Is HIV an Issue for Us?

In Egypt, a campaign against the spread of HIV has gotten underway. Condoms are now readily available, but conservative morality still keeps doctors and religious leaders from advocating safer sex too openly. By Christina Bergmann

At "On the Run", a restaurant on the Cairo bypass, popular with young upper-class Egyptians, condoms are available at the cash register. And in the modern-design drugstores in the shopping malls where many Egyptian young people hang out, entire shelves are filled by the "tops", offered in all shapes and colours.

Egypt has produced condoms for some time, but until now they could only be obtained on request from behind the drugstore counter. They were regarded at most as a birth-control method for married couples.

The open presentation illustrates a certain shift in thinking, at least at Egypt's Ministry of Health and at the NGOs which address the spread of AIDS in Egypt.

"Safer sex is still not being promoted out loud, but the improved availability of condoms basically aims at the same thing," says Ashraf Azer in Cairo. He is a director of the UN High Commission for Refugees (UNHCR), which is participating in the Egyptian campaign.

The illusory protection of religion

At this time the UNHCR is helping to organize the campaign. The largest such campaign against the fatal virus to date, it has been operating not only in Cairo, but also in Alexandria and the Upper Egyptian cities of Minya and Assiut. One great success was an anti-AIDS concert in Azhar Park near Cairo's Old Town, attended by a surprising number of young people and families.

Of course they had come to hear the popular singers Simone and Khalid Selim, but they also listened with interest to the educational presentations between the songs. Two short films showed how AIDS can be contracted and which forms of contact with AIDS victims are safe.

"Egyptians, including young people, are not aware about the danger of infection," says Azer. Polls of students, both at state universities and at the exclusive American University Cairo, confirm Azer's assessment. "Only prostitutes and homosexuals are at risk, and fortunately we don't have them in Egypt," says Mohammed.

Protected by morals

"Is AIDS really an issue for us?" Rana the reporter asks provocatively, and adds: "Islam and our morality protect us from this terrible disease." "Public toilets are risky. And you should never shake an AIDS victim's hand," explains Mariam.

The dilemma is that in Egypt the key risk factors for AIDS, i.e. extra- and pre-marital sex, drug use and homosexuality, are taboo topics, as Azer sums up the problem. Thus it is almost impossible to explicitly advise someone to use a condom if he ever is unfaithful. By contrast, the rigorous monitoring of blood donations has had a positive effect.

Just a few years ago 24 percent of infections occurred in hospitals. Thanks to improved hygiene, says Azer, this problem has practically been solved.

Many new infections

As shown by a recent conference of regional religious leaders on the subject of AIDS, the moral argumentation is changing as well. Earlier the priests and sheikhs simply promoted "abstinence and fidelity" and AIDS was regarded as divine punishment for aberrant behaviour; now, however, more and more religious leaders seem to be speaking out for combating the epidemic and advocating sympathy for its victims.

This reflects a general shift in attitude, says the speaker of the UN's AIDS program (UNAIDS) in Egypt, Nasr Sayyed. Today most HIV patients are not shunned by their families, as they once were, but are taken care of at home.

Arab region least affected

The religious establishment's great interest in AIDS is a result of the disturbing statistics which have been circulating in Egypt since December, Sayyed goes on to say. The Arab countries are the region of the world least affected by AIDS, but the number of new infections along the Nile has increased by 28 percent in the last two years.

Egypt's Ministry of Health estimates the number of infected Egyptians to be 1500; according to the estimates of UNAIDS, however, there are 8,000 AIDS cases in Egypt's population of 74 million.

In comparison with sub-Saharan Africa this is still a very low number, Sayyed explains. But Egypt definitely has the potential to become more severely affected.

Risks are posed not only by the lack of education, but also by Egyptians' sexual activity. Although they assert the contrary, pre- and extramarital sex, homosexuality and prostitution are widespread.

Other sources of risk are the increase in tourism and the flood of refugees from sub-Saharan Africa, where the average rate of infection is 25 times higher than in the Arab world.

Christina Bergmann

Translation from German: Isabel Cole

This article was previously published by the Swiss daily 'Neue Zürcher Zeitung'.