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Iran: Tehran Begins To Confront The 'Time Bomb' Of HIV/AIDS

The number of people with HIV/AIDS in Iran has risen in recent years, and Iranian officials describe the disease as a "time bomb." Officially, Iran identifies about 5,000 people infected with HIV/AIDS. However, some experts and officials put the actual number at 20,000. Drug addicts are said to make up about 70 percent of AIDS patients in Iran. And experts warn that with the country's fast-growing population of drug addicts, the deadly virus could spread even further.

Prague, 10 November 2003 (RFE/RL) -- The first official case of AIDS in Iran was identified in 1987 in a 6-year-old boy who contracted it from HIV-contaminated blood brought in from abroad. So far, about 700 people are believed to have died from AIDS in Iran.

AIDS figures in Iran are still low by international standards, but officials and experts say the number of people infected with HIV/AIDS is increasing.

Today, Iran has identified about 5,000 people, mostly prison inmates, who are infected with HIV, the virus that causes AIDS. But health officials say the real number of Iranians who are HIV-positive is much higher.

Dr. Mohammad Mehdi Gouya is head of the disease-management department of the Iranian Health Ministry. In an interview with Radio Farda correspondent Farin Assemi, he estimated the real number of HIV-positive people in the country could be up to five times higher.

"The [patients on the] official registries have undergone three tests, after which we declare them as being infected. There is a big gap between the registered statistics and the estimated ones. [Sexually transmitted diseases] are considered hidden diseases because no one admits to their deeds. Hence, the estimated statistics are important. We estimate that in Iran, there are between 23,000 to 25,000 cases of people infected with HIV," Gouya said.

Some experts even estimate that up to 40,000 people may be HIV-positive in Iran.

Officials say the majority of those Iranians infected with HIV are drug addicts. Iran is a major transit route for drugs being trafficked from neighboring Afghanistan to Europe. According to official figures, up to 70 percent of HIV-positive people in Iran have used infected needles.

There are believed to be more than 2 million drug addicts in Iran, of which 300,000 are intravenous drug users. Iranian health officials estimate that only about 12 percent of those infected acquired HIV through sexual contact.

Along with his brother, Dr. Arash Alaei established the first counseling and care center for HIV-positive patients in Iran a few years ago, in the city of Kermanshah in western Iran. Alaei was recognized by the World Health Organization for his HIV/AIDS work and is credited with helping Iran become more open in addressing HIV/AIDS problems.

Alaei believes the spread of HIV through sexual contact will become a more serious problem in Iran. "We should not neglect this issue. For example, a drug addict who spent some time in jail and became infected after using a common dirty needle could have sex after being released," he said. "Therefore, I anticipate that, in the future, AIDS transmission through sexual contact will increase."

Officials in the country have only recently begun to openly speak about AIDS, however. Alaei says many doctors in Iran are still not comfortable treating AIDS patients. "As a doctor, I would suggest to you that among my colleagues in the health system, as in a segment of society, there is fear about AIDS," he said. "There is fear about treating an infected patient. For example, we had a case who had a broken arm and while being transferred to the operation room for surgical treatment, the operation was canceled because [it was learned] he was infected with AIDS."

Alaei says the attitudes of such doctors are also shared by much of the general public. "In the other classes of society, AIDS awareness is also still limited. There is fear and maybe they consider it as a social stigma," he said.

In a new effort to limit the spread of the disease, Iran's Health Ministry is urging health workers not to turn away patients who are HIV-positive and to give them proper treatment.

Dr. Gouya of the Health Ministry says more AIDS counseling centers have been created across the country. "It is imperative that health centers and clinics across the country make it easier for those who acted recklessly to come forward and receive proper counseling and even undergo tests, if necessary," he said. "This can now be done in medical universities across the country."

Alaei says that, in his center, HIV-positive patients are treated anonymously. "We don't probe into the background of those who have been infected. We don't ask their names or their addresses," he said. "Our only goal is to help people who are facing addiction, people who have sexually transmitted diseases or who are infected with AIDS."

Health officials liken AIDS in Iran to a "time bomb." A Health Ministry official says 400 people are diagnosed as HIV-positive every three months. Alaei says that if a serious awareness campaign is not launched, the spread of AIDS will be disastrous for the country.

"If we neglect raising awareness among people and among the youth, and if we don't accept infected people and don't confront the stigma, then in the future it will turn into an uncontrollable human and health disaster with economic, social and health losses," Alaei said.

Iran's Education Ministry announced recently that information on sexually transmitted diseases, including HIV/AIDS, will be included in school textbooks.
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    Golnaz Esfandiari

    Golnaz Esfandiari is managing editor of RFE/RL's Radio Farda, which breaks through government censorship to deliver accurate news and provide a platform for informed discussion and debate to audiences in Iran. She has reported from Afghanistan and Haiti and is one of the authors of The Farda Briefing newsletter. Her work has been cited by The New Yorker, The New York Times, The Washington Post, and other major publications. Born and raised in Tehran, she is fluent in Persian, French, English, and Czech.