Iraq: HIV-positive persons fear reprisals

BAGHDAD, 14 January 2009 (IRIN) - Wife and now widow Hana'a Khalil (a pseudonym she uses to disguise her identity) fainted when a doctor at one of Baghdad's hospitals told her in the late 1990s she had contracted HIV. When she came to she could not take in what the doctor was telling her.

"I was physically at his office but my mind was elsewhere, fixated on the health and social consequences I could face," she said.

To be HIV-positive in Iraq means social isolation - and even death at the hands of religious extremists who believe the virus is proof that an HIV-positive person must have engaged in indecent acts.

Iraq has a very low HIV prevalence rate: only 44 people are HIV-positive, according to Ihsan Jaafar, who heads the Health Ministry's public health directorate, responsible for combating HIV/AIDS.

He said the directorate encouraged people to get tested and monitored the health of HIV-positive persons and their families, providing them with "free-of-charge treatment in addition to financial aid".

Hana'a's husband became infected two years after their marriage in the early 1990s. At that time the couple had one child and decided not to tell anyone, for fear of being stigmatised. But when she was diagnosed HIV-positive, the couple decided to reveal their secret.

Shunned

"We panicked and needed support," Hana'a told IRIN. "We told my husband's parents, with whom we were sharing a house, but unfortunately they didn't understand, telling us to leave because they felt ashamed of us," she said.

Her parents did not welcome them, so the three-member family decided to rent a house, telling other relatives they were travelling abroad. In the early 2000s her husband died of tuberculosis, the most frequently occurring opportunistic infection in people living with HIV.

After the US-led invasion in 2003, the widow's plight entered a new phase with Muslim extremists saying HIV-positive persons were "sinners" who should be killed.

"I became like a Bedouin, moving from place to place looking for food and water, but in reality I was looking for safety," she said.

First detected in 1986

The virus first came to Iraq in 1985 via contaminated blood imported from a French company. It was detected the following year in scores of people suffering from haemophilia, a hereditary blood disorder, said Wadah Hamed, the head of Iraq's AIDS Research Centre.

"Treatment at that time was tough and arbitrary. Those found to be infected were placed in segregated medical facilities," said Hamed, who also heads Iraq's national AIDS prevention programme.

Some 482 cases have been detected since 1986. Of these, 272 were Iraqis and the rest foreigners. Today only 44 are still alive, he said.

Patients get the equivalent of about US$85 per month from the government, as well as a clothing allowance. Those infected in 1985 are paid an extra $200 monthly.

They get free monthly check-ups; their partners are examined every three months, and other family members are checked every six months. Baghdad has at least 11 medical centres for this purpose and there is also one such centre in each province.

Low-key awareness campaign

"Give yourself a chance and have a medical check-up in one of the HIV/AIDS centres, free of charge. Your name and any personal information are not needed," says a poster in Hamed's office.

Tentatively, the ministry is launching a campaign to raise awareness about HIV/AIDS, coordinating with local media outlets, distributing posters and holding workshops.

Awareness programmes have also been included in the curricula of secondary schools, and a hotline has been set up to enable people to get advice.

"We believe the campaign should be low-key because our country is still not open to such subjects. We don't want to trigger panic and anxiety among the public when they see these posters everywhere," Hamed told IRIN.

In cooperation with the World Health Organization (WHO), the ministry prescribes combination therapy involving three antiretroviral drugs free of charge.

Keeping a low profile

Each time Ammar Mohammed (not his real name) goes for his monthly assessment or draws his monthly payment, he dreads being seen by someone who knows him.

"I feel as if I'm a thief hiding from people," said Mohammed who was shocked in late 2006 to learn of the murder of an HIV-positive person being treated at a medical centre.

"Since then I've started to change the medical centre from time to time in order not to be spotted at the same centre each month," he said.

The Iraqi health and security authorities have no data on HIV-positive persons killed by gunmen.

sm/ar/cb