Qatar making progress fighting AIDS ‘taboo’

Doha, Qatar – Prejudice against people with HIV/AIDS is one of the main areas of medical discrimination encountered by health officials around the world.

UNAIDS argues that travel restrictions on people living with HIV and AIDS have no public health justification and violate human rights. But members of the Gulf Cooperation Council disagree.

The region has some of the world’s toughest rules in place regarding entry of HIV-positive individuals, despite a worldwide trend to overturn such policies. There are 45 countries that still impose restrictions on entry, stay, and residence for people living with HIV.

It is illegal to enter Qatar, the United Arab Emirates and other GCC nations if you have HIV, and discovery after entry usually leads to deportation. All new expatriates are confronted with these policies when they submit blood samples for residency permits.

AIDS ‘taboo’

For much of the past two decades, there has been an information vacuum in the Gulf for epidemiological data on HIV and AIDS. According to a study by the World Bank, the Middle East and North Africa remains “the only region where knowledge of the HIV epidemic continues to be limited and subject to much controversy”.

Much of this has to do with cultural objection to some of the means of transmission, particularly in cases of men who have sex with other men (MSM).

Dr Laith Abu-Raddad, an investigator at of Cornell’s Infectious Disease Epidemiology Group, says Qatar and other GCC countries are making progress tackling these taboos.

“Generally speaking, there has been tremendous progress over the last ten years,” he said. “Surveillance work, and prevention, and intervention programs have begun, whereas a decade ago governments wouldn’t recognise [HIV] existed in their country, especially due to MSM, injection drug users and sex workers.”

While government surveillance and treatment programmes have significantly expanded in scope over the past decade, attitudes towards people with HIV have not.

In October, the Qatar Statistics Authority released an extensive attitude-assessment survey of households in the country, the results of which demonstrated an overwhelming disapproval of people living with HIV.

Only five per cent of young men expressed accepting attitudes towards people living with HIV. The percentage of women in the same age bracket was just two per cent.

Despite these figures, Abu-Raddad suggests the overall trend is still positive. “Comprehensive knowledge of HIV is low, but growing. There are high rates of people who want [HIV patients] treated with dignity.”

“Most of our patients, including Qataris who are HIV infected, are living normal lives.“ – Dr Abdullatif Al-Khal

Changing nature of HIV in Qatar

Dr Abdullatif Al-Khal from Hamad Medical Corporation’s Clinical AIDS Programme seems accustomed to repeating the same statement: “Qatar does have a treatment programme for people living with HIV,” he told Al Jazeera.

In fact, Qatar has HIV-positive residents, both Qatari and foreign, who live and work in the country legally. The government provides free treatment, including regular clinic visits and blood testing, antiretroviral treatment and counselling for 98 patients. There are usually between five to twelve new cases diagnosed each year.

“Most of our patients, including Qataris who are HIV infected, are living normal lives. They are in their studies or working, and those who test positive … this information is kept confidential,” Al-Khal says.

The characteristics of AIDS in Qatar have changed since 1986 when the first blood tests were made available in the country.

Since that time, 275 people have tested positive, many of whom have since died or left the country. Most new patients say they were infected through heterosexual transmission while travelling abroad, typically outside of, or before, marriage.

With advanced surveillance and treatment programmes in place, Al-Khal sees HIV being transformed into a chronic disease that is controllable, such as diabetes. He hopes Qataris will view it the same way.

Testing positive

Positive blood testing does not guarantee deportation in all cases. Expatriates who have a “stable” family life and job are allowed to stay and receive treatment, according to HMC.

But for those expatriates in the country alone, working low-wage, low-skill professions, the chances of being allowed to stay are slim.

“We ask that they go back home, that they resign from their job, that they get their benefits, without informing their employer, trying to keep confidentiality as much as possible,” Al-Khal says.

Then there are those somewhere in the middle. People who find out they are positive while outside of the Gulf often choose to hide their status.

Waleed – who requested his real name not be used – is an Arab-American who found out he was HIV-positive earlier this year.

“I thought I was safe because of these really strict [HIV/AIDS] policies,” he told Al Jazeera. “But the irony is that I contracted the virus in the Gulf.”

Treatment options are limited for people in his situation, despite the fact that he previously worked in a GCC country. After deciding to “stay below the radar” while in the region, he has since returned to the United States, where he receives antiretroviral medication.