Officials look to Iran for help on AIDS
(Liverpool, England) Health experts are holding up a perhaps unlikely country as a model for fighting AIDS in drug users: Iran.
Experts at an international AIDS conference this week are studying how the hardline Islamic republic’s methadone clinics and needle exchange programs may be a model for other countries, including some in the West.
Being right next to Afghanistan’s opium fields, Iran has long struggled with large numbers of drug addicts.
When AIDS arrived in Iran, the virus first hit the country’s heroin users. To curb the outbreak and prevent it from spilling into the general population, Iranian leaders adopted an approach that appeared surprisingly progressive for an authoritarian regime.
“It might be seen as socially liberal, but from a public health point of view, it’s just pragmatic,” said Joumana Hermez, an AIDS expert at the World Health Organization’s office in Cairo. On Tuesday, Hermez and other officials were addressing how the Middle East has responded to the disease at the International Harm Reduction Association’s 2010 conference in Liverpool.
For years, Iran had a hard-line drug policy, and it still executes people for certain drug trafficking crimes.
Experts say attitudes began to shift about a decade ago when doctors and academics managed to convince religious and governmental authorities that unless they helped drug users kick the habit, Iran would face a much bigger AIDS epidemic.
“They began to understand it was better to have a (drug) addiction problem than an addiction problem with HIV,” said Dr. Seyed Ramin Radfar, an executive manager at an Iranian non-governmental organization that runs methadone clinics and needle exchange projects throughout the country.
Religious leaders issued fatwas declaring that drug users shouldn’t be prosecuted if they sought help. In 2005, Iran’s top judge decreed initiatives to combat the spread of AIDS were aimed at protecting society and should not be blocked.
That led to a change in how addicts were treated. “If drug users agreed to accept treatment, then they could be viewed as patients, not criminals,” said Radfar.
Methadone clinics to help wean addicts off heroin and provide clean needles first started in Iranian prisons where drug abuse is rampant. The clinics only popped up in regular communities when authorities realized released prisoners had nowhere to continue their treatment. The government has since set up more than 200 methadone clinics and there are more than 1,000 private clinics.
Even in countries like Australia, Canada and the U.S., it is hard for prisoners to get methadone or clean needles. Until recently, the U.S. refused to fund needle exchange programs – in which addicts get clean needles in exchange for used ones – as part of foreign aid.
“Iran is absolutely a model for the world in certain respects,” said Susie McLean, a senior adviser in HIV and drug abuse at the International AIDS Alliance. “No one ever would have thought they would make delivering services to junkies a priority.”
Still, McLean said the country is far from perfect and the initiatives still need to be rolled out on a much bigger scale.
There are also occasional problems with the methadone supply and services across the country can be patchy.
Though officials are still conducting surveys to find out how many people are infected with HIV in Iran, they say the country’s policies have probably made a dent in the virus’ transmission. Still, the number of people infected is growing and in 2008, the health ministry estimated there were from 70,000 to 100,000 people with HIV in Iran.
With more cases now being picked up beyond drug users, experts say it is time for Iran to fight the virus in other vulnerable groups: gay men and prostitutes. So far, Iran has made no attempt to protect them, and homosexuality, adultery and prostitution remain illegal. Condoms are distributed in prison, but only for conjugal visits. President Mahmoud Ahmadinejad once declared there were no gay people in the country, and there are no AIDS initiatives aimed at gay men or sex workers.
If Iran is to stop AIDS, that may be the next frontier.
“There are a lot of contradictory things happening in Iran, but they seem to get around it for controlling HIV,” said Gerry Stimson, executive director of the International Harm Reduction Association.
Stimson has visited a methadone clinic inside an Iranian prison close to Tehran. He was impressed with the prison’s cleanliness, Iranian carpets and free condoms, but admitted he was probably shown the facility’s best parts.
“They have made some good progress on things we never would have expected,” Stimson said. “But I still wouldn’t want to be inside an Iranian prison.”
Researchers: Zimbabwe’s crisis driving HIV decline
(Cape Town, South Africa) Fewer Zimbabweans are getting infected with AIDS, and researchers speculate it’s due in part to a battered economy that’s leaving men short of money to be sugar daddies and keep mistresses.
Presenting a study of the infection rate among pregnant women at a major international AIDS conference …
SENEGAL: Jailing of gay activists sets back AIDS fight
The men, who were involved in providing HIV prevention, care and treatment services to Senegal’s lesbian, gay, bisexual and transgender (LGBT) community, have been sentenced to eight years in prison.
