Tuesday, October 02, 2007

Let's Talk Science: Is AIDS going to threaten Jordanians?

Few hundreds, just a few hundred Jordanians carry HIV. It's always been around that number.
Am I concerned?

The Ministry of Health has warned in 2006 that not enough measures are being taken to prevent the spread of AIDS in Jordan.

Let's look at numbers:

We have some of the lowest percentages of HIV positivity in the world (0.01-0.1%), but what's worrisome is having plenty of undiagnosed cases. One might carry the virus for years before being diagnosed with it. In Jordan, people may die without being diagnosed with the illness.

Here's a scary fact: In the US, there are nearly one million reported cases of HIV. However there's another quarter million who do not know that they carry the virus.

There are 334 reported cases in Jordan. If you extrapolate the data above to Jordan, we can assume we've got 400 or more cases of HIV in Jordan.

But it's never that simple.

In the US, HIV is always looked after. It's always being tested, in emergency rooms and the smallest community clinics, among the straight and the gays, among the young and the old.

In Jordan that's not the case, and most patients with HIV present with the full-blown picture of AIDS with all of its complications because none of the many doctors who have previously seen these patients thought about the disease.
Doctors almost never ask their patients about sexual practises, and if they do patients almost never say they're having an extramarital affair, let alone being homosexual.

The UNAIDS estimates that the number of HIV-infected Jordanians is greater than a thousand.
Now here's another fact: AIDS in Jordan is not a disease of homosexuals. Most infected individuals acquired it by heterosexual sex.

The following makes me concerned:

1- Young people are having more unprotected sex. There's an assumption that only vaginal sex can transmit the disease, not knowing that anal intercourse poses a more serious risk for the transmission of the virus. Many Jordanians especially men are having unprotected sex outside Jordan and plenty of them acquire sexually-transmitted diseases (STDs) before coming back home. They get treated for most STDs but and HIV test is usually not performed. With antibiotics being sold over-the-counter in Jordan, the incidence of STDs might be much higher than recorded.

A good example is the Jordanian peace-keeping force in Croatia in the early 1990s where ten soldiers acquired HIV during a short period of time. They were detected because of a close health surveillance performed by the military hospitals for soldiers in peace-keeping forces. They might have been easily missed if they didn't have the opportunity (or rather the option) to be tested for HIV.

2- Homosexuality, though present for a long time, is becoming more public in Jordan and homosexual activities are on the rise, yet sexual awareness is almost non-existent among Jordanians including many highly-educated citizens.

3- Ignorance and unjustified fear. I've taken only one 50-minutes lecture about HIV during my whole six years of study in a medical school in Jordan. We had an HIV-positive patient in the University of Jordan Hospital and the DOCTORS there refused to take care of him because they were afraid of transmission. A Jordanian physician here describes how a hospital in Amman in 1998 refused to treat an HIV-positive patient because they were afraid of transmission of the illness.

Almost all Jordanians don't know that HIV is different from AIDS, and that people carrying the virus nowadays can live more than 25 years even have a normal life span if they get treated.

Most people don't know that HIV is treatable while hepatitis B and C infections are much more difficult to treat and have killed and are killing thousands of Jordanians. Most people think that AIDS is an illness of only the gays and drug users.

AIDS is not a major problem in Jordan. I believe all the numbers the Ministry of Health releases about its prevlance in the country. What makes me nervous is the future, perhaps the very near future, and I have some good reasons to be worried.


Asoom said...

Also, in the US there's a major AIDS awareness campaign in the media, in schools, on campuses, popular publications, etc. I've never noticed such a thing in Jordan and I think that contributes to alot of undiagnosed cases, and I definately believe it's highly undiagnosed i Jordan, but I'm surprised to know that even the doctors are ignorant about it!

Isam Abu Salhieh said...

Excellent article Ammar ... Really informative ...

eyad said...

thnx for the post, its informative, but you didn't give any suggestions how we can change that reality in jordan.

Mazz said...

to answer eyad's question, i believe that this post itself is a start. we need to get those who practice unprotected and uneducated sex to snap out of it to minimize the risks to start with. and we need to educate the medical sector on how to deal with it. and we also need to educate the patients themselves.

thanks for a good read.

SR said...

what you are depicting here is very true, the future seems worrying, because of the unprotected sexual activity and the ignorance of citizens, yet what worries me even more the medical attendance to HIV cases in Jordan, this issue has to be resolved, and I believe doctors should no better, since HIV cannot be transmitted except through body fluids, I'd understand a practitioners concern when conducting an operation for example or during the case of blood transfusion but in both of these cases protective measures could be taken, like wearing protective googles, what I believe sghould be done is an awreness campagines that involves all concerned parts from teenagers to academics to doctors, the ministery of health should be encouraged to start such a campaign, I only have ine question, how come HIV is treatable?

Anonymous said...


Firas said...

Very true.

Where did you get all your facts from #2 and #3?

Yeah, most probably they think if the gover. starts such a campaign people will be saying : Oh look, the end is near, AIDS is all over no wonder they are starting this campaign, moral corruption la abu muzeh, close uni, no women walking alone, Shari'a laws now, vote IAF.

I think the best solution will be starting rumors that AIDS is transmitted through Tabwees, man I love it to see the end Of Tabweesing in Jordan (ok ban only the men tabweesing, females is ok:D

طفيلي( ahmad) said...

Firas said... man I love it to see the end Of Tabweesing in Jordan (ok ban only the men tabweesing, females is ok:D
3:54 AM
You are a genius. I really hate this habit whyyyyyyyyyyyyyyyyyyy? it is awful when you get kissed from man with big mustache and ate garlic.

