Lebanon: Situation of persons with AIDS; whether they are targeted or face discrimination; possible recourse available to them; the risk of their becoming victims of honour killings for having relations with girls
| Publisher | Canada: Immigration and Refugee Board of Canada |
| Author | Research Directorate, Immigration and Refugee Board, Canada |
| Publication Date | 26 April 2004 |
| Citation / Document Symbol | LBN42540.FE |
| Reference | 1 |
| Cite as | Canada: Immigration and Refugee Board of Canada, Lebanon: Situation of persons with AIDS; whether they are targeted or face discrimination; possible recourse available to them; the risk of their becoming victims of honour killings for having relations with girls, 26 April 2004, LBN42540.FE, available at: https://www.refworld.org/docid/41501c2b15.html [accessed 1 June 2023] |
| Disclaimer | This is not a UNHCR publication. UNHCR is not responsible for, nor does it necessarily endorse, its content. Any views expressed are solely those of the author or publisher and do not necessarily reflect those of UNHCR, the United Nations or its Member States. |
Government initiatives against HIV and AIDS
The first case of HIV/AIDS in Lebanon was reported in 1984 (Kaiser Network 19 June 2003; Lebanon n.d.b; M2 Presswire 28 June 2001). Since then, the Lebanese government has established a national organization dedicated to AIDS prevention and treatment programs (ibid.). In 1989, a year after it declared that HIV and AIDS were "a serious public health danger," the government founded the National AIDS Control Programme (Lebanon n.d.c). Since 1994, the Lebanese government has reserved a portion of the national budget to support the program (ibid.), and all costs associated with the fight against HIV/AIDS are covered by the government (M2 Presswire 28 June 2001). The fight against AIDS was one of eight priorities listed in a Lebanese report on objectives for the new millennium, published in November 2003 (L'Orient-Le Jour 27 Feb. 2004).
According to the Daily Star, "[t]he Health Ministry offers free medication to all HIV positive Lebanese citizens and they often distribute condoms in bars and clubs" (5 Dec. 2003). In 2003, the National AIDS Control Programme planned to release a fiveyear national strategy to fight the disease (Daily Star 5 Dec. 2003).
In summer 2001, M2 Presswire reported that Lebanon lacked adequate resources to provide HIV/AIDS testing to the hundreds of thousands of migrant workers living in the country (28 June 2001). According to Africa News Service, among the 15,000 to 17,000 Ethiopians who work in Lebanon (most as domestics), those known to be HIVpositive are deported (23 Feb. 2001).
HIV/AIDS statistics
There are several estimates as to the number of people in Lebanon who are HIVpositive or who have AIDS (L'Orient-Le Jour 2 Dec. 2003). The official figure is 745 (ibid.), but other sources have published various estimates: 765 (Daily Star 5 Dec. 2003), 1,951 (WHO 2003), 2,000 (most of whom are unaware that they are HIVpositive) (L'Orient-Le Jour 2 Dec. 2003), 2,500 (AFP 20 Feb. 2003), or even up to 3,000 (IPS 22 June 2001), as well as 0.09 per cent of Lebanese adults (CIA World Fact Book 2003 1 Jan. 2003).
Officials are particularly concerned about the groups with the highest rates of HIV infection – young heterosexuals in Beirut and young homosexuals (for whom the situation is much more serious) (Daily Star 5 Dec. 2003). Because homosexuality and prostitution are illegal in Lebanon, outreach services targeting homosexuals and prostitutes face several challenges, particularly the fear that both groups have of being arrested by police (ibid.).
Health services available to people with HIV
According to an article in the Daily Star, one of the more serious problems that people with HIV face is finding doctors and hospitals that are willing to treat them (5 Dec. 2003). The newspaper also reported that "intolerance extends to all people who have HIV/AIDS, even from within the health field itself" (Daily Star 5 Dec. 2003). According to Dr. Jacques Mokhbat, an infectious diseases specialist in and an expert on HIV/AIDS,
[translation]
Even in the 20th century, it is still impossible to [admit someone who is HIVpositive to a hospital] because some hospitals – including those run by the government – refuse these patients under the pretence of not having the means to care for them. This is ridiculous, because no special means are required. Caregivers simply need to wear gloves. In fact, I would hope that they wear them when treating all their patients and not just when dealing with those with AIDS (L'Orient-Le Jour 2 Dec. 2003).
