While HIV/AIDS increase in many Muslim countries, a common response has been to propagate Muslim ideals for protection. The political, social, cultural and religious frameworks in these countries often impede the development of effective prevention and support services. It is deeply taboo to discuss private matters such as sexuality in public.

The meeting explored how Muslim religious and political concepts influence cultural and personal behaviours leading to HIV transmission as well as medical care and human rights. The participants recognized that AIDS is much more than a health problem, confronting people with their religious beliefs, sense of morality, ethics and their relationships. It highlights problems around gender relationships and inequalities, family and community concerns, economic empowerment and development, political frameworks and psychosocial issues.

A wide range of topics was addressed including women's and men's reproductive and sexual health, intravenous drug use, needs of youth, medical systems and antibody testing, the family, human rights, ethics and the law, living with HIV/AIDS, monitoring and networking. Specific recommendations were made for new orientations or practical action. These included enshrining the rights of people living with HIV/AIDS (PHAs) and their families and proposing practical ways to improve knowledge and develop prevention and support services.

Many participants noted that marriage is a particular focus for unequal relations that make women vulnerable. Cultural practices such as polygamy, limitations on female remarriage after divorce or widowhood, and Mut'a (temporary) marriages, were seen as increasing women's vulnerability. Participants also recognized the difference between the public Muslim face and what men may do in private without sanction, provided they are discreet. For instance, male to male sex, premarital and extramarital sex were acknowledged to occur in all Muslim countries, particularly where cultural and economic pressures exist to delay marriage. In reality, women may also diverge from publicly accepted sexual norms, but this is much more heavily condemned if it comes to light.

Differing views were expressed on the role of Shari'a law as a deterrent for high- risk behaviour. In countries with a strong emphasis on shame over any deviation from sex within marriage, public campaigns emphasizing these Muslim values were felt particularly important. Participants also recognized that the use of shame drives HIV/AIDS underground, making it harder to cope with and control.

A second strategy of "discrete" prevention methods was deemed acceptable to address the needs of marginalized groups or those practising high-risk behaviours. This could include condom promotion and distribution and other approaches sought by the communities themselves. Part of the strategic response should be community funding and empowerment to help support groups and activists take action themselves.

Another serious problem in building up effective AIDS service organizations is the extent to which staff feel insecure in relation to political and religious leaders because of the sensitive nature of their work. In a religious climate that respects silence on private areas of life, it is deeply disturbing to start open discussion of sexuality and related issues. Cooperation and understanding between the leaders and educators should be strengthened to create a safe environment to explore sensitive issues around AIDS. This is also essential for the development of sustainable initiatives that can continue to gain adequate financial and technical support.

To address the informational needs in this sensitive climate, confidential and "safe" channels must be found. The workshop recommended the establishment of free confidential telephone lines staffed by individuals trained to deal with reproductive, sexual health and intravenous drug use issues. 

Though there appears to be a conflict between the rights of the community for protection against HIV infection and individuals' rights in the context of confidentiality, participants felt that these two frameworks need to be seen in a complimentary context. Recognizing that women's socio-economic and political status makes them extremely vulnerable to HIV infection, the meeting emphasized that AIDS policies should strengthen rather than undermine women's emancipation and human rights.

In exploring PHAs' needs, the participants discussed the economic, social and psychological impact of infection as well as health needs. Calls were made to train more counsellors to help individuals and families cope, and to link counselling training with information on how to help people access financial, practical, medical and other support. Counsellors should be able to refer people to community support, self-help groups as well as formal government and NGO support services. New forms of support would also be needed, including homehelp and dropin facilities. A Social Care Fund could be established by government and Muslim institutions to help develop the new services required.

The meeting further addressed medical issues including traditional treatments and care, HIV testing, drug trials and safety of blood supplies. Human rights were again emphasized and the need to make nonallopathic treatments, safe needles and syringes, HIV tests and modern medical treatments available and affordable to everyone.

Training needs also extended to policy-makers, management boards, staff at different levels and volunteers in NGOs and other agencies. The meeting recommended that training cover appropriate outreach programmes, community involvement, designing education and intervention strategies, needs assessments, project management, grant writing, financial management, monitoring and evaluation and educational resource development.

The value of networking was acknowledged, as it reduces the sense of isolation in which many groups operate; it was recommended that agencies share experiences and lessons learned. A call was made for funding to develop international networks of Muslim NGOs and PHAs, and for further consultative meetings. A report of this first consultation is now available from the Naz Project. It is hoped that this will form the basis for continued discussion and appropriate programmatic responses over the coming years.