'Religious immunity' a dangerous Aids myth: UN expert
DUBAI // The Middle East must stop relying on so-called "religious immunity" if it wants to slow down the growing HIV/Aids epidemic, a leading expert said yesterday.
Dr Khadija Moalla, a regional coordinator for the United Nations Development Programme, said the belief that strong Islamic principles prevent the spread the disease would seriously hamper efforts to reduce infection rates. Eight in every 10 women in the Middle East and North Africa (MENA) region who have HIV/Aids contracted it from their husbands, she revealed at a public lecture in Dubai last night.
"We think we have a religious and cultural immunity here," she said. "We need to accept what is happening and stop the denial, not to denounce people but to help them. "We need to accept who is doing what, with who, and how. We have paid sex whether we like it or not, and we have drug users whether we like it or not." Speaking at the Dubai School of Government, Dr Moalla said even strict Muslim countries must accept that practices such as sex outside of marriage and drug use were commonplace in some areas.
Simply telling young generations that risky behaviour such as intravenous drug use were "haram" would not prevent the continued increase in infection rates, she added. The MENA region is one of only two in the world in which there has been an increase in HIV/Aids cases year-on-year. In 2008, there was an estimated 35,000 new cases, bringing the total to about 310,000, according to the Joint United Nations Programme on HIV/Aids (UNAids) and the World Health Organisation (WHO).
According to the UAE country progress report, there was 636 UAE Nationals with the disease last year, of which 476 were men. It did not state how many expatriates were found to have disease. Expatriates are deported if they test positive. A report published in June - titled Characterising the HIV/Aids Epidemic in the Middle East and North Africa - stressed the point that religious beliefs do not necessarily eradicate risky behaviours such as unprotected sex outside of marriage.
The report, which was a joint effort between the WHO, the World Bank and UNAids, stated: "Counting only on the "cultural immunity" of religious and traditional mores is not enough to prevent the worst of the HIV epidemic." The 282 page document, which compiled the most comprehensive data available in the region, acknowledged that adherence to Islamic codes of conduct was "not perfect" and that Muslims "do engage in sexual and injecting drug activities not sanctioned in Islam."
Dr Moalla is focusing a lot of her work in the region on targeting religious scholars to help reduce the stigma and discrimination which surrounds HIV/Aids. She hopes that by educating Imams and encouraging them not to judge those at risk, countries can become more tolerant and better equipped to face and, therefore, tackle the problem. "Imams are preachers not judgers," she said. "Any many are very receptive to the work we do. We need to spread this message further. Islam should not be interpreted to say we must judge people with this disease, we should help them."
As well as enforcing negative stigmas and stereotypes, she said "cultural immunity" also prevents countries from understanding the extent of the problem. In the 2010 country progress report compiled by the UAE for the UN General Assembly, there was no statistical data on the modes of transmission. There was also no data on the numbers of at-risk populations such as female sex workers, homosexuals or intravenous drug users.
Every country compiling a report was asked to provide data on the percentage of adults who had "more than one sexual partner in the last 12 months who report the use of a condom during their last intercourse". The UAE said this information was "not relevant". Dr Moalla argued that this was a dangerous way of thinking. "Eighty per cent of women in the region who have HIV/Aids were infected in the bond of a legal marriage," she said. "The women thought they were protected because they were being faithfully and extremely religious. The problem is not what is inside the marriage, it is what is outside."
To protect people, especially women, properly, she said, countries must "stop the denial once and for all." Dr May Al Dabbagh, a research fellow at the Dubai School of Government and one of the organisers of the public talk, said it was a positive sign that countries such as the UAE had begun to discuss "taboo" topics such as HIV/Aids in a more open forum. "We need to come face to face with the reality we are living in," she said. "Just because things may not manifest themselves in your life does not mean they are not there.
"This is a very important area and just because it's contentious doesn't mean we shouldn't necessarily talk about it." Other strict Muslim countries in the region have already started acknowledging and tackling the high-risk behaviours and populations. Saudi Arabia, for example, has built 20 voluntary testing and counselling clinics and Iran launched a harm-reduction programme which includes needle exchanges and condom distribution points.
The Ministry of Health here said it would build voluntary testing clinics to try to reduce the fear of criminalisation but it has not made any progress so far. Some countries have also been more proactive in collecting accurate data in an attempt to reduce infection rates. Egypt claims that just more than five per cent of men who have sex with other men have contracted HIV/Aids, and Djibouti says a fifth of sex workers are affected.
Published: October 6, 2010 04:00 AM