The same doctor said that he spent three days looking for a hospital that would take one of his patients (ibid.). He was finally admitted to a small hospital, but only after hiding the fact that he was HIVpositive (Daily Star 5 Dec. 2003).
Medication offered to people with HIV
Treatments are very expensive for HIV patients; monthly costs are approximately US$1,200 per patient (ibid.). Patients need to receive continuous treatments for them to be effective (L'Orient-Le Jour 2 Dec. 2003). However, due to the Ministry of Public Health's [translation] "poor management of inventory and purchasing," medication is not always available, even though it is free (ibid.). If a patient [translation] "misses" a dose, it is generally preferable that he or she stop the treatment (ibid.). However, negotiations with pharmaceutical companies to reduce the cost of treatments could soon help to resolve the lack of medication (ibid.).
Legislation regarding HIV/AIDS
Although no legislation on HIV/AIDS could be found among the sources consulted by the Research Directorate, the Website for the Ministry of Public Health noted that "many laws and decrees have been issued in relation to HIV, namely blood safety, obligatory reporting, confidentiality, non discrimination, [and] mandatory screening of high risk groups (sex workers ... )" (Lebanon n.d.c). Lambda Legal, a Website providing information on HIV/AIDS, indicated that an HIV test is required to obtain residence permits in Lebanon (June 1997).
Non-governmental initiatives against AIDS
The Ministry of Public Health published the following list of NGOs working to control HIV/AIDS: Lebanese Family Planning Association, Soins infirmiers et développement communautaire, Caritas Liban, Dar al-Amal, Lebanese Red Cross, Armenian Relief Cross, Lebanese AIDS Society, Oum el-Nour Society, Jeunesse anti-drogue, Lebanese Scouts Union, Amel Association, Forum des ONG, Islamic Health Association, Imam Sader Association, Jeunesse contre la drogue, Lebanese Health Society, Makassed Communal Health Care Bureau, and Human Protection Association (Lebanon n.d.a).
Among the services offered by these NGOs are HIV/AIDS awareness and prevention campaigns, counselling, coordination of hospital social services, support for families of persons with AIDS, social rehabilitation programs for high-risk groups, fundraising activities for the treatment and support of patients with AIDS, and scientific research (Lebanon n.d.b).
Of the 25,000 young volunteers who receive first-aid training from the Lebanese Red Cross every year, approximately 120 were expected to complete a special HIV/AIDS training program by the end of 2002 (IFRC 8 May 2002).
In 2001, the French NGO Sidaction subsidized the creation of a support group for people with HIV in Lebanon (Daily Star 5 Dec. 2003). According to a social worker from Health Care and Community Development (Soins infirmiers et développement communautaire), her NGO runs the "only place [where people with HIV] can talk about AIDS in an open way" without feeling stigmatized (ibid.). According to Mustafa alNakib, Director of the National AIDS Control Programme, "Lebanon . . . is among the most proactive countries in the Middle East . . . in dealing with HIV/AIDS" (ibid.).
Health Care and Community Development (Soins infirmiers et développement communautaire), which offers free health care to the underprivileged, founded the first AIDS hotline in 1994 (IPS 22 June 2001). According to an article in the Daily Star, "Lebanon has six HIV/AIDS hotlines and more than 15 NGOs offering educational outreach" (Daily Star 5 Dec. 2003). Some NGOs target groups that are particularly at risk, such as prostitutes, drug users, and homosexuals (ibid.; WHO 3 Oct. 2002).