Homosexuality is punishable by up to five years in prison, according to the Senegalese penal code. In this case, the judge added three years for criminal conspiracy.
In a statement released last week, the International AIDS Society, which promotes new HIV research and best practice and is the custodian of the International AIDS Conference, and the Society for AIDS in Africa (SAA), which works to slow the spread of HIV, said criminalising and discriminating against any group of individuals only served to fuel the HIV epidemic by denying services and relevant prevention messages.
“The arrest of these men, based purely on their sexual orientation represents a major setback for the Senegalese response to HIV, which is widely viewed as a model in Africa,” said Joanna Mangueira, President of the SAA.
Cheikh Niang, professor of anthropology at Cheikh Anta Diop University in Dakar, the Senegalese capital, and author of studies on AIDS and sexuality in the country, agreed that jailing the activists was “counterproductive”.
“The severity of the sentence has created an atmosphere of panic amongst the associations that are working on HIV prevention and treatment with men who have sex with men (MSM),” he told IRIN/PlusNews.
Michel Bourelly of AIDES, an international organisation working with men who have sex with men in Senegal, said gay activists had gone into hiding or fled the country since the judgement. “Everything has stopped. The associations that provide HIV/AIDS services for homosexuals and MSM are too scared to work.”
Contradictions
According to Bourelly, the men were arrested while attending a meeting on HIV prevention. Brochures, condoms and model penises were confiscated as pornographic material.
“The condoms that were considered pornographic material during the trial were provided by the Senegalese government,” he pointed out.
A young gay member of an HIV/AIDS organisation serving MSM in Senegal, who did not want to be named, confirmed that intolerance of homosexuality had risen.
“Physical violence is more common now. Before we had groups which helped us – they gave us the courage to meet. We would do work on prevention, but now it’s too dangerous,” he said.
The jailed men were detained just two weeks after Senegal hosted the International Conference on AIDS and STIs in Africa (ICASA), where speakers emphasised the importance of addressing the needs of sexual minorities in African AIDS programming. Over 50 gay activists attended.
In an interview with IRIN/PlusNews in November 2008, Souleymane Mboup, President of ICASA, said MSM were a reality in Africa that could not be ignored.
“This is a question that we cannot run away from if we want to advance [the fight against HIV],” he said. “Many countries, including Senegal, must open their eyes and learn. We must think about which strategies to adopt.”
In 2007 the Global Fund to Fight AIDS, Tuberculosis and Malaria granted Senegal US$32 million to strengthen its HIV/AIDS response. Part of the grant was earmarked for targeting “vulnerable groups”, including MSM, with prevention campaigns, condoms and MSM-friendly clinics over the next five years.
“Senegal has been given considerable sums of money to address the needs of MSM in its national AIDS programme,” said Bourelly. “But now they are jailing the people they are supposed to be targeting.”
No one from the National AIDS Committee, one of the two principal recipients of the Global Fund grant, was available for comment. Abdoulaye Wade, director of the AIDS division at the Ministry of Health, told IRIN/PlusNews that the government continued to provide HIV/AIDS prevention and treatment services for MSM, but did not elaborate on what those services were.
Regressive
Joel Nana, advocacy director at the South African office of the International Gay and Lesbian Human Rights Commission (IGLHRC), said Senegal had been praised for its progressive and inclusive HIV/AIDS programmes in the past.
“Senegal was the first country in Africa to address MSM in HIV programming, so this [judgment] is really a step backwards,” he told IRIN/PlusNews.
While Senegal has maintained a low HIV prevalence of about one percent in the general population, official data and studies conducted at Cheikh Anta Diop University suggest that about 21.5 percent of MSM were HIV positive in 2005. The studies also found that over 80 percent of MSM had female as well as male partners.
“It is a considerable error to think that this is just a homosexual problem,” said Bourelly. “Most MSM have had, or continue to have, sex with women, so the impact of effectively shutting down MSM programmes will be considerable on the general population.”
Human rights groups and AIDS organisations are calling for the immediate release of the nine imprisoned men, and for a change in Senegal’s penal code. Niang agreed that it was time to debate the merits of the law.
“There is no point in saying that men who have sex with men do not exist in our societies,” he said. “It exists and it is an ancient phenomenon. By ignoring its existence we will not respond appropriately [to the HIV epidemic].”
| Published by |
 |
Original source : http://gay_blog.blogspot.com/2009/01/senegal-jaili…
