Shahram is a 29-year-old man from the Molavi neighborhood in southern Tehran. We have come to the area to talk to people about AIDS and safe sex. Most people we speak with have little awareness of HIV or AIDS, and are not familiar with the basics of safe sex — a common phenomenon, it turns out, across a range of social groups in Iran.
Many of the people we talk to, like Shahram, have never used a condom. “I work all the time,” Shahram says. “I am not into girls. Every once in a while, once a month or maybe once a year, one of the guys will bring someone in. What good it is if we have to put on a condom for that one time?”
On July 29, Dr Massoud Mardani from the National AIDS Committee said in an interview that the number of people contracting AIDS had risen in Iran by 33 percent in recent years, with an 11 percent rise in the last two years. According to official figures, 29,000 people have been diagnosed with AIDS in the last two years, rising from 26,125 cases in 2012, and 27,888 at the end of 2013.
But these are only official figures. Dr. Mardani believes the actual number of people with AIDS is somewhere around 90,000. Dr Minoo Mohraz, head of the Iranian AIDS Research Center, estimates the number of AIDS-diagnosed people in Iran to be around 120,000, based on the World Health Organization mathematical model (a calculation of four times the official or registered number of patients). Hamshahri newspaper, managed by Tehran Municipality, published research that put the figures even higher than this estimate. Among drug addicts alone, around 230,000 are believed to have contracted AIDS.
Recent statistics also indicate that, increasingly, most of the HIV/AIDS cases in Iran are a result of sexual contact, rather than needle-sharing, blood transfusions using infected blood, or other factors.
Four days before Massoud Mardani’s remarks, Abbass Sedaghat, the head of the Health Ministry’s AIDS and sexually transmitted disease control department, stated that, in the first decade of the century, AIDS cases were in decline among drug addicts — but they ware on the rise among sexually active communities. “Unprotected sex is the chief factor responsible for this second wave of increase in AIDS figures,” he said. “This has raised concerns about more women having unplanned pregnancies and giving birth to HIV-positive babies, which could initiate the third wave of increase in AIDS.”
If the current trend continues, AIDS cases will be roughly equal among men and women. Not only has the number of people diagnosed with AIDS increased, but the number of women and young girls who carry the virus has multiplied by 10 and risen from three to 30 percent.
“The figures have gone from 97 percent male sufferers and three percent women to 70 percent men and 30 percent women,” a blood specialist in Tehran, who spoke on condition of anonymity, told Iran Wire. “This is a red-alert situation. The younger people should acknowledge that this danger is real. Unlike in the 1980s and 1990s, AIDS is no longer only found among drug addicts. This is now a common problem in cities and in rural areas.”
The specialist said he believed the current crisis was the result of inadequate Health Ministry policies. Institutions responsible for informing the public — including some branches of the security forces — have failed in their duties, he said, neglecting to educate people across all social groups about the importance of using condoms and creating barriers to knowledge as a result. Because of the silence around AIDS prevention, it is increasingly difficult for people to take responsibility for their sexual and overall health, he said. “Reckless” sexual conduct was now commonplace, “a practice that is an outcome of depression and anger and helps AIDS spread faster.”
IranWire spoke with a number of young boys and girls in Tehran, many of whose attitudes supported the concerns expressed by the doctor. Many young people from a range of different social backgrounds say they “do not believe in” or “are not interested” in safe sex.
Neda, 28, who works for Qatar Airlines in Tehran and lives in Ekbatan complex, says in her life, her two enemies are alcohol and condoms: “I always use a condom with my boyfriend. But when I go out with other boys, the only way to overcome shyness is to drink whisky. When you drink whisky, you only think of sex and don’t think about AIDS. Then you get drunk and the last thing you think of is using a condom; I think the boys think the same.” She laughs and continues: “It is funny, yes. But believe me this is the reason. I never have sex without a condom when I am not drunk — and I never use condoms when I am drunk.”
Like Neda, Behrooz, 19, is not aware of the fact that the spread of AIDS is on the increase, and certainly not because of unprotected sex. For Behrooz, who lives in Sadeghieh, the main reason for not using a condom is shyness. “When I go into a pharmacy, if the salesperson is a woman, I can’t ask her. If it's a man, I look around. If no women are around, I ask for condoms; otherwise, I escape!”
Behrooz introduced us to his younger brother, Behtash, who is 16 and in high school. Behtash says many of his classmates “have sex with their girlfriends, but usually anal sex.” He said he’d “never heard of anyone using condoms.”
Education is a Must
In 2008, a government center tasked with combating drug addiction installed five automatic dispensers in Tehran, distributing syringes, condoms and sterile equipment in an attempt to reduce the spread of infectious diseases in Tehran. But eventually, the health ministry stopped the initiative, stating that “such acts help spread immoral acts in society.”
In Tehran, we asked men and women aged between 40 to 50 years old about whether they talked to their teenaged children about using condoms and about safe sex. Only two out of 12 said they had discussed such matters. The rest looked at us angrily, mocked us, or simply said, “It is none of your business.”
Hamid, 47, runs an architectural firm in Karim Khan Street and has a 15-year-old son. He says he has not spoken to his son about safe sex. “I think I must speak to him; but I don’t know. We have a difficult relationship. I am not religious, but we Iranians are conservative. Sometimes I think I have to tell my son about this, but something prevents me. But with what you have just said, I think I have to tell him — his mother and me both. I think these matters should be taught at school. It would make it easier for us and it would be better for the children.”
Although sexual activity accounted for the spread of HIV in as many as 36 percent of cases in 2014, education ministry officials fail to make it a priority. In an interview with Ghanoon newspaper, Dr Abbass Sedaghat said the education ministry had failed to incorporate the basic facts and precautionary measures into school text books. “There is a concern in the ministry that bringing up these matters will break a taboo.”
Maryam, 32, who lives in a well-off neighbourhood in Saadat-Abad, says she is so bored and life is so dark for her that she does not really think about such dangers any more. “I think: What difference does it make if I catch the virus or not? People around me are prestigious and they won't be infected. Even if they are, I am not so afraid. I am so depressed, I smoke and drink so much, I don’t think about such matters. Life has hurt me. To hell with AIDS. I sometimes wish I'd become infected, so I can get rid of this life.”
Maryam’s remarks are somewhat typical of a large section of society, at least when it comes to understanding the serious threat that AIDS poses to their lives. National television, the health ministry, municipal government and other institutions that deal with health issues have a common, unwritten ideological reason not to enter into th debate seriously or try to address the problem with any real effectiveness. Their reluctance relates to taboos in society, and an unwillingness to see the dangers of remaining silent about the risks. Authorities agree to interviews; they provide different figures on different occasions. But evidently they have no real intention of seriously fighting AIDS. And while this is the case, AIDS is becoming more prevalent in Tehran and other citiies, moving toward a very serious public health crisis.
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