Stigma and a lack of education and prevention efforts are fueling the spread of HIV in Afghanistan, the New York Times// reports.
According to the Times, there are 69-recorded cases of HIV in the country; however, some health officials say the actual number of cases is much higher. The World Health Organization estimates that about 1,000 to 2,000 Afghans are HIV-positive.
Nilufar Egamberdi, a World Bank consultant on HIV/AIDS, said the WHO estimate is "not even close to reality." According to the Times, Afghanistan "faces the additional vulnerabilities of countries emerging from conflict -- lack of education and government services; mass movements of people; and a sudden influx of aid money, commerce and outsiders."
In addition, Afghanistan's proximity to Russia, China and India -- which have some of the fastest-growing HIV/AIDS epidemics worldwide -- and the migration of its residents are fueling the spread of HIV. The country, which produces the largest amounts of opium and heroin in the world, has about one million injection drug users, according to United Nations estimates. In addition, about 30% of blood used for transfusions in the country's hospitals is screened for HIV, according to a World Bank report.
According to Saifur Rehman, director of the National AIDS Control program at the Ministry of Health, about 80% of government hospitals screen blood for HIV, but many other institutions do not. Rehman added that health providers in the country are not well-informed about HIV and often reuse needles. A lack of knowledge about the virus among commercial sex workers in Kabul, the country's capital, also is contributing to the spread of the virus, according to the Times.
A 2003 survey by the German international aid organization ORA International found that one of 126 surveyed sex workers was familiar with condoms and that one had knowledge of HIV/AIDS. There are no treatment centers in the country,
and one clinic in Kabul monitors HIV/AIDS but does not provide access to antiretroviral drugs, the Times reports.
According to the World Bank, which is providing $10 million to fight HIV/AIDS in the country, although several organizations are working to implement needle-exchange programs and to increase awareness of HIV/AIDS, a wider program is needed. Stigma is the "most difficult" challenge in fighting HIV/AIDS in Afghanistan, according the Times.
Health providers in the country say that HIV-positive people will face ostracism and possibly death if their communities learn their HIV status. The Ministry of Health keeps the identity of HIV-positive people confidential to prevent stigma. The health ministry also is working with the country's Ministry of Hajj and Religious Affairs to educate religious leaders, who often are the most influential people in villages, to promote HIV/AIDS education and reduce stigma surrounding the disease, the Times reports.
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