AIDS in Iran: Increasing prevalence among women and through sexual intercourse

Iran's latest official statistics on AIDS show an increase in the number of infected people, especially among women and through sexual intercourse. An interview with Dr. Kamyar Alaei, an international health expert in New York, on the occasion of World AIDS Day.

According to official statistics in Iran, AIDS has increased among women and young people in the country. Statistics show that injection drug addiction and sex are the main ways of infection with the HIV virus in Iran. However, infection through sex has gradually increased and the number of infected people in the 21-35 age range has also increased.

Other reported routes of transmission include mother-to-child transmission, blood, and blood products.

According to statistics announced by Parvin Afsar Kazerouni, head of the AIDS Department of the Ministry of Health, to ILNA News Agency, as of April 1, 2017, the number of people infected with AIDS in Iran was estimated at 66,359, of which 34,949 have been identified.

Many experts believe the actual number of people infected with AIDS in Iran is much higher than official statistics.

"We can estimate these figures based on groups at risk of HIV or high-risk behaviors," Dr. Kamyar Alaei, an international health expert in New York and former researcher at Harvard University, tells DW. "It seems that the number of infected people is estimated to be more than 100,000."

Dr. Alaei explains: "If we were to do a rough calculation, there are more than three million addicts in Iran, of which about 20 percent have an injection drug addiction. That means we have about 600,000 injection drug addicts in the country, and the HIV rate among them is more than 15 percent. That means we have at least 90,000 injection drug addicts with AIDS in Iran."

According to him: "Given that two-thirds of AIDS cases are through injection drug addiction, if we add one-third to 90,000, the estimates show over 120,000 people. And since about 36,000 people have been identified, in fact, by dividing 36,000 by 120,000, we find that about 25 to less than 30 percent of people with AIDS are aware of their status."

Prevention of risky sex

Dr. Kamyar Alaei considers education to be the best way to reduce the possibility of contracting AIDS through sexual intercourse. He says: "Young people between the ages of 15 and 30 are at risk of unprotected sex, and if there are no ongoing educational programs in schools, universities, barracks, or anywhere that can attract young people, it will cause a young and single person to unintentionally contract sexually transmitted diseases, including AIDS, through unprotected sex."

In his opinion, the lack of education in this field, which is justified by cultural barriers, and the lack of adequate training in the Iranian Broadcasting Corporation, universities, and schools, "have made this trend worrisome in the future."

Using condoms during sexual intercourse and treating infected mothers, according to Dr. Alaei, "reduces the chance of transmission from 35% to below 2%."

Experts consider early diagnosis to be a key factor in patients enjoying a normal life. Dr. Alaei says: "The sooner an infected person is identified, the sooner they will not only prevent them from transmitting the disease to their loved ones, a man to his wife and a woman to her child, but if they are treated as soon as possible, the chance of transmission can be reduced to zero, and thirdly, their lifespan can be increased to a normal level."

Another key factor for the patient to enjoy a normal life is adherence to treatment. Dr. Kamyar Alaei says about the advances in drug therapy for the treatment of AIDS: "There are more than 25 different types of drugs in this field. There are multiple drugs that, through different mechanisms, stop the replication of the virus in the body, and this stop causes the level of the virus in the blood to decrease and reach a level that is difficult to detect. This reduction in replication causes the body's immune cells to not be destroyed, their production increases, and the person's immune system is strengthened and the chance of developing opportunistic infections decreases."

Another strategy to combat AIDS is to prevent the birth of new babies with AIDS by timely identification of pregnant mothers.

Referring to the strategy of testing pregnant women for AIDS, Dr. Kamyar Alaei says: "The Ministry of Health wants to make this policy universal starting next year, which is actually a very good thing. But this policy must be conditional. First, this should not be universal nationwide, but rather it should be carried out in some parts of the country as a pilot, and second, these tests should be carried out in cities where there are definitely triangular clinics."

This expert believes that, due to the adverse consequences that may arise for pregnant women due to cultural issues after an AIDS diagnosis, this test should be carried out in a place where there is a triangular clinic: "It would be irresponsible for us to recommend to everyone that all pregnant women should be tested without considering that if people are positive, they should be counseled by triangular clinics to prevent social disasters."

Dr. Kamyar Alaei, along with his brother Arash Alaei, is one of the founders of the Triangle Clinics in Iran. Like his brother, he was imprisoned in Iran for several years for his work in the fight against AIDS.

The Triangle Clinics, which were first established in Iran 17 years ago, have three vertices of a triangle of counseling and treatment for AIDS, addiction, and sexually transmitted diseases (other than AIDS), which have been established in major cities in Iran to combat this disease.

The services of these clinics, which were established with the help of the Ministry of Health, are provided in a confidential or anonymous manner if the patient wishes, and patients do not need to introduce themselves or reveal their names to undergo testing and receive counseling.

Source: DW