Workers at a health clinic in Jordan panicked when a doctor discovered a woman she was treating for an inflammation was HIV-positive.
“They removed the bed sheet and threw it in the trash can, as well as her instruments. Of course everything was drawing attention to me, and ultimately they rejected me,” the woman said.
A Yemeni was shunned when she first learned she was infected. “My family told me not to sleep or sit by the side of my daughter. They took her from me,” she said.
In Egypt, a woman said: “My husband forced me to have sex, raped me many times. I got sick, and he confessed that he is infected with the virus and that he infected me on purpose.”
These stories are narrated in a UNAIDS study on women living with HIV in the Middle East and North Africa (MENA), which was released this month and presented at the week-long AIDS2012 conference that began here in Washington, D.C., on Sunday.
Women make up about 40 percent of the 470,000 people infected with the disease in the region, and they are at the forefront of the suffering due to their lack of economic power, social isolation and the stigma surrounding the disease, according to the report, “Standing up, Speaking Out”.
Currently, the HIV/AIDS infection rate in MENA countries is low at 0.2 percent of the population. But it is one of only two regions world wide where infection rates are on the rise, says UNAIDS. The other is Eastern Europe and Central Asia. Without education and training, HIV easily could spread from concentrated pockets among sex workers, people using drugs and men having sex with men, it said.
MENA REGION WOMEN ESPECIALLY VULNERABLE
A confluence of factors make women in the MENA region especially vulnerable, said Shereen el-Feki of the Global Commission on HIV and the Law. A conservative cultural and religious environment creates taboos around discussing prostitution, drug use and homosexuality, the main vectors through which HIV is brought into the home.
Women are often socially isolated, unaware that their husband is infected, ignorant of the symptoms and then often reviled by the medical community that diagnoses them.
Education about sexually transmitted disease is very limited, not only in schools but also within the medical community. A doctor from Jordan told a workshop HIV that one in four doctors during his training said they would not treat someone with HIV.
Rita Wahab, coordinator for a women’s outreach group MENA Rosa, said that in Tunisia, a health-care worker told one woman at a clinic: “The doctor tells me you have HIV. That means you are not a good person.”
The Arab Spring presents new openings for expanding education and awareness campaigns, said El-Feki. But governments in transition also present new challenges.
In Egypt, for example, some women’s rights have been rolled back and non-governmental organizations have lost funding or been ejected. The rise in societal violence even as state-led violence has declined alters the security issues facing women, drug users and homosexuals, said Wessam El Beih, UNAIDS country officer in Egypt.
“The sheer confusion in government makes things very difficult,” she said. “If you need anti-retroviral drugs, who do you contact in government? Who is the minister of health this month? We have had four already.”
Young people adept at using social media are gaining access to information about HIV from the Internet. In the Lebanon, for instance, knowledge about the disease is high but misinformation and social stigma remains equally high, said Wahab. “They still think you can get HIV from mosquitoes and toilet seats,” she said.
Combating the rise in HIV infections requires no different steps from those taken anywhere else in the world – education, training and treatment programs, said Wahab from MENA Rosa. The challenge lies in surmounting the cultural taboos and breaking the silence to reach women.
El Beih agreed. “We don’t want to get to the point where HIV is an epidemic because of the stigma.”