"I will tell them, 'You should abstain from sex. But if you travel and cannot hold yourself, there's something called a condom that you should use,'" said al-Harithi.

"I'm sure some people will be upset at this kind of language, but I don't care," he added. "My aim is to protect people."

Many Saudis disagree with al-Harithi, saying recommendations for safe sex among married couples, such as one posted on the Health Ministry Web site, are as far as activists or the government should go.

The site says: "There are simple and effective ways to protect against the disease and the most important one, which is more important than any vaccine that may one day be discovered, is clinging to moral, social and religious values that ban dangerous sexual conduct and that limit sex to marriage."

Of 10,120 people who have tested HIV positive in the kingdom since the first case was identified here in 1984, 2,316 were Saudis, according to figures released by the Health Ministry in August, the Arab News reported.

That figure is up from 7,804 in 2005, the newspaper quoted Tarek Madani, adviser to the health minister and consultant for contagious diseases, as saying.

Almost 80 percent of AIDS cases in the kingdom are age 15-49, and 6.4 percent are children, the report said.

The government sponsors public awareness campaigns, such as one this week to mark World AIDS Day on Friday, that include lectures, 500,000 phone text messages, billboards and other activities.

The government also treats Saudi AIDS patients for free, at a cost of $2,700 a month. Expatriates are sent home after an initial treatment.

A few AIDS societies also are being set up and awaiting government permits, including Al-Husna Society. A member, Laila Taha al-Dulaymi, said the group plans financial help for AIDS patients and their families and to tackle issues like joblessness, as AIDS patients are often fired once their employers learn they are HIV-positive.

That is a problem that Jiddah resident Jibril Ahmed, a 31-year-old guard, faced in 2004 when he told his boss he had AIDS.

Ahmed learned he had the disease after his pregnant wife died in the seventh month of pregnancy. Tests determined she, the dead fetus and Ahmed were all HIV-positive. Ahmed assumes he became infected eight years ago, but he would not say how.

"Everyone makes mistakes," he said.

Ahmed said relatives at first worried about catching the disease and would not touch dishes or cutlery he used. But now, they have come to terms with it. His daughters, 8 and 14 years old, do not have HIV. They know he is sick but don't know the details.

"I hope they will eventually understand I didn't mean for this to happen," said Ahmed.

Umm Muhammad contracted the disease from her husband, she says.

"At first, I was very upset and yelled at my husband and asked how the disease has penetrated our home," she said. "But I'm certain he hasn't done anything bad. That's why I'm still with him and I support him."

But she draws the line when it comes to telling her family.

"When my 12-year-old daughter asked me recently what AIDS is, I changed the subject," said Umm Muhammad. "It's hard for me to tell her, even though I know exactly what it is."

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