Hareega said...

asoom, I totally agree that most doctors and nurses are so ignorant about it. Now we don't have to freak people about it, we have to edcuate them. The methods used in preventing HIV transmission are also very helpful in preventing other STDs and infections transmitted by needles like hepatitis B,C. It's helpful to have HIV awareness.

Isam... thanks man, if you wanna call me Ammar I have no problem with it.

eyad... I know. The article would have been much longer if I did! Basically more awareness programs especially in schools.

Hareega said...

mazz... thanks for reading, and for your suggestions

sr... HIV is treatable but not curable. There are more than 4 classes of drugs and each class has plenty of medications that ca be given. Each patient get to get t least 3 drugs, and each drug acts in a diffeent way to suppress the replication of the virus. The first drug introduced was AZT in 1987 so most people who had HIV before that year died. No if they take their drusg they almost always live a near-normal life with a relatively good immune system. They're still at a higher risk of developing some infections and cancers but not nearly as close as they did before treatments were introduced. The advances in treating HIV is unbelievable.

Hareega said...

anonymous.... I don't know what do elections have to do with HIV. In Jordan we were able to control some infections and illnesses, and we can probably do that with HIV. It's not like HIV is out of control but there are reasona to be nervous about it spreading quickly

Hareega said...

number #2 about homosexuality is just apparent. There are Jordanian gay chat rooms and Jordanian gay hangouts. I was reading a tourist book about Jordan here in the US and it mentioned some gay-friendly restaurants, of course books was the first to be mentioned and a couple of other places that I forgot their names. I saw a couple of young male patients with anal warts that could never be transmitted except by anal sex. These 2 have a high risk of having acquired HIV as well. None of my doctors then even thought about testing for HIV.

Point #3, doctors freaking out: I was there in the hospital when it happened.

I agree with you and Tafili, no more tabwees !

The Observer said...

People should be aware of the way AIDs is transmitted. We should cross the line of shame and advertise for condoms (even for extra-marital relationships).

طفيلي( ahmad) said...


طفيلي( ahmad) said...

It is very interesting article .You should read it.


looks a little like an up-market holiday camp.

The neat white houses within the grounds are freshly painted. The lawns have been carefully mown. The residents all seem happy.

As a visitor, you would never guess that this was the setting for one of the world's most controversial Aids prevention programmes.

In the mid-1980s, when little was known about the virus, Cuba compulsorily tested thousands of its citizens for HIV. Those who tested positive were taken to Los Cocos. They were not allowed to leave.

The policy, perhaps only possible in a highly controlled communist society, was condemned by human rights groups across the world.


"We disagreed profoundly at the time when Cuba was quarantining, or locking up people with HIV," says the executive director of UNAIDS, Dr Peter Piot.

"There are norms and values that you have to respect."

But the evidence is that the tactic worked.

Cuba now has one of the very lowest Aids infection rates in the world.

This is despite the fact that its neighbours in this region have been badly hit by the epidemic. Infection rates in the Caribbean as a whole are second only to sub-Saharan Africa.

Over the past 20 years, Cuba has built on its success in containing the disease.

It has also evolved its policy. Patients at Los Cocos are now able to leave if they choose.

Dollar lure

Those who develop Aids are well looked after. Cuban doctors may earn just $15 a month - but the treatment they offer is comparable with the world's richest countries.

Even the drugs are the same - copied by Cuban physicians from the patented versions.

Cubans were once able to depend on the state to provide for almost all their needs. Now, with those Soviet subsidies gone, they are increasingly having to fend for themselves.

But there is a new challenge to Cuba's battle to control Aids: tourism.

Fifteen years ago, only a few thousand tourists came to Cuba every year. This year the government is hoping that two million will visit.

Since the demise of its Soviet benefactor, Cuba has been forced to depend on tourism for its hard currency.

And not all the visitors come for the sun and the salsa. Walk along the beautiful white sand beaches just east of Havana and you'll soon notice plenty of middle-aged European men with young Cubans.

Despite repeated government crackdowns, prostitution is rife here.

The reason is simple. A woman can earn more in one hour with a tourist than she'll earn in a month on her state salary.


Most nights, Lydia strolls along the Malecon, Havana's seafront promenade, looking for customers.

Like many Cuban prostitutes she is aware of the dangers of Aids. But she is also complacent.

"Aids is very bad in other countries," she says. "But here?"

Lydia says she is a prostitute because she needs the money to buy things like food and medicine.

Cubans were once able to depend on the state to provide for almost all their needs. Now, with those Soviet subsidies gone, they are increasingly having to fend for themselves.

Much of Cuba's success in combating Aids can be attributed to that fact this is a society where public good has taken preference over private freedom.

But as Cubans again turn to the oldest private enterprise in the world, can that success last?

Hareega said...

thanks Ahmed for the good link

viagra online said...

Jordan has low HIV/AIDS prevalence, but if preventive measures are not implemented, HIV/AIDS and other communicable diseases could increase or re-emerge and have significant social and economic consequences.[1]

In 2007, there were an estimated 380,000 people living with HIV/AIDS (PLWHA) in the region, according to UNAIDS. Although figures are low compared with southern Africa or Asia, they are still a cause for alarm, particularly since they are rising rapidly, especially among high-risk groups, such as injecting drug users (IDUs) and vulnerable youth. Systematic monitoring of the epidemic, however, is far from complete. Surveillance systems remain inadequate in their coverage of at-risk groups and thus fail to reflect risk behaviors or provide incidence and prevalence rates.[1]

In addition to weak surveillance, the adoption of preventive practices is very limited, the participation of PLWHA and civil society in the HIV/AIDS response is still nascent, and despite some progress, general attitudes, institutions, and laws often do not facilitate implementation of an expanded response. The first step in addressing the spread of HIV/AIDS is recognizing the presence of the disease and the sociocultural, political, and economic patterns that fuel and bear the burden of its impact.