The National AIDS Control Programme, in partnership with many NGOs, has already organized several awareness campaigns, including a televised forum in which prominent figures in the fight against AIDS, as well as 2,000 youths, participated along side several Lebanese politicians (Lebanon n.d.d). It is also worth noting that posters were put up at bus stops in downtown Beirut to advertise three HIV/AIDS hotlines, and Lebanese pop artists released songs promoting HIV/AIDS prevention (ibid.). Another example, which dates back to the summer of 1998, is the huge auction organized under the patronage of the Lebanese prime minister's wife; proceeds from the auction were donated to treating low-income persons with AIDS (WHO Dec. 1998).
Society and HIV
The fact that HIV and AIDS are still religiously and culturally taboo in Lebanon makes the fight even more difficult (Daily Star 5 Dec. 2003). Although guidelines guaranteeing patient confidentiality are respected, "[m]any Lebanese are embarrassed' to take an HIV test" (Kaiser Network 19 June 2003). Furthermore, "any kind of information regarding sexual behavior is prohibited" in certain communities (ibid.).
The problem of social discrimination of people with HIV/AIDS is also apparent in the workplace. According to Dr. Mokhbat:
[translation]
. . . many people who are HIVpositive are fired from their jobs, even though they would not expose anyone to the virus simply by doing their job . . . Some employers are conscious of the scientific fact and keep their employees, while others cannot accept the idea of having a carrier of the virus on their team. Believe me, education does not help change this mentality. Unfortunately, those afflicted cannot hide the disease because they have to go through their company's administration for reimbursement of their medical treatments from the National Social Security Bank (L'Orient-Le Jour 2 Dec. 2003).
"A poll of 1,000 people released by the National AIDS Control Program found that 60.6 percent of those who responded favored publicly releasing the names of all HIV/AIDS patients, so that society could protect itself better" (Daily Star 5 Dec. 2003).
Risk of honour crimes
No information on whether a person with HIV who has relations with girls would risk being killed in an honour crime in Lebanon could be found among the sources consulted by the Research Directorate within the time constraints for this Response.
This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of additional sources consulted in researching this Information Request.
References
Africa News Service. 23 February 2001. "IOM Launches Study on Trafficking in Ethiopian Women." (NEXIS)
Agence France Presse (AFP). 20 February 2003. Assaad Abboud. "Propagation alarmante du sida au Proche-Orient." (NEXIS)
CIA World Fact Book. 1 January 2003. "Lebanon." Daily Star [Beirut]. 5 December 2003. Rhonda Roumani. "Coming Clean on AIDS is Key to Preventing Epidemic." Inter Press Services (IPS). 22 June 2001. Reem Haddad. "Health-Lebanon: Sex and AIDS Hotline Cuts Across Cultural Taboos." International Federation of the Red Cross and Red Crescent Societies (IFRC). 8 May 2003. "Moyen-Orient et Afrique du Nord – Activités." Kaiser Family Foundation. 19 June 2003. "Lebanon's HIV/AIDS Awareness Still Rudimentary,' Lebanese AIDS Society Founder Says." Lambda Legal. June 1997. "HIV-Related Testing Requirements and Restrictions for Entry into Foreign Countries." Lebanon. n.d.a. Ministry of Public Health. "List of NGOs." _____. n.d.b. Ministry of Public Health. "AIDS Program – Background." _____. n.d.c. Ministry of Public Health. "AIDS Program – Background." _____. n.d.d. Ministry of Public Health. "AIDS Program – Activities." M2 Presswire. 28 June 2001. Selim Tadmoury. "Lebanon." (NEXIS)
L'Orient-Le Jour [Beirut]. 27 February 2004. "Développement – Un document sur le sujet a été publié en novembre dernier." (NEXIS)
_____. 2 December 2003. "La grande misère des malades du sida au Liban." (NEXIS)
World Health Organization (WHO). 2003. "World AIDS Campaign 2003: Fact Sheets." _____. 3 October 2002. "Progress Report on Acquired Immunodeficiency Syndrome (AIDS) in the Easter Mediterranean Region." _____. December 1998. Eastern Mediterranean Region AIDS News. "Auction Sale in Lebanon." Additional Sources Consulted
Internet sites, including: Amnesty International, Bureau du coordonnateur global sur le sida, European Country of Origin Information Network (ECOI), Human Rights Watch, United States Department of State, World News Connection (WNC).
