Despite its close proximity to AIDS striken Africa, AIDS has been relatively slow to arrive in the Middle East. It has been speculated upon that strict religious and societal taboos against extramarital sex, homosexuality and drug use are at the root of the prevention efforts. Only 208 AIDS cases had been reported by 1989 throughout the Arab world, including countries such as the Sudan, Djibouti and Somalia, which straddle the Sahara. But the cumulative total grew to 1,082 last year.

Reported AIDS cases as of 1991 in the Arab world:

Sudan: 476 Tunisia: 105 Djibouti: 104 Morocco: 98 Algeria: 92 Saudi Arabia: 35 Egypt: 34 Qatar: 31 Lebanon: 29 Oman: 24 Jordan: 13 Somalia: 13 Syria: 11 United Arab Emirates: 8 Iraq: 7 Kuwait: 1 Libya: 1 Bahrain: 0 Yemen: 0 TOTAL: 1,082

In Saudi Arabia, one adult and one child developed AIDS 2.5 and 3.5 years after a blood transfusion of 11 units from a commercial distributor in the United States. Since an undetermined number of Saudi patients have received imported blood from the United States, there is possiblity that and AIDS outbreak may be a serious problem. It has been suggested that measures such as limiting the importation of blood from high incidence countries should be taken to prevent the spread of AIDS.

The prevalent public message regarding AIDS is that the disease comes in the shape of a foreigner and Allah is the best means for fighting the disease. At a recent viral disease symposium in Riyadh, two King Saud University doctors suggested that Saudi Arabia should use stiff punishment against homosexuals, prohibit extra-marital sex, screen blood donors, and widely test for AIDS antibodies. The common prevention plea in the Middle East has been in the use of a "morale vaccine." The country punishes homosexuals with flogging for a first offense and decapitation for a second offense. Foreigners must take an antibody test to work in the country. Religious groups have been opposed to widespread testing saying that such a technique would assume that Saudis have had premarital and/or extra-marital sex.

The assumptions may be partly to blame for an AIDS caseload in the Arab world that has more than quintupled in the last two years. The disease that feeds on the promiscuity and drug abuse so rampant in the West is settling into the Muslim societies of the Middle East, where it remains a disease of fear and, worse, of shame. Several Arab countries for some time refused even to report their AIDS cases to international authorities, and underreporting, or misreporting, is still thought to be widespread.

Arabnet: page which gives info on the need for an HIV test
Saudi Arabia's WWW Sites

Prevention and Education:

The obstacles in prevention and education efforts are enormous in a nation where homosexuality is not supposed to exist along with non-marital sex. A main difficulty is in safe sex efforts when the sheiks of Islamic institutions believe that the principles of the Koran are enough to protect people. There has been an on-going battle at the Egyptian Health Ministry for permission even to talk about condoms. One television service announcement is now allowed to mention the word. The commercial shows a verse from the Koran prohibiting illicit sex, then cuts to a drawing of the globe. "Abroad, people use condoms to prevent AIDS," the narrator says. "But our youth, if they maintain their religious principles and morals, will not suffer any danger."

Mohammed Wahdan, who heads the World Health Organization's regional AIDS program in Alexandria, Egypt admits that sociocultural religious patterns in particular have worked against the rapid spread. There is, however, an increasing realization that the region can no longer isolate themselves from the disease. WHO estimates that 70% of new cases in the Arab world are sexually transmitted, more than half through heterosexual contact. "The idea that it's all coming from outside is going to change now," says the Egyptian Health Ministry's Sayed. "AIDS is no longer an imported disease."

GULF-HEALTH: Partnerships Across Borders Against HIV/AIDS

Treatment and Healing:

Treatment for AIDS depends on where you are. Basically only the oil-rich Persian Gulf states offer costly drugs such as AZT. Most of the other countries of the region treat only AIDS-related complications such as tuberculosis. "In Middle Eastern countries, you have to keep everything at a very low tone. Everything happens, but you have to be very sensitive to other people's sensibilities," said an Arab physician who works for an international relief organization. "If somebody here is stamped as having contracted AIDS through illicit sex, they'll be goners. Society will never support them, and they need all the support they can get."

There has been increasing attention being paid to the level of awareness Saudi physicians have regarding the epidemiology and treatment of HIV/AIDS. Studies have revealed significant gaps in physician knowledge regarding AIDS. There is much concern that erroneous information will be conveyed to the public. Glove wearing and needlestick injuries of health care personnel have drawn attention yet far.

Horizontal versus vertical transmission of human immunodeficiency virus type 1 (HIV-1)
Occupation risk of needlestick injuries among health care personnel in SaudiArabia
Continuing medical education needs regarding AIDS
Knowledge and attitudes towards AIDS among primary health care physicians
Response of dental professionals
Hepatitis b delta HIV-1 HTLV-1 serologic profile

Community Based Organizations:

GULF-HEALTH: Partnerships Across Borders Against HIV/AIDS