New campaign to tackle stigma and misconceptions

The Johns Hopkins University in Baltimore, US, and Constella Futures, a US-based research organisation, have been awarded contracts to implement Afghanistan's first major HIV/AIDS projects in four cities, the Ministry of Public Health (MoPH) told IRIN/PlusNews.

The two projects, costing about US$3 million, are designed to improve advocacy and communication on HIV/AIDS, help tackle widespread stigma, identify policy gaps and provide recommendations for timely interventions to prevent the spread of the virus.

"The Johns Hopkins University will conduct three integrated, biological and behavioural surveys until 2010, which will enable us to draw up appropriate policy and effectively design and implement preventive measures," said Saif-ur-Rehman, director of the national HIV/AIDS control programme in the capital, Kabul.

Afghanistan launched its national HIV/AIDS programme in 2003 and has since received $23 million funding from various international donors. The health ministry, which runs the national HIV/AIDS control programme, has reported that thousands of people may be living with HIV/AIDS, but only 436 positive cases have been recorded over the past three years.

Tackling stigma

More than half the estimated population of 26.6 million are younger than 23 years, but fewer than 20 people per day visit Afghanistan’s six HIV/AIDS testing centres, and most of those are people who wish to travel abroad and require health certificates, Rehman said.

The very high level of stigma associated with HIV/AIDS in this conservative society means Afghans do not voluntarily visit test centres, health officials conceded. No HIV-positive person has ever publicly disclosed his status.

Some conservative MPs, and even government officials, believe that people with HIV/AIDS should not be given health services ...they say 'let these sinners die'

During a parliamentary debate over the HIV/AIDS programme budget and activities in March 2008, several MPs in the lower house of the National Assembly reportedly labelled people living with HIV/AIDS as "criminals and adulterers who deserve death".

"Some conservative MPs, and even government officials, believe that people with HIV/AIDS should not be given health services ... they say, 'let these sinners die'," said one official who did not wish to be named because of the sensitivity of the issue.

However, the MoPH said it was working hard to build up support for the country's HIV/AIDS control efforts among decision-makers and political leaders. "We try to spread the message that people living with HIV/AIDS are not criminals and should not be discriminated against," Rehman said.

A common misperception

"There is a common misperception that HIV/AIDS results solely from illegitimate sexual relationships," said Rehman.

Yet HIV prevalence among injecting drug users is three percent compared to zero percent among sex workers, according to MoPH statistics.

A survey by the UN Office on Drugs and Crime (UNODC) in 2005 showed there were 920,000 drug users, including injecting drug users, in Afghanistan, which produced over 90 percent of the illicit drugs consumed worldwide in 2007.

Opium cultivation and heroin production has rapidly increased over the past three years, and so has the number of domestic drug users. Health experts have warned that this is the group most vulnerable to HIV infection.

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