Submitted by admin on Mon, 2007-03-19 08:00. ::
KABUL, AFGHANISTAN — Cloistered by two decades of war and then the strict Islamic rule of the Taliban, Afghanistan was long shielded from the ravages of the AIDS pandemic. Not anymore.
HIV and AIDS have quietly arrived in this land of a thousand calamities. It remains almost completely underground, shrouded in ignorance and stigma as the government struggles with the help of American and NATO forces to rebuild the country in the face of a new offensive by Taliban insurgents.
The few surveys that exist suggest that Afghanistan has a low prevalence of HIV — only 69 recorded cases, and just three deaths. Yet health officials warn that the incidence is certainly much higher.
"That figure is absolutely unreliable, even dangerous," said Nilufar Egamberdi, a World Bank consultant on HIV/AIDS. The World Health Organization has estimated that 1,000 to 2,000 Afghans are infected, but Egamberdi said even that was "not even close to reality."
Dr. Saifur Rehman, director of the National AIDS Control program in the Ministry of Health, agreed. Afghanistan, a deeply religious and conservative country — sex outside marriage is against the law — may still be less at risk of the spread of the disease than other places.
But international and Afghan health experts warn that it faces the additional vulnerabilities of countries emerging from conflict — lack of educational and governmental services, mass movements of people and a sudden influx of aid money, commerce and outsiders.
It is surrounded by countries with the fastest-growing incidence of AIDS in the world — Russia, China and India. Other neighbors, Pakistan and Iran, have high levels of drug addiction and a growing number of HIV infections, as does Central Asia to the north, experts say.
AIDS can easily cross borders, carried by migrants or refugees who picked up drug habits or had sex with infected people in those countries and returned home.
Though the Afghan government and senior religious leaders have won praise for making HIV a national priority, they are struggling with many problems.
"In Afghanistan, all the traditional risk factors for rapid spread of HIV exist concurrently," said Dr. Fred Hartman of Management Sciences for Health, a Boston-based group working in Afghanistan.
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