AIDS denial on the Nile

Egypt's rounding-up and incarceration of HIV-positive people is unjust, unrealistic and unhealthy.

Egypt has embarked on a troubling anti-AIDS campaign, of sorts. Rather than redoubling its efforts to arrest the spread of the killer virus, the government has been rounding up people who are HIV-positive.

In moves described as a widening “crackdown” by Amnesty International and Human Rights Watch, police have recently arrested 12 men suspected of carrying the virus, four of whom have already received one-year prison sentences.

“This not only violates the most basic rights of people living with HIV. It also threatens public health by making it dangerous for anyone to seek information about HIV prevention or treatment,” the two groups warned in a joint statement.

Although Egyptian police have denied that the men were taken in because they were HIV-positive, they have been forced to take HIV tests and to submit to intrusive examinations intended to ascertain whether they have engaged in homosexual acts.

This cynical attempt to link Aids with homosexuality is another troubling aspect of these cases. In addition, linking AIDS with sexual orientation is likely, in a country where sexual education is relatively modest and largely informal, to lull heterosexuals into a false sense of security.

This all brings back haunting memories of the early years of the AIDS epidemic, when terrified Christians conservatives tried to “rationalise” HIV as being divine wrath against “sodomites” and managed to convince many segments of society that it was the “gay disease”. Gay friends have even suggested to me that the advent of AIDS set back their cause by years. Luckily, however, it has recovered in the west; their Arab counterparts are not so fortunate.

“Arbitrary arrests, forcible HIV tests, and physical abuse only add to the disgraceful record of Egypt's criminal justice system, where torture and ill treatment are greeted with impunity,” Amnesty International's Hassiba Hadj-Sahraoui said.

In recent years, the Egyptian regime and its security services have worked hard to prove their credentials as equal-opportunities oppressors. While Egypt's unlawful “state of emergency” over the past quarter of a century has been traditionally used against the Muslim Brotherhood and other Islamists, it has also, since the shocking Queen Boat fiasco of 2001, been employed to crack down on homosexuals.

This approach was probably motivated by the need on the part of the regime, which had never really bothered with Egypt's discreet gay community before, to counter allegations that its anti-Islamism was anti-Islamic, and to steal some of the Islamists' moral thunder.

But by refocusing attention on the “moral” side of HIV/AIDS, the government is endangering and undermining its own and other attempts to staunch the spread of the disease. These effort include its plans to produce generic antiretroviral drugs, the country's decision to join UNICEF's international campaign to combat AIDS among children, and numerous initiatives from the health ministry and in civil society. It also overlooks the fact that many people with HIV got it from their monogamous partners, from blood transfusions or in the womb.

Commenting on the arrests, one commentator on Horytna.net, an independent onine youth magazine and radio, wrote: “In 2005, the former Egyptian health minister Awad Tag el-Deen, said his ministry was prepared to do everything necessary to help AIDS patients. But, today, if you have HIV, prepare yourself to be arrested.”

This fixation on AIDS as a “social disease” with a social cure is about as futile as western efforts in the early 20th century to combat the spread of syphilis by focusing on abstinence, monogamy and other traditional values. Last weekend, I attended an exhibition entitled Disease: between body and soul, which displayed a number of moralising French- and English-language posters from the first half of the 20th century.

It also puts me in mind of the current abstinence campaigns gaining in popularity in the United States. Interestingly, despite their mutual accusations of global jihads/crusades and conspiracies, conservative Christian and Muslim groups have managed to find common cause on the issue of Aids to try to pressurise their governments against committing to UN efforts to combat the epidemic.

However, promoting abstinence as the best medicine is not working because, sexually liberated or not, people will always have casual sex. Although Egypt is still classified as a low HIV-prevalence country, the rate of new infections has risen dramatically since the 1990s. The World Bank warns that the rate of infection could reach 4% of the Arab world's population by 2015. And because of limited data and the social stigma attached to the disease, some experts contend that the actual infection rate is possibly 10 times higher than the number of recorded cases.

Groups at particular risk include, as in other countries, drug addicts, homosexuals and sex workers. In addition, according to UNICEF, up to 30% of married women in remote parts of the countryside have sexually transmitted diseases, which may suggest that they are at particular risk of contracting AIDS, as are the estimated 1 million street children in Cairo.

No matter what conservatives think of the morality of AIDS patients, their sense of humanity should lead them to forgive the “sinners” their transgressions and not kick the sick while they are down.

Some Islamic authorities are trying, within a Muslim framework, to minimise the stigma. For instance, a leading Egyptian religious scholar has opined that people who die of Aids should be regarded as “martyrs“.

Moreover, not all religious authorities take a fire-and-brimstone view of AIDS sufferers. Just as some Christian charities and churches offer support to people with HIV, some mosques and segments of Islamic civil society do the same.

In addition, whatever people of faith think of sexual liberation, they should exercise a certain amount of pragmatism. People can catch a dizzying array of scary diseases through food, yet no one advises them to fast to avoid the risk.

While sex is not quite at the same level as food on our needs list, people have, and will always have, a strong appetite for it. Very few people can lead a life of saintly chastity – particularly given the late age at which Egyptians increasingly tend to get married.

Millions of young Egyptians certainly engage in some very un-Islamic relationships. An estimated 10th of Egyptian university students are engaging in casual sex under the cover of informal temporary “marriage” contracts known as “urfi”. And that's not to mention those who practise the less safe variety, without the flimsy paper protection.

Besides, casual sex has, given the traditional ease of contracting and terminating temporary marriages, long been a feature of Muslim societies. For instance, Ibn Battuta, the famous 14th-century Moroccan globetrotter, married and divorced at almost every leg of his three-decade-long trek around the world.

Family legend has it that my own family and most other Diabs in the Middle East are descended from Diab Ibn Ghanim, a legendary adventurer and traveller from the Maghreb who sired children with local women across the region.

If Egypt needs proof that “chastity” is not the answer to AIDS, here it is: while the number of people infected with HIV is rising in Egypt and other Arab countries, it is falling in the sexually more liberal west because of improved sex education and awareness, blood vetting, clean-needle campaigns, and so on. It would seem that, in the west at least, safe sex is better than no sex at all.

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This article first appeared in The Guardian on 23 February 2008.