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Sexual Health Exchange 2001-2
"Egypt doesn't have AIDS, so it doesn't need AIDS education"
Joris Luyendijk
An AIDS case in a Cairo hospital recently made the headlines – quite remarkable, because apart from a few committed people and organisations, there tends to be a deafening silence around AIDS in Egypt. "Egypt does not have AIDS," seems to be the general opinion of government, the media and society in general, "because Egyptians do not have premarital sex and do not inject drugs." AIDS is mainly associated with punishment from God or the result of some foreign conspiracy.
Following this line of thinking, AIDS education is not considered necessary and is even unwanted, because "theory may lead to practice." This is what an NGO staff member found out when he was setting up an AIDS education programme for secondary schools: "The resistance among authorities and parents was enormous," he says, "almost as big as the lack of awareness among the students." In the programme, the students were asked to write down anonymous questions on pieces of paper – and so they did: "whether you could get AIDS from a woman,… from masturbating,… from staying in the same room with a foreigner...." An additional problem in Egypt is the widespread belief that condoms cause impotence, because they reduce sexual pleasure.
Unlike in sub-Saharan Africa, HIV/AIDS is still uncommon in Egypt. According to WHO estimates, less than 10,000 people are HIV-positive. Even if this estimate were ten times greater, only some 0.15% of the total population of 65 million would be infected.
Although a National AIDS Control Programme is now in place, authorities are often complacent about the current situation. Anonymous HIV testing is not available, and most drugs are totally unaffordable or even illegal. According to the government, Egypt is not at risk, because the conservative attitudes towards sex among the Muslim and Coptic Christian Egyptians protects the country from AIDS. But according to WHO, within the next five years the HIV prevalence rate will increase 25-fold. Unless the official policy changes, all hard-gained progress in maternal and child health will be lost.
Real risks in Egypt
Commercial blood banks are particularly risky, because they do not test their donors for HIV. In December 2000, a man who had just been found HIV-positive appeared to have been donating blood on 14 occasions in the last year, for about US$5 per donation – one-tenth of a government clerk's monthly salary.
In addition, Egyptian youths could be a lot more sexually active than their parents or political and religious leaders (want to) believe. According to a social worker "It is not the conservative values that block sexual liberty in Egypt, but rather the mere lack of empty apartment buildings and other places to experiment with sex. Egyptian youth live with their parents until they marry, and the police heavily patrol so-called "lovers' lanes": whoever is caught having sex in a car can expect heavy punishment and confiscation of the car. In the case of students, they will be expelled from university for life. The only thing unmarried lovers can do is hold hands on a Nile bridge," says the social worker, who wants to remain anonymous, because working in AIDS education can always mean social isolation.
Stigma and discrimination
After the recent AIDS case in Matareya Hospital, the nurses had an unpleasant time: "Nobody wants to talk to us anymore; everyone, including our own colleagues, is afraid of us. They think we also have AIDS now."
Even worse off was the patient himself, whose full name, address and job were published in a local newspaper, as well as the fact that he had made recent business trips abroad. HIV/AIDS is still seen as a "foreign disease," brought to Egypt by tourists, businessmen and spies. HIV infections are not considered a public health issue, but a matter for national security services.
Even some health officials contribute to existing discrimination. In a recent interview with a leading newspaper, one of them said: "AIDS patients are psychologically broken and start to hate society. Just think of that young girl that started seducing as many men as possible after she found out she was HIV-infected: after having sex, she would write "join the AIDS club" in lipstick on the bathroom mirror." Not surprisingly, a majority of policymakers seems to favour quarantining HIV-infected persons. HIV/AIDS may still be far away from Egypt, but an effective response is even farther away.
Joris Luyendijk, Middle East correspondent, based in Beirut, Lebanon. |
