AIDS and the revolution

Although I have written about HIV/AIDS in Egypt before, and despite the general attitude of avoiding this heavy subject, there's always a need to address it and discuss the situation of HIV/AIDS in the new context of Egypt.

January 25th revolution was basically about dignity and freedom. People revolted because they felt they're living under a police state that violated and humiliated citizens. I thought at some point after the revolution we would be facing the social challenges, but we found ourselves facing another form of dictatorship by the now ruling military. It's a difficult battle but hopefully it's the state of revolt will linger on and we achieve our demands.

Unfortunately, on the front of HIV/AIDS, there were negative developments. Last July, the ministry of health decided to stop the operation of a big a project by a coalition of civil society organizations working to raise awareness about HIV/AIDS and particularly the stigma around this disease which is the main obstacle to making achievements in this regard. This step came shortly after a big press conference by this coalition of organizations where reports and facts regarding HIV in Egypt were presented and discussed The press conference also witnessed the first "coming out" of a person living with HIV in front of media cameras without hiding his face.

You may be wondering why the ministry of health took this backward decision. The general sense is that it's because this coalition of NGOs were raising the issue, spreading the word, and empowering the voices of people living with HIV. This probably made the ministry unhappy and they wanted to tighten their control of media information and the general situation of AIDS in Egypt.

In a recent interview on HIV/AIDS, I spoke of stigma especially from health service providers (the ones who should be best equipped to deal with people living with HIV).

It's a very grim reality that even healthcare providers exercise the worst forms of discrimination against people living with HIV/AIDS. Yes, the disease is linked to certain misconceptions about sexual behavior. Whenever we organize events to raise awareness on HIV, I ask participants about what transmits the virus. The most common answer is illegitimate sex! Unfortunately the amount of disinformation/lack of awareness is huge.

Sadly people continue judging to judge others based on assumptions.  Some people like to play God's role and punish others for their certain behaviors!

A recent report entitled Combating HIV/AIDS Related Stigma In Egypt available in Arabic and English  tells of the situation for people living with HIV/AIDS in Egypt and their grievances. The number of people living with HIV in Egypt is estimated to be 11,000 people. Some other estimates say that the number must be much more in reality. The stigma around the disease causes fear and mistrust, so people don't end up getting proper info or receiving already available services such as testing and counseling.

As the report shows, stigma and discrimination is rife in different sectors. It comes from healthcare providers, the government, the media, the workplace, religious leaders, and sadly family and friends. Each of those sectors exercise their stigma turning the lives of people living with HIV/AIDS into living hell. 

For me, HIV/AIDS is not just a health problem. It's a multifaceted societal problem where stigma and discrimination are key obstacles. We all have to speak up against the stigma, break the taboo, grant people's dignity no matter who they are; that's perfectly in line with the values of our revolution.

The Price of Stigma

When it comes to discussing HIV/AIDS in Egypt, most probably you’d be faced by either one of two reactions: one that is characterized by fear, shock, and discomfort or a reaction marked by denial and disdain. I would like to discuss why.

AIDS has come to be associated with sex and death, and both topics are hard to digest in our culture. We avoid discussing sexuality-related issues in our adolescence within the family and formal education. Comprehensive sexuality education is nearly absent and only limited information are given through curriculums and has been further abridged recently. Little awareness exists of HIV, its modes of transmission, prevention, and treatment. No wonder then that most people experience feelings of discomfort and fear. However, we need to listen and understand attentively because ignorance breeds fear and fear breeds hate!

Clearly, the biggest obstacle to HIV awareness work is the stigma against people living with HIV. People living with HIV have to suffer in silence, shameful to seek help or treatment and if it was revealed that they are HIV+, they’re shunned, mistreated by their community, workplace, and even their close and loved ones. This life of isolation is the killer in the case of HIV, rather than the disease itself.

The stigma is even greater when it is coupled with being a member of Most At Risk Populations (MARPs). These are groups of people who more frequently engage in behaviors that lead to HIV transmission.  These behaviors include unprotected sex, sex with multiple partners, and using the same injecting equipment. Such populations include men who have sex with men, female sex workers and their clients, and injecting drug users.

A comprehensive survey of Egyptian youth revealed that only 21% of them would be willing to interact with a person living with HIV, which is definitely disturbing. We all need to realize that stigmatizing those groups leads to higher spread of the virus into the community, by denying those people access to health and awareness services, and not allowing them to get the care and compassion they need. We need to face this, because we might have a low number of people living with HIV in Egypt, but the risk is even greater with this level of ignorance and stigma, plus we are not gods to judge their behaviors.  

The second reaction of denial and scorn comes from the view that HIV is a Western problem and that our moral society and religiosity is enough to keep us away from it; they see that maintaining our ‘cultural norms’ is the solution to HIV, and all other problems perhaps! A mere reality check negates this view.

However, some others question the amount of funding and prioritization given to HIV aid at the expense of improving overall health systems, which may be a valid concern. However, HIV remains a global issue that affect the life of millions. It demands nothing less than our diligent, tolerant attention.