| Popis: |
Clinical, social and ethical aspects of HIV-1 infection as occurring in the Arab Gulf State of Qatar are presented. Up until November 1989, 50 patients were reported with HIV infection. In more than 75% of cases, the disease was acquired via transfusion of imported blood; 52% have developed AIDS and 65% of these have died. In response to the problem, the Ministry of Health has established a National AIDS Committee whose major function has been to educate both the medical profession and lay public about the disease and on ways to prevent its spread. Furthermore, the Committee has also taken on the role of patient advocate and has been instrumental in resolving many HIV-related difficulties in the community at large. Specialized HIV clinics have also been set up, with both Qatari and expatriate patients being enrolled in treatment programmes. No expatriate patient has been deported due to infection with HIV. Although many social and ethical issues remain unresolved, it appears that a rational and humane public health policy has been adopted in Qatar with respect to the AIDS threat.Described is how the National AIDS Committee of the Arab Gulf State of Qatar has managed medical and public education, screening of immigrant workers, and treatment of HIV-infected persons and AIDS cases. Qatar is unusual for being a rapidly emerging Bedouin Muslim culture with a majority of guest workers, and comprehensive, free, state-of-the-art health care. There were 50 HIV+ patients as of 1989, of whom 52% developed AIDS, and 65% of these have died. After an 18-year old girl with no risk factors except having been transfused with imported blood got AIDS in 1984, all transfused persons were screened. The 50 (26 native Qatari) with HIV included 28 males and 22 females, 31 adults and 19 children under 15. 38 were infected by transfusion, 6 were children of infected mothers, 2 were infected abroad, and the source of infection in 2 men was unknown. 17 have dies, and 3 left Qatar. The Qatar National AIDS Committee is educating the medical profession and the public with press releases, news and television interviews, a brochure, and teaching conferences. Weekly HIV clinics, called "Immunocompromised Host Clinics" are conducted by Board Certified Infectious Disease Physicians, trained nurses, and a dedicated social worker. The AIDS Committee has acted as patient advocate for delicate situations such as school attendance, a divorce, a prison inmate, and objections of health care workers. All patients receive azidothymidine and several are receiving pentamidine. There are special cultural issues, such as difficulty in getting informed consent from illiterate nationals, getting compliance from fatalistic fundamentalist Muslims on contraception. While struggling to design the most humane AIDS policy for natives and expatriate workers, Qatar has opposed the WHO recommendations by screening and refusing entry of infected immigrants. |
