Conservative interpretations of Islamic values in the Arab
Gulf states as well as prevailing cultural taboos tend to
inhibit effective educational programmes needed to combat
the spread of AIDS in the region. The oilrich Gulf region
officially has the worlds lowest incidence of infections
from human immunodeficiency virus (HIV) but the number of
patients is on the rise.

U.S. researcher Dr. Shannon O'Grady, who has just
concluded a ten month study of Bahrain's AIDS education
programmes, told the German Press Agency dpa that a frank
dialogue was urgently needed as a big part of society lacks
information regarding virus transmission and preventive
methods.

In Bahrain HIV positive cases have more than doubled
during the past three years, says O'Grady. According to
estimates by the World Health Organization (WHO), there are
500 cases of HIV infections in the country. O'Grady
believes the actual numbers are much higher.

The tiny Gulf island state was the first country in the
region to address the problem and is still at the forefront
in its information programmes.

Testing for HIV was introduced in 1987. AIDS education
was introduced in schools in 1988, but only four years
later the first serious public campaign was launched ahead
of the summer holidays. The campaign, which focuses on
Moslem beliefs, aimed mainly at encouraging people to
refrain from sexual contacts abroad. Expatriates as well as
every job seeker in the country have to present a health
certificate that includes blood testing. Random blood
samples are also collected in all health care institutions,
says the chairman of Bahrain's National Committee for AIDS,
Dr Mohammed Haddad.

Thirty people have died so far of the disease. Bahrain
has a total population of just above half a million people.
Around 350,000 are nationals. Of them nearly half are under
16. Dr Haddad believes that education and awareness are the
essential factors in tackling the fatal disease.

"Health officials worked carefully to provide
educational messages that suit their local culture, but
with AIDS continuing to threaten the region, a more
aggressive information campaign is needed," says O'Grady.

But the head of Bahrain's Health Education Section, Dr
Amal Jowder, says it is difficult to promote condoms
because society would not accept it and religious leaders
might protest.

"People don't engage in extramartial sex because they
are afraid of AIDS and if I come and tell them 'use
condoms' it would encourage people to have more sinful
sex," she stresses. Dr Haddad agrees that the issue of
condoms is "still a little touchy" in the entire Middle
East but in his eyes it is not necessary to "create a war
with the clergy over the issue because they can inform
peole and they do talk about AIDS during Friday prayers in
the mosques".

For O'Grady the key issue is to encourage AIDS
education in small groups: "People are too shy in
traditional cultures to talk about sex, so a lecture in a
company or community hall doesn't give anybody the chance
to stand up and ask a question."

According to her findings, most people believe they are
fairly safe since prevailing morals supposedly prevents
promiscuity. But "behaviour usually attributed to the West
is just as widespread here. Only they remain taboo and a
lot of men therefore put their wives at risk", she says.

The researcher fears that, with Moslem Shiite unrest
affecting Bahrain for over two years, AIDS education might
be put on hold at a time when it is most needed.

"Drug users are already in the thousands and go
directly to heroin because it is easily accessible here and
this is very likely to increase as unemployment and social
unrest are key contributers to drug usage," she warns. In
contrast, Dr Haddad says only around 300 people in Bahrain
are drug addicts. According to his clinical experience with
patients at the Psychatric Hospital, the problem is less
accute than generally believed.

The majority of drug users are occasional users and
could not be regarded as addicts since they would not
manifest withdrawal symptoms, Dr Haddad insists. But around
18 per cent of drug users that attend the clinic or are
brought in by the police have been tested HIV positive.

Needle exchange programmes for heroin addicts, as
heavily promoted in Western countries, do not exist in the
Gulf. The sale of sterile disposable syringes is controlled
by prescribtions and Bahrain strictly monitors and enforces
this.

According to a 12month study conducted by Dr Haddad
and three of his colleagues on 242 intravenous drug users,
higher rates of HIV infection were found among the lower
socioeconomic groups and participants with lower
educational status.

The study also revealed that 63 per cent of interviewed
drug users claim to be regular, paid blood donors a
factor "which could potentially influence the spread of HIV
in the overall Bahraini population". In contrast to the
West, where HIV infections among women are on the rise, the
virus still seems to be rare in the female segment of the
population. According to Dr Haddad, no single baby was born
in Bahrain that had been infected during pregnancy by the
mother. dpa um/jp ct