Despite stigma, HIV infection rates rise in Jordan

There has been a large rise in infections during the last three years

A volunteer lights candles forming the shape of a red ribbon during an awareness event organised on the eve of the World Aids Day last month (AFP via Getty Images)

This article first appeared in our partner site, Independent Arabia

There has been a notable rise in HIV/Aids infections during the last three years in Jordan, with the coronavirus pandemic apparently contributing to the trend, owing to the lack of healthcare provisions available throughout lockdown.

According to the Ministry of Health, a total of 21 cases of HIV/Aids infections have been recorded so far this year in the country. All of the cases recorded were of Jordanian nationals, three of whom were women. This brings up the total number of HIV/Aids cases to approximately 357, with 250 patients undergoing treatment. However, 25 percent of cases were recorded in the last few years, with most patients aged between 30 and 39 years old. The average age has dropped in recent years, with more infections now being recorded in 20-24 year olds across both genders.

The first case of HIV in Jordan was recorded 35 years ago, and those infected by it have faced severe stigma, compounded by a reluctance towards testing out of fear of persecution. Unofficial estimates put the actual number of infections in the country at around 2,000 cases.

Human Rights Concerns

Several organisations, including Human Rights Watch (HRW), have criticised the Jordanian government’s handling of cases. Medical staff and health centres are effectively obliged to report HIV positive cases to the government. Foreigners residing in the country who are found to carry the disease are deported, regardless of the impact this may have on their health and wellbeing. They are barred from returning to the country for life, in breach of international law, which prohibits deportations solely based on HIV/Aids infection.

A report by HRW details how Jordanian nationals are forced to test for HIV/Aids when applying for public sector jobs, as are foreigners looking to apply for work permits. A person who is found to carry the virus is denied employment.

Amidst accusations levelled at authorities of forced deportations and discrimination against people with HIV/Aids, Abdullah Hanatleh, Director-General of the Forearms of Change Center, an Amman-based organisation that facilitates access to treatment, documents dozens of cases of deportation on the basis of infection every year.

Social Stigma

Observers maintain that the real numbers of infections is much higher than official figures suggest, adding that the “stigma” plaguing some patients stops them from being open about their condition. They assert that all recorded cases in Jordan have been the result of illicit sexual relations, with no case as of yet of infection through blood transfusion.

Experts are calling for voluntary testing to be rolled out, and for discrimination against those infected to be stopped in order to fight this disease and control it. They also urge against prejudice, misinformation and misconceptions around issues such as the transmission of the disease.

The Jordanian Health Ministry has a national programme to fight HIV/Aids, which provides counselling and voluntary testing services for patients. The programme allows patients to remain anonymous and offers the services of a therapist who provides patients with proper psychological support.

Discrimination

Patients ask that their privacy be respected, and that they be able to receive treatment without fear of discrimination. Some face the possibility of losing their jobs, while others seek treatment outside the country, owing to poor medical services. Al Bashir Hospital is the only medical facility in Jordan to offer treatment for HIV/Aids cases. There are calls to provide patients with health insurance and a wider range of treatments.

The Jordanian government rejects all accusations of shortcomings in this area, saying that it has a policy in place to treat people with this virus. It is also seeking to implement a legal framework that addresses the socio-economic repercussions of the disease and has a legal review process.

First-hand accounts

Forearms of Change, which cares for patients in Jordan, documents the experiences of suffering of those infected. Among them is 40-year old Muhammad who says he attempted to take his life upon learning of his infection through blood contamination while he was working abroad, but has decided to live with the disease for the last 25 years.

Muhammad recounts the details of his difficult treatment, the looks of disapproval he received from those around him, including medical staff, and his conflicting emotions when he decided to tell his family and wife of his infection. He also spoke of the extreme psychological pressure he endured for fear his employer would find out, as many employers fire those carrying HIV/Aids.

Self-Treatment

The poor services offered to patients drove Saeed to treat himself, having discovered in 2016 he was carrying the disease, after he was asked to perform a medical check-up in preparation for a move abroad. His dreams of a job and career then turned to disappointment, depression and social disgrace.

Saeed recalls the suffering of patients during the coronavirus pandemic because of repeated lockdowns, curfews, decrease in the dispensing of medication and the focus of medical staff on combating coronavirus.

Forearms of Change reports the story of a Jordanian woman living with AIDS, who went to deliver her baby and was met with discriminatory treatment as soon as she set foot in the hospital. She was isolated from other patients as soon as her case was known to medical staff, who then refused to assist her, and asked her instead to go back home and return once in labour.

The First Case

The first case of infection in Jordan was recorded in 1986. However, official numbers of infections among Jordanians do not reflect the truth on the ground, according to Social worker Hussein Al Khuzai, who says that for every recorded case, there are 10 hidden ones.

According to Al Khuzai, patients suffer from a range of psychological and social issues. These range from trauma, emotional incontinence, anger, stress and anxiety to denial, fear of illness and incapacitation, and guilt, because Jordanian society acknowledges neither the disease nor the idea of living with it.

Reviewed by Celine Assaf