Middle East / North Africa and the Millennium Development Goals ...

Middle East / North Africa and the Millennium Development Goals
fear, indeed do not dare, to take an HIV/Aids test. They are reluctant to
look up a doctor for fear that they may find themselves publicly labeled
and marginalized.
In fact, HIV/Aids is far more widespread than average among drug addicts
and prostitutes – while the figures for homosexuals are only slightly above
average. In Morocco, where only 0.2 % of all adult men and less than
0.1 % of all women are infected, the rates for prostitutes and prison inmates
are 2.3 % and 0.8 %, respectively. In Libya 90 % of all newly infected
persons are drug addicts. In Iran 4 % of all drug addicts are infected.
On the other hand, no more than 1 % of all homosexuals appear to
be infected in any country of the region – with the possible exception of
Sudan (UNAIDS / WHO 2004, 67).
Thus far most infections have resulted from the use of contaminated syringes.
The government of Iran has evidently recognized this fact and has
authorized all of the country’s pharmacies to dispense sterile syringes and
needles free of charge. Libya on the other hand restricted their sale in the
late 1990s, and this has led to a sharp rise in the use of contaminated syringes.
In the neighboring country of Tunisia, where every infected person,
regardless of nationality, is eligible for free retroviral treatment, has subsequently
noted a rapid increase in the number of persons infected with
HIV (ibid.).
There is, however, reason to fear that the region will, in the coming years,
be faced with a surge of new cases that are transmitted mainly through
sexual contacts. A second wave of infections would mean increased risks
chiefly for prostitutes, but also for the spouses of infected persons. In Iran
50 % of all drug addicts are married and 30 % have occasional extramarital
sexual intercourse.
Even today the number of persons infecting themselves through unprotected
heterosexual intercourse is on the rise. The reason for this is that the
topic of Aids continues to be taboo in the MENA countries and for this
reason far too few people take appropriate preventive measures. In one of
Sudan’s southern provinces (Rumbek), where HIV/Aids is especially
widespread, a survey found that not even 2 % of those who engage in occasional
sexual intercourse with different partners used a condom. Only
20 % even knew what a condom is and what it is used for. Even in the
Egyptian capital Cairo only one third of sexually active persons have ever
German Development Institute 77