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Wednesday, 20 March, 2002, 11:45 GMT
Tackling Aids in Iran
Iranian women attending Aids awareness classes
Engaged couples have to attend Aids awareness classes

Despite its strong attachment to religious values, the Islamic Republic of Iran has thrown its weight behind an extremely enlightened campaign to combat the Aids virus, an affliction normally associated with such un-Islamic practices as intravenous drug abuse and extra-marital sex.

So far, the figures are low by international standards.


The numbers are low, but the burden is heavy.

Dr Mohammad Mehdi Goya
Officials say that nationally, something over 3,400 HIV positive cases have been identified, with nearly 400 cases of full-blown Aids, of whom 350 have died.

But officials are far from complacent.

The spread of drug abuse and related patterns of crime and prostitution could create conditions for a much bigger explosion of the deadly virus.

"The numbers are low, but the burden is heavy," said Dr Mohammad Mehdi Goya, of the Iran University of Medical Science, who is helping direct the national campaign.

"It could definitely get much more serious - we're no different from any other country in the world in that respect."

Blunt message

At the cutting edge of this campaign is the province of Sistan Baluchistan, abutting the Pakistani and Afghan borders in the far south-east of the country.

Although it has low HIV positive rates, officials regard it as particularly vulnerable and have launched a vigorous, taboo-busting public awareness campaign that is hard to ignore.

Step off the plane at the airport of the provincial capital, Zahedan, and a huge poster declaring "Aids - the Plague of the Century" confronts you as you wait for your baggage.

Elsewhere in town, enormous placards carry the same message.

Drug user's needle
Drug users can get new needles from pharmacies
The local health department created and sponsored dramatic video advertisements which have been carried on local TV.

They pull no punches.

They show junkies sharing needles as they shoot up in a park, and advise the use of condoms to avoid the spread of the virus through sexual contact.

They explain that the virus can also be transferred through innocent everyday practices such as ear-piercing, shared razor blades, tattooing or even borrowing a toothbrush.

And they try to prevent Aids victims from being demonised.

"Aids sufferers have done nothing wrong. They should not be driven out of society, the workplace, or the family."

Polygamy

National figures show that more than 60% of HIV positive cases involve intravenous drug abusers sharing infected needles, while only about 25% have caught the virus through sexual contact.

But in Sistan Baluchistan, the proportions are reversed - an estimated 64% of the cases are sexually transmitted, while the drug abuse figure is much lower.


There is a lot of polygamy in this area, so migrant workers who get infected give it to all their wives

Dr Mohammad Taghi Tabataba'i
Officials attribute this to the region's special location and social conditions.

"There is a lot of labour migration from here across the border to Pakistan and across the Gulf to the Arab countries," said Dr Mohammad Taghi Tabataba'i, who heads the Zahedan Health Department's campaign.

"There is a lot of polygamy in this area, so migrant workers who get infected give it to all their wives," he added.

"That's one reason why we also have a much higher percentage of women sufferers here than nationally.

"On top of that, we are astride a major drug smuggling route from Afghanistan, so drugs are cheap here and addicts come from other areas to indulge their habit."

Special attention is given to screening high-risk groups such as prisoners, a large majority of whom are in jail for drug-related offences, and many of whom inject heroin intravenously to maximise its effect.

Once HIV positive cases are identified, they and their families are registered and given special counselling on what they should and should not do, at a discreet new centre opened recently above an existing clinic which dispenses advice and information to engaged couples.

Marriage guidance

The clinic is part of an impressive arsenal being deployed at grass-roots level to spread information about Aids.

Young couples are obliged to attend the clinic, where they are given a blood test for thalassaemia (a common inherited disorder here ) and they cannot get married without the requisite certificate of attendance.

Dr Miradi holds up a condom to a class
People are encouraged to use condoms
But part of the system now is that they are also given classes in Aids awareness, and later fill in a questionnaire to test their knowledge of how the virus is transmitted and how to avoid it.

"It's really useful," said one groom. "I knew nothing at all about Aids until I came here."

Religious elders have also been enlisted to help, and even this most conservative - and influential - sector of society has responded positively, spreading the word among the faithful attending prayers in the city's mosques.

"Aids is there, we can't deny it, and we have to have to help prevent it, because that's the only cure," said Nabil Allah, as he sat among a group of bearded sages being taught about Aids by a Health Department official.

Condom awareness

From local health centres serving each district, voluntary health workers, many of them young girls, hold classes in private houses in which even young children are taught the basics of Aids transmission and avoidance.


The most important part of my job is teaching people to use condoms

Dr Mohammad-Reza Miradi
Spearheading the drive, Dr Mohammad-Reza Miradi from the Zahedan Health Centre does not flinch from unfurling a condom in front of a roomful of chador-clad women, who giggle and hide their faces in embarrassment.

"Don't be shy about it, this is important," he tells them. "Using a condom is the only way to be sure you won't catch the virus from sexual contact."

"The most important part of my job is teaching people to use condoms," he said later.

"If I left that out, it would be a betrayal. Health education must be carried out without censorship.

"As a doctor, I just have to tell them that this little rubber barrier can protect them from this virus that has become so universal."

There are still some areas where campaigners would like to see more advance - such as needle-exchange programmes and drug replacement treatment in jails and rehabilitation centres.

But Iran has led the way in the region in adopting a frank, realistic and humane approach to a problem that is all too often swept under the carpet, but will not go away.


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09 Dec 01 | Middle East
09 Aug 01 | Europe
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