Health experts in Iraq are worried that the number of sexually transmitted HIV/AIDS cases may be on the rise, following the discovery of new trends in modes of transmission.
"The trend of how a person is infected has changed from initially via blood transfusions to sexual transmission and this will shape the magnitude of the coming national strategic plan," Dr Wahab Hamed, director of the AIDS Research centre in Iraq and manager of the National AIDS Prevention Programme, told IRIN in Baghdad.
According to Hamed, in the years before 2003 they detected around seven HIV positive cases per year, practically all of them related to haemophiliacs (who require blood transfusions to tackle an impaired ability to control bleeding).
In the last year the number has doubled and changed its route of transmission, he added. Fifteen new cases have been detected over the past few months, which is considered a high number in such a short period of time. What worries the medical experts is that 90 percent of these cases were infected through sexual contact.
"It is a situation that should be controlled before there is an outbreak," Hamed added.
The HIV/AIDS control programme, part of the Iraqi Ministry of Health, was established in 1987 as a response to the first case detected in the country, when blood transfusions for haemophiliacs were found to be carrying the virus.
Since then, the programme undertook a wide range of activities concerning the prevention and control of HIV/AIDS and sexually transmitted infections (STIs).
According to the AIDS research centre in Iraq, a total of 448 HIV/AIDS cases, including those who died of the disease, have been detected since 1987.
At present Iraq has a total of 67 newly detected cases, of which 15 were reported in 2004. Of this figure, 25 were infected through sexual transmission, six are children who caught the virus from their mothers who were HIV positive when they got pregnant, 35 were through blood products used by haemophiliacs, and one was from a separate blood transfusion case.
In all cases the patients are HIV positive but have not yet developed full blown AIDS.
During Saddam Hussein's regime, some access to treatment reducing the impact of HIV/AIDS was available. But at the same time patients often suffered from discrimination and were sometimes kept away from society and treated like criminals.
Organised gangs allegedly took over blood centres on the country's borders, charging entrants a fee to avoid taking the test. Today an AIDS test is free of charge, but during Saddam's time US $50 was charged for the examination.
After the fall of Saddam Hussein, programme activities were halted as a part of the destruction of the health infrastructure and communication with registered HIV/AIDS cases was also lost. The main hospital for HIV/AIDS in Baghdad was looted and damaged along with the main central and peripheral HIV laboratories.
As a rapid response, the World Health Organisation (WHO), along with the Ministry of Health, allocated funds for HIV positive people and resumed health care for them in a relatively short period of time. However, many challenges and difficulties still face the programme, according to officials.
Voluntary counselling and testing (VCT) has now been introduced in the country for the first time as an added screening method.
Although Iraq lies in the category of having a low prevalence rate, according to a 2002 WHO report, the health authorities believe that the figures are largely underestimated, due to the limited development of health facilities and their ability to cope with HIV/AIDS/STI care and prevention.
Prevention campaigns, according to Dr Hamed, are one of the difficulties, as the killer disease is still a taboo subject in the country. "We will start step by step in order not to shock the population," Dr Hamed said.
Efforts will start with radio messages asking people to take a free test at a care and prevention centre in Baghdad. TV advertisements were a long way off, he said.
Under the previous regime there was no public information about how to prevent the disease. However, on World AIDS day, the government gave air time to the Ministry of Health to talk about the subject on TV.
"If we had more information from the media in our country, maybe I could have prevented myself from getting this disease. It is terrible and I hope that people will know more about it in the future," one HIV-positive person told IRIN.
Another problem that carriers of the virus face is the shortage of antiretroviral drugs. Many of the drugs that were in hospital stores were looted or damaged, and due to their high cost the government is having difficulty in replacing them quickly.
"We have had a meeting with the Ministry of Health to discuss our problem and we asked for $1 million to complete our work, but it hasn't being released yet," Dr Hamed said.
The Ministry of Health has invested $100,000 to date in the AIDS research centre in Iraq, together with other investments by WHO, but much more is required for the total finishing of the project.
WHO has been covering many activities at the centre and at other sites around the country. One of the first programmes that should be started quickly is the training of personnel since 95 percent of staff in Iraq are not trained in line with current standards, equipment and treatment methods.
"We are working on a full programme including the education of the health professionals in the total process of prevention and management of HIV/AIDS in Iraq," Dr Naeema Gasseer, director of the WHO Iraq office based in Amman, Jordan, told IRIN.
She added that they have been working hard in the area of blood transfusions in order to prevent infected donations from being accepted at hospitals across the country.
For those who may lose their loved ones to HIV/AIDS, help cannot come soon enough. "I may lose my son. But I ask God to help those people reach all the Iraqis and prevent others from being infected from this terrible incurable disease," a mother of an HIV-positive young man told IRIN.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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