Luring HIV-positive individuals out of hiding has become increasingly important, if not the most important, step in the fight against HIV/AIDS in the Middle East and North Africa (MENA) region—one of two regions globally where the HIV epidemic is growing fastest.
Understanding the dynamics of the epidemic is inextricably linked to understanding the religious and socio-cultural context that undergirds community attitudes and shapes risk-taking behavior in the predominantly Islamic region.
As concerted efforts to raise awareness about the disease unfold, the potent role of religious leaders is becoming more appreciated. International organizations working on HIV are now realizing that the magnitude of silence surrounding HIV can only be conquered with the help of religious leaders who can do much in breaking enduring taboos and in humanizing the disease.
For many people living in the West, it might prove difficult to discern the breadth of influence wielded by Islamic institutions and Islamic leaders or the profound role played by an Islamic fatwa (religious ruling) in galvanizing public opinion and bringing about profound social change. However, in most societies of the Islamic world, religion pervasively permeates both the public and private spheres and can thus facilitate, at best, and hinder, at worst, the pursuit and implementation of public health interventions and programs.
Particularly in the fight against HIV, religious leaders, who are at a unique position to lead anti-stigma and anti-discrimination efforts because of their embeddedness in local communities and their legitimacy, can most effectively battle associations of the disease with moral depravity and promiscuity and its characterization as a “non-Muslim” disease imported from the West.
Take for example the belief, espoused by some in Egypt, that the deceased who are rumored to have had HIV should not be allowed to have Islamic funerals and burial rites, which are cherished traditions that honor the deceased and hold incredible meaning to their family.
Such practice, grounded in false religious beliefs, entrenches stigma and brutally shuns people living with HIV. Thus, as the disease and its etiology continue to be construed within theological and religious frames, the opportunity to engage religious leaders in the fight against HIV/AIDS becomes invaluable.
Many religious leaders are starting to confront the sobering reality that the Muslim community is not immune to HIV. Looking at the disease through the prism of sin is thus revealing a myopia and ignorance that are brought to light as the prevalence of the disease rises in the region.
In fact, many religious leaders are starting to change the way they approach the disease and are departing from accusatory rhetoric that blames and shames. Instead, there is a growing tendency to focus on compassion in lieu of condemnation.
This becomes exceedingly important with the realization that some of the primary reasons why people in the region are not accessing essential HIV services are not a general paucity of services and prohibitive costs of antiretrovirals alone but a stigma and discrimination that have cultivated a silencing fear around HIV and AIDS.
The role of religious leaders can thereby be instrumental in breaking the silence that prevents those infected from seeking essential care and support.
A surge of progressive Islamic fatwas that were issued tackling issues brought to the fore by the epidemic illustrate the vast role that could be played by religious leaders. One fatwa, for example, issued during the International Consultation on Islam and HIV/AIDS organized by Islamic Relief Worldwide (IRW), sanctioned the use of condoms by married discordant couples despite the controversy around condom use in Islam. This fatwa has many implications; for one, it has the ability to legitimize condom distribution programs of international organizations working in conservative communities that would have otherwise been met with resistance and denunciation. It can also encourage Islamic faith-based organizations working on HIV to start their own condom distribution programs without fear that they would be contravening Islamic principles or teachings.
Fatwas can facilitate the uptake of key interventions by local communities and religious leaders can do much in bridging some of the gaps between evidence-based public health interventions and the practices and precepts of faith.
If public health campaigns that attempt to address the social stigma of AIDS—cited as the principal barrier to seeking care in the region—continue to be divorced from the sociocultural and religious reality of the Middle East and North Africa, failure will inevitably follow. Partnerships with religious leaders can no-doubt help change the course of the pandemic and pave the way for evidence-based public health responses to HIV.
Edited by Joshua Brooks