VZCZCXRO1708
PP RUEHBC RUEHDE RUEHKUK
DE RUEHDIR #0019/01 0921221
ZNY SSSSS ZZH
P R 021221Z APR 07
FM IRAN RPO DUBAI
TO RUEHC/SECSTATE WASHDC PRIORITY 0085
INFO RUCNIRA/IRAN COLLECTIVE
RUEHDIR/IRAN RPO DUBAI 0078
RUEAIIA/CIA WASHDC
RHEFDHP/DIA DHP-1 WASHINGTON DC
RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC
RUEHDE/AMCONSUL DUBAI 0080

S E C R E T SECTION 01 OF 02 IRAN RPO DUBAI 000019 
 
SIPDIS 
 
SIPDIS 
 
BERLIN FOR PAETZOLD, LONDON FOR GAYLE, BAKU FOR HAUGEN 
PARIS FOR WALLER, BAGHDAD FOR GALBRAITH 
 
E.O. 12958: DECL:  4/2/2017 
TAGS: IR PHUM SOCI PGOV TBIO
SUBJECT: IRAN:  SOCIAL FACTORS INCREASING HIV RATES 
 
RPO DUBAI 00000019  001.2 OF 002 
 
 
CLASSIFIED BY: Jillian Burns, Director, IRPO, DOS. 
REASON: 1.4 (d) 
 
Iran:  Social Factors Increasing HIV Rates 
 
1.(C) Summary:  The HIV/AIDS epidemic in Iran is accelerating, 
mostly due to use of intravenous drugs.  Iran's total number of 
HIV cases has almost doubled in the past two years, and 
intravenous (IV) drug users account for 63% of the country's 
total cases.  The highest HIV prevalence rates are among IV drug 
users in large cities and prisons.  According to one Iranian 
expert, however, the disease is spreading rapidly and starting 
to cross over into the general population, apparently linked to 
increasing sexual promiscuity.  End summary. 
 
Concentrated HIV/AIDS epidemic established among Iran's IV drug 
users 
--------------------------------------------- -------------- 
---------- 
 
2.(C) The HIV epidemic in Iran is accelerating, according to an 
Iranian infectious disease doctor, who confirmed the country's 
official and UN published HIV/AIDS data.  The doctor is an AIDS 
researcher from Iran's primary AIDS Research Center at the 
University of Tehran, which is partially supported by the office 
of the Iranian president.  UNAIDS (Joint United Nations Program 
on HIV/AIDS) and the Iranian Ministry of Health estimate that 
there are 70 thousand HIV/AIDS cases in Iran, although the 
number of reported cases is under 14 thousand.  HIV prevalence 
in the general population is still low at 0.1%, but this number 
is increasing quickly.  Iran's Ministry of Health and the World 
Health Organization confirm that HIV/AIDS cases in Iran have 
almost doubled in the past two years and that localized 
epidemics exist among IV drug users.  IV drug use currently 
accounts for 63% of Iran's total HIV/AIDS cases, sexual 
transmission accounts for 7.3%, infected blood products 2% and 
mother to child transmission 0.4%; transmission routes are 
unknown in about 30% of cases.  HIV prevalence among IV drug 
users is highest in large cities and prisons; with rates of 23% 
among IV drug users in Tehran and 25% in Shiraz Prison. 
 
3.(S) The doctor noted that HIV infection rates and incidence in 
the general population are both on the rise.  According to 
Iran's Ministry of Health and Medical Education, Iran has an 
estimated 3.7 million drug users, and 137,000 inject drugs. 
Unofficial estimates for drug use in Iran are as high as 7 
million.  Prevalence among IV drug users was about 15% in 2004, 
mainly among low socioeconomic drug users, but now 25% of the 
injecting drug users examined are infected.  The doctor, who 
previously ran the AIDS research center in a major city, said 
that the highest HIV/AIDS incidences are among IV users in 
Kermanshah, Fars, Lorestan, and Tehran. 
 
 
Increase in recreational drug use 
--------------------------------- 
 
4.(C) According to the Iranian HIV/AIDS expert, one reason for 
the rise in HIV is a general increase in recreational drug use. 
Drug use has a long history in Iran and smoking of natural herbs 
and opiates is traditional in the region, although possession of 
drugs is forbidden by Iranian law.  Several Iranian visa 
applicants said that smoking hashish and opium is not taken very 
seriously in Iran, though injecting hard drugs is looked at 
quite differently.  Some Iranians claim that some clerics use 
opium and two recent contacts claimed that Supreme Leader 
Khamenei, and former Foreign Minister Velayati smoke opium. 
What was traditionally a social activity for older males is now 
spreading to females and youth.  At the same time, abuse of 
other synthetic drugs such as ecstasy and methamphetamines are 
also increasing. 
 
5.(U) Narcotics reports say that opium, which is traditionally 
smoked, has become increasingly expensive in Iran.  Many drug 
users are attracted by the cheap prices of synthetic and cut 
opiates such as heroin, which are extremely addictive and cause 
people to quickly turn to injection where they can get the same 
affect with a smaller cheaper dose.  According to the Iranian 
AIDS doctor, a heroin dose is about 2000 tomans or about two 
dollars. 
 
6.(C) According to two Iranian parents of teenagers, drugs are 
becoming more accessible for young people, but schools are 
conducting anti-drug campaigns.  Parents are increasingly 
watchful of this issue, they said, and try to engage their kids 
in hobbies.  One mother said she thinks children are becoming 
 
RPO DUBAI 00000019  002.2 OF 002 
 
 
more defiant as a response to the restrictive lifestyle in Iran. 
 
 
Shifts in social norms 
---------------------- 
 
7.(C) At the same time, Iran's culture as a whole is shifting 
toward greater sexual activity.  Within the sector of drug 
users, an UNAIDS published behavioral study from 2004 among 
injecting drug users in a drug treatment center indicated that 
41% of the sexually active participants had over six partners, 
42% of them had exchanged money for sex, and 50% never used 
condoms.  In the general population, 70% of the country's 
population is under the age of 30, divorce rates are increasing, 
and people are getting married later, if at all.  Such factors 
are likely to increases the number of sexual partners people 
have (including prostitutes), increasing the risk of infection. 
There is also the practice of "sigheh," which allows for 
temporary marriages with the blessing of a cleric, even for one 
night, which some say is used at times to skirt the illegality 
of prostitution.  Some Iranian men who travel in the region 
reportedly return with HIV and infect their wives, according to 
several Iranian visa applicants.  In a 2005 study published in 
Middle East and North Africa's 2006 AIDS Epidemic Update, some 
28% of 15-18 year old males in Tehran were sexually active, yet 
about half of this group had never seen a condom or knew they 
could prevent STDs, despite the availability of free condoms in 
health clinics.  They believed HIV could be transmitted by 
mosquitoes or acquired in swimming pools. 
 
8.(C) Though little is being done in Iran to monitor HIV among 
prostitutes, the disease is reportedly increasing among Iran's 
prostitute communities.  According to a study published in the 
UNAIDS Iran report, one group of women prostitutes in western 
Tehran had a 6% infection rate.  More people are becoming 
infected through unsafe sex, specifically through prostitution, 
according to the Iranian AIDS expert.  She explained that the 
overlap between injecting drug use and sex for money facilitates 
the spread of HIV to the general population, as clients of 
prostitutes spread the disease to their partners.  However, 
because prostitution is illegal, underground, and stigmatized, 
it is difficult to survey this group, according to the expert. 
There is a lack of information on this marginalized group and 
issues of sex are still too sensitive to address publicly, added 
the doctor. 
BURNS