Two noted Iranian HIV physicians spoke at the AIDS Foundation of Chicago (AFC) Nov. 13 as part of a brief educative visit to the city.
Brothers Dr. Arash Alaei and Dr. Kamiar Alaei have pushed for comprehensive AIDS treatment and prevention in their native Iran since 1997. The men have been persecuted, imprisoned and banned from operating in the Islamic nation. They are currently based in Albany, N.Y., where they teach and draft Middle Eastern HIV strategies.
"We grew up in the western part of Iran, and we saw HIV/AIDS issues and drug addiction," Arash said. "The Iranian government ignored [early AIDS reports] and said: In the Islamic Republic of Iran, we don't have any sex, we don't have any injecting drug users, and we don't have any LGBT [people]. The thought was: HIV/AIDS is for western countries, and we are not a western country."
As friends and classmates became infected, the young doctors felt compelled to act. They created a network of so-called triangular clinics, which provided treatment and prevention for those impacted by drug use, HIV/AIDS and sexually transmitted diseases (STDs).
"At the beginning, we had one patient per week," Arash said. "After six months, we had 50-60 patients a day. Step by step, the quality of programs increased."
The approach was simple: Provide culturally competent care at each patient's level.
For example: When the Alaei brothers realized that many at-risk populations were illiterate, they changed how education materials were distributed. Brochures and pamphlets weren't going to reach the right people, Arash said.
Women could access all-female staffs, including doctors, nurses and midwifes. And patients with deep-seated distrust of the medical community spoke to peer educators.
There were soon triangular clinics in 67 Iranian cities. Each addressed cultural stigma and medical misperceptions head-on, much to the chagrin of the religious government, Arash said.
He explained that before the 1979 Islamic Revolution, Iran offered methadone clinics and other progressive drug addiction treatments.
"[But when the new government came in,] they changed all of the laws and said: There are no options for drug users," Arash said. "Using drugs is illegal, and [people who use drugs] have to go to prison without any treatment."
Those suffering from HIV/AIDS, drug use or STDs were deprived of treatment, as the government categorically denied such issues existed in Iran.
"A lot of our friends and neighbors were suffering, and we had to do something for them," Kamiar said of the brothers' clinics. "We didn't think we were heroes who wanted to save the country. We thought: This is a need, and we have to do something. Something is better than nothing."
In 2008, the Iranian government imprisoned the Alaeis for an alleged conspiracy to overthrow the Iranian government, as well as alleged ties to the U.S. Central Intelligence Agency (CIA).
The doctors spent several years in jail, where they continued their activismpushing for better sanitation, healthier food, more exercise and smoking cessation in prisons.
When they were released, the Alaeis were told they could not work in social settings in Iran, which effectively barred them from operating the triangular clinics. Today, the men develop global AIDS strategies from separate posts in Albany, N.Y.
During Tuesday's presentation, Kamiar shared a story from his childhood. One day, an uncle of his suffered a heart attack. The uncle was scared to go to an emergency room because he had been drinking earlier, and alcohol was banned in Iran.
"He waited for hours so the symptoms of alcohol could disappear," Kamiar said. "He went [to the hospital] the next morning, but it was too late. He died two days later."
Kamiar cited this incident as his inspiration for studying medicine. He has devoted his life to helping the underprivileged, and is hopeful that Iran's impending presidential elections will allow him to go home.
"If the environment changes, we'll go back," Kamiar said.
AFC President David Ernesto Munar praised the Alaeis for their progressive work.
"The [U.S.] still has such conflicting relationships with Iran," Munar said. "It's important to remind ourselves that despite what our countries may be doing, that it is not representative of its people."