HIV/AIDS is a taboo topic in much of the Arab world, although programmes such as the UNDP's HARPAS are attempting to raise awareness about it. While some bloggers in the region report encountering ignorance about HIV/AIDS, others are impressed at the progress being made in destigmatising the disease.
Duncan is a Peace Corps volunteer working on a water infrastructure project in Morocco, and he has written some personal reflections on attitudes towards HIV/AIDS in the rural area he is working in. He believes, while the prevalence of HIV in Morocco is low among the general population, HIV/AIDS could prove to be a great public health risk to the country as a whole:
There are a number of factors that make the country vulnerable to the disease becoming wide spread.
First is ignorance about the disease. Speaking generally, people don’t know what it is. If people have heard of it they know no specifics and what they know might very well be wrong. They don’t know how it is transmitted. People say that the disease is transmitted by sharing toothbrushes, going to the hammam (public bath), and by being breathed on. I’ve never heard someone say that sex is a mode of transmission for the disease.
Second is that cultural boundaries that discourage honest discussion of the topic. This is a very religious society where appearing pure is very important to fitting into one’s community. So this makes it difficult to bring up such important issues as condom use.
Third (seemingly contradicting the previous issue) is the prevalence of prostitution in the country. This is particularly the case for my province, Khenifra, which is known for its prostitution. I’ve heard that the province has three of the four biggest prostitutions towns in the country. One of these centers is very close to me and I know that men from my village visit prostitutes there. They’ve told me. Compounding this problem is the fact that many of the sex workers in these prostitution centers come from out of town. I believe these places could easily become spreading points for the disease.
In sum, it’s a topic that people are ashamed to talk about and no one knows anything about.
Read more about Moroccan attitudes to HIV/AIDS in this post.
Last year Bahraini blogger Suad attended a workshop in Cairo to raise awareness about AIDS, and she later wrote the story of Aisha, a Sudanese woman who contracted the virus through a blood transfusion. Aisha describes the process of falling ill, and how she finally discovered what was happening:
بعدها أخذني زوجي لطبيب آخر فتح الظرف امامي وقال لي بأني مصابة بالإيدز، صعقت ولم أملك حينها سوى ان أبكي من هول الصدمة، انا مصابة بالإيدز؟؟ منذ متى وكيف؟ فرد الطبيب: اسألى نفسك، تذكري ماذا ارتكبتي بحق نفسك لتنقلى اليك هذا المرض القاتل. هكذا ببساطة وصمني الطبيب بالمومس دون ان يعرف اي شئ عني. قلت له أنا امرأة متزوجة وليست لدي أى علاقات غير شرعية خارج اطار الزواج وهنا دخلت أمي وزوجي إلى غرفة الطبيب الذي صب جام غضبه على زوجي متهما اياه بنقل المرض لي. شعرت بالغضب الشديد من زوجي فبدأت أهاجمه وأوبخه وانا ابكي، حاول ان يدافع عن نفسه ولكني لم أكن أرغب في سماعه وكانت أمي تحضنني في هذه الاثناء. منذ ذلك اليوم ساءت علاقتي وعلاقة أهلي بزوجي الذي وجُهت اليه اصابع الاتهام حتى ظهرت نتائج الفحص التي بينت ان زوجي وأولادي خاليين من المرض. أعتذرت من زوجي وأدركت حينها ان المرض قد أنتقل لي عن طريق الدم الذي نقل لي في المستشفى.
Then my husband took me to another doctor, who opened the envelope in front of me and told me that I had AIDS. I was stunned, and didn't have time even to cry from the terrible shock. I'm infected with AIDS?? Since when, and how? The doctor replied, “Ask yourself. Do you remember what you have been doing that this deadly disease was transmitted to you?” In this way the doctor simply marked me as a prostitute without knowing anything about me. I told him that I was a married woman, and had never had any illicit relations outside marriage. At that point my mother and my husband came into the doctor's room, and the doctor directed his anger at my husband, accusing him of giving me the disease. I felt really angry with my husband, and began to attack and rebuke him while crying. He tried to defend himself, but I didn't want to listen to him. In the meantime my mother was hugging me. From that day, my relations and those of my family with my husband soured; fingers of accusation were pointed at him until the results of the tests came, showing that my husband and children were free of the disease. I apologised to my husband, and then realised that the disease had been transmitted to me by way of blood given to me in the hospital.
Even if Yemen is much more ahead of its Arab neighbors in tackling HIV/AIDS, it's still a long way from making facilities and medication easily available and accessible to those afflicted. HIV/AIDS testing facilities are available in all major medical centers and labs. But, it's when one has tested positive that the problem starts; it then becomes extremely difficult for the afflicted. At the moment, HIV/AIDS infected people have to travel and go all the way to Sana'a, Yemen's capital city, for them to have their CD4 cell count and viral load tested; it's only by having these tests, that a patient can be properly treated and medicines can be suitably prescribed. [...] For HIV/AIDS medication too, patients have to travel, regularly (every 3 or so months) to Sana'a to receive the medicines; they are not available in other Yemeni medical centers or pharmacies. One can only imagine how difficult and exhausting this can be for the already mentally strained, HIV/AIDS afflicted person and the people around him. It costs much money traveling all the way to Sana'a; and food and accommodation cost even much more. [...] And though, compared to two or so years ago, many people now are aware of HIV/AIDS – most simply don't understand the disease; and some people still consider it disgraceful and shameful for one to be afflicted by HIV/AIDS.
However, it seems that steps are being made to destigmatise the disease in some countries in the region. The Egypt Guy recently had his first HIV test at a government lab:
To my amazement, the way I was received by the doctors prior to the actual testing was pretty welcoming. I found that they didn't ask for a name, but rather for a pseudonym and a birthdate to be my identity there. Then, I was sent to a counselor whose job was to give simple information about AIDS and HIV. The guy didn't show any signs of disrespect for the fact that I'm going to check if I have HIV, which was astonishing. I heard that until very recently AIDS was seen as such a taboo even by doctors. And after the counseling session they gave me a few condoms and lubricants, and three booklets with information about AIDS, and then I went to have the test. I'll go get the results next Sunday, hopefully it'll be negative, wish me luck!! :-)
Oh, I also didn't pay a penny for any of that.
It was a very nice experience that I didn't expect to have at a government lab, and I'm happy my country is having a more liberal approach to sexually transmitted diseases and is actually propagating against the whole stigma that's associated with them, especially HIV and AIDS.
You can read about an initiative by Egyptian bloggers to destigmatise HIV/AIDS here.