BANGLADESH: Anti-HIV/AIDS Efforts Follow Men to the Mosques

By IPS Correspondents Reprint | | Print |

Qurratul Ain Tahmina

DHAKA, Nov 15 2002 (IPS) - Spiritual affairs usually dominate the Friday sermons of Maulana Athikur Rahman at a mosque here in Bangladesh, but these days he touches on religion, life – and risky sexual behaviour.

”I tell my congregation, ‘Never engage in sex with any woman other than your wife. Never engage in homosexual activities either’, says Rahman, an imam at a mosque on the outskirts of the capital in this country, more than 90 percent of whose people are Muslim.

”As the Holy Koran says, both are strictly forbidden in Islam. Fifteen hundred years ago, our Prophet had warned people of the deadly outcomes of such acts,” he adds.

”And then I explain to them how HIV is transmitted,” he explains, ”that illicit sex is one of the main causes for getting this virus of which there is no cure and death is inevitable. I also warn them about the non-sexual routes of HIV transmission.”

His remarks address risky behaviour patterns here, despite Bangladesh’s low level of HIV prevalence of 2 percent: considerably high premarital and extramarital sex, high rates of clients and very low rate of condom use in commercial sex.

Other factors for HIV/AIDS here are increasing intravenous drug abuse, unscreened blood transfusion and above all, lack of awareness. Government figures say there are only about 180 HIV-positive cases in this country of 130-plus million people.

But experts say there is no room for complacency, which is why Athikur Rahman was roped into HIV/AIDS training scheme he took six months ago at the Imam Training Academy, an organ of the Islamic Foundation Bangladesh (IFB) run by the government’s ministry of religious affairs.

In 1998, the ITA added HIV/AIDS awareness and prevention in its curriculum and imams also discuss primary health care, reproductive health and sexually transmitted diseases. Some 20,000 imams have received training on HIV prevention in the light of Islam, ITA says.

”We believe the training has been extremely beneficial, as the imams command credibility and respect in their communities,” says Mohammad Abadulla, ITA deputy director for training.

”They can reach the youth and make them aware of the danger. They can persuade other opinion leaders,” he adds. ”Many people from villages go abroad to work. Since sex is a biological demand, they may lose control any time in a foreign country. The imams can caution them against the dangers of that.”

Having the imams target male behaviour is also an added bonus of this programme – except for a handful of city mosques, all the rest of the some 200,000 mosques in the country are open only to men.

”They can easily overcome the social taboo against discussing HIV/AIDS as they address a male-only congregation,” says Syed Ashraf Ali, IFB director general. ”Besides, an imam addresses a familiar cohort, one that he meets every week.”

Imams are also encouraged to spread HIV awareness and prevention messages at everyday prayers, regular ‘waaz mahfils’ or religious public meetings they lead and weddings.

But HIV/AIDS activists point to limitations in the information religious leaders give out. Athikur Rahman for instance touches on promiscuity and morality, but leaves out condom use, which Islamic leaders say is wrong but health activists find key to HIV/AIDS prevention.

”I do not talk about condoms,” Athikur Rahman says, ”because condom is only needed when one engages in illicit sex outside wedlock or in homosexual activity”. Adds Abadulla: ”We cannot promote condom for preventing HIV from a religious point of view.”

Athikur Rahman however asks his all-male congregation to pass on HIV information and relevant religious restrictions to their female kin.

”I did not know much about AIDS before,” says Taslima Akhter Swapna, Athikur Rahman’s wife. ”After my husband got the training I learnt from him how it spreads and how it doesn’t. I now pass on the information to other women. I tell them that they themselves should abide by religious codes and try and make their husbands do the same.”

Swapna agrees with her husband about not pushing condom use, but says: ”The problem is those who go bad way do not understand how wrong and risky it is”.

In a society where a wife has little voice and far less negotiating power even if she knows of safe sex, she is not likely to be in a position to effect it if her husband goes ‘bad way’, activists say.

They agree that every means of giving information about HIV/AIDS is important, but are uncomfortable with ”religious restrictions” and moral judgments that they say hinder efforts to fight the pandemic.

”We have found that if imams are convinced, they can very easily and quickly convince others in our support. But we do not need to train them only to repeat religious restrictions.” says Dr Smarajit Jana of the non-government group CARE, which runs the largest HIV prevention programme in Bangladesh.

”The reality is that people do have polygamous behaviour,” adds Dr Jana, ”and the majority of those who get HIV infection get it through the sexual route”.

”HIV prevention therefore cannot gain without promoting safe sex, of which condom promotion is an essential factor. To be meaningful, any such programme got to overcome the argument that promoting condom is promoting immoral activity,” Jana explains.

Maj Gen A S M Matiur Rahman, head of the National AIDS Committee who teaches the ITA course on HIV/AIDS, is tactful while mentioning safe sex and condoms to the imams.

”If one does get the virus, I tell them, then it is his or her responsibility to protect his/her lawful partner. And for that condom is the answer. I also ask them to convey this message to their congregations,” he explains. M Abbas Uddin, who runs the Islamic Research Cell of Family Planning Association of Bangladesh and a former prayer leader, finds this roundabout approach to safe sex useless and unnecessary. He says ITA’s approach ”centres on the notion that it’s a disease of the sinners. That view is devoid of the essential humane approach to HIV/AIDS”.

Adds Abbas: ”I don’t see why religious leaders cannot promote condom for safe sex. If they have enough knowledge, if they understand human behaviour and limitations, there is no religious bar for them to do so.”