Iran officially stones and beats homosexuals and last year flogged more than 1,000 people for consuming alcohol. Yet the fundamentalist Islamic government also offers methadone therapy and needle exchanges for heroin users, condoms for prisoners and sex workers, and an HIV prevention handbook for high-schoolers discussing safe sex and drug use. “There is an Islamic saying that allows you to choose between bad and worse,” says Hamid Setayesh, MD, of UNAIDS in Tehran. “Drugs and sex are bad, but HIV is worse.” Iran is the only country in the region with such HIV prevention programs (most of which aren’t widely available in the U.S.). Of Iran’s 69 million citizens, 70,000 are HIV positive, and Iranian AIDS organizations run workshops that draw attendees from neighboring Iraq and Afghanistan.
Religious clerics began supporting prevention as wives and children of infected men, mostly drug users, started dying of AIDS in the late ’90s. Setayesh says facilities are popping up around the country, though access in some areas remains limited. Positive Iranians can get free meds, but stigma keeps many from requesting them. “Their families reject them; many commit suicide,” says Kamiar Alaei, MD, founder of Pars Curative Research Institute. “We are combating that. Now you can even say ‘Use condoms’ on the radio.”