Iran Should Teach Bush How to Use Condoms

I always thought it was strange that Americans would favor bombing a country without knowing anything about it. That's why the timing of this story is all the more interesting. It sounds like Iran, a country with 70,000 HIV-infected citizens, has a more comprehensive AIDS prevention program than the United States.

"Iran now has one of the best prison programs for HIV in not just the region, but in the world," said Dr. Hamid Setayesh, the coordinator for the U.N. AIDS office in Tehran. "They're passing out condoms and syringes in prisons. This is unbelievable. In the whole world, there aren't more than six or seven countries doing that."

AIDS activists say they're surprised Iran's government and religious leaders so openly advocate discussing the disease and efforts to prevent it. After all, it took 30 meetings just to create a slim AIDS-awareness handbook for Iran's conservative high schools, according to a Knight Ridder report:

A drawing of a condom disappeared early on; a photo of a syringe survived. A mention of sexual transmission was approved, but only with a reminder that sex before marriage is forbidden.

Even after the government's wordsmiths were satisfied, AIDS workers in Tehran had to take the book south to the holy city of Qom, the spiritual center of Iran's all-powerful clergy. To everyone's surprise, the clerics endorsed it.

Iran's progressive AIDS program has been so successful, it's being exported to Afghanistan, Lebanon, Iraq, Syria, Pakistan and other Muslim nations:

"I told my colleagues in the United Arab Emirates, 'You're not more rigid than us. We're the only country in the world where it's the law to wear a head scarf, where it's a pure Islamic government, where you can't drink,'" said Dr. Arash Alaei, one of Iran's most respected AIDS researchers. "If we have a prevention program, why don't you?''"

In a region where other Muslim governments ignore the epidemic, quarantine HIV-infected people or preach abstinence as the only solution, Iran's approach is especially remarkable.

It still doles out floggings to Iranians caught with alcohol, but it gives clean syringes and methadone treatment to heroin addicts. Health workers pass out condoms to prostitutes. Government clinics in every region offer free HIV testing, counseling and treatment. A state-backed magazine just began a monthly column that profiles HIV-positive Iranians, and last year the postal service unveiled a stamp emblazoned with a red ribbon for AIDS awareness. This year the government will devote an estimated $30 million to the program.

Many AIDS workers feared the worst after ultraconservative President Mahmoud Ahmadinejad was elected and said AIDS wasn't a priority:

The education minister stopped the printing of pamphlets for young students, saying they needed revisions, Setayesh said. Another government official told Alaei that the red handbook he'd worked so hard to publish was embarrassing to Iran's image. It was uncertain whether distribution would continue.

Then Iran's characteristically unpredictable president surprised AIDS workers at a governmental meeting on the intertwined problems of opiate addiction and HIV by coming out in favor of distributing methadone.

AIDS activists are optimistic that the programs will continue. "Four years ago, if you talked about condoms, you couldn't go on the air," said Dr. Arash Alaei, referring to state-run television. "This year, they said, 'You are free to say what you like.' I just kept saying, 'Use condoms. Use condoms. Use condoms.'"

Perhaps Dr. Alaei could teach Bush about condom use. Bush's overseas abstinence education programs are failing miserably, according to a study by the Government Accountability Office. The State Department is even requiring countries to cut back on existing programs that provide education and condoms to sexually active people, according to the Global AIDS Alliance:

A public statement issued earlier this month by Global AIDS Alliance noted a GAO survey of 17 countries that receive aid from the US government for anti-AIDS work. GAO found that most of the countryies view the policy of teaching condom use along with abstinence made little sense.

Many countries participating in the survey told the GAO that State Department requirements diminish the effectiveness of all of these education programs.

Global AIDS Alliance director, Dr. Paul Zeitz called for congressional intervention to reverse State Department requirements. "There has been deep concern with this policy," Zeitz said, "from the European Union, UN officials, African experts, religious organizations and others, and it has been fully justified."

"Lives are in the balance, and so we need Congress to step in quickly to fix this policy," he said.