The Council Of European Jamaats

On 3rd October 1998, the following resolution was passed by the
Executive Council of the World Federation:
" In view of increasing number of cases of HIV & AIDS and increasing number of children born with Thalassaemia Major in our community world wide, it is resolved that all member Jamats and Federations require proposed bride and groom to produce evidence of each of them being free of HIV & AIDS virus and that both are not Thalassaemia carriers. Members should establish necessary modality for implementation before Nikah is recited."

Has HIV & AIDS penetrated our community?

As far back as early 1990, the Medical Advisory Board of the World Federation had brought up the subject of
HIV & AIDS in our community for discussion in one of the Executive Council meetings held in Peterborough.  It
drew the community's attention to the fact that if no urgent action is taken, this deadly infection will affect our whole community.  The audience were shocked to hear this and some found it difficult to believe that such a disease could penetrate our community. Alas, HIV & AIDS has indeed already penetrated our community and got hold of it.  So far over 200 community cases of HIV & AIDS have been received at the Medical Advisory Board and most of them have already died.

What is AIDS? What causes AIDS?

AIDS stands for acquired immunodeficiency syndrome. An HIV (Human Immunodeficiency Virus) infected person receives a diagnosis of AIDS after developing one of the CDC (The Centres for Disease Control and Prevention (CDC), located in Atlanta, Georgia, USA, is an agency of the Department of Health and Human Services.) defined AIDS indicator illnesses. An HIV-positive person who has not had any serious illnesses also can receive an AIDS diagnosis on the basis of certain blood tests (CD4+ counts).

Infection with HIV can weaken the immune system to the point that it has difficulty fighting off certain infections. These types of infections are known as "opportunistic" infections because they take the opportunity a weakened immune system gives to cause illness.

Many of the infections that cause problems or may be life threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS is weakened to the point that medical intervention may be necessary to prevent or treat serious illness.

What is HIV?

HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called HIV infection. Most of these people will develop AIDS as a result of their HIV infection.

These body fluids have been proven to spread HIV:

• Blood
  
• Semen
  
• vaginal fluid
  
• breast milk
  
• other body fluids containing blood
  

These are additional body fluids that may transmit the virus that health care workers may come into contact with:

• cerebrospinal fluid surrounding the brain and the spinal cord
  
• synovial fluid surrounding bone joints
  
• amniotic fluid surrounding a foetus
  

How does the HIV Virus infect The T Cell?

Here is the basic process by which the HIV virus infects the helper T cell:

• First the virus binds to the cell via the CD4 receptor on the cell membrane.
  
• After it binds to the cell, the virus penetrates the cell membrane and releases the HIV RNA into the cell.
  
• Within the cell, the HIV RNA undergoes reverse transcription where the RNA codes for the HIV DNA. This new DNA strand then enters the cell's nucleus where it codes for more RNA.
  
• These RNA strands are then released into the cytoplasm where they are translated into protein, which then form the capsoid that carries the new HIV RNA. 

HIV Virus infecting the T Cell

• In the final step the new HIV virus' collect along the cell membrane budding on the edge of the membrane.
  
• Finally, when the cell membrane can no longer hold all of the HIV, it explodes releasing the HIV into the body.
  

How long does it take for HIV to cause AIDS?

Since 1992, scientists have estimated that about half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors, including a person's health status and their health-related behaviours.

Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventative health care.

What is meant by "Asymptomatic Period"?

Many people do not develop any symptoms when they first become infected with HIV. Some people, however, have a flu-like illness within a month or two after exposure to the virus. They may have fever, headache, malaise, and enlarged lymph nodes (organs of the immune system) easily felt in the neck and groin. These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection.

More persistent or severe symptoms may not surface for a decade or more after HIV first enters the body in adults, and within two years in children born with HIV infection. This period of "asymptomatic" infection is variable, however. Some people may begin to have symptoms in as soon as a few months, whereas others may be symptom-free for more than 10 years. During the asymptomatic period, however, HIV is actively infecting and killing cells of the immune system. HIV's effect is seen most obviously in the blood levels of CD4+ T cells (also called T4 cells) -- the immune system's key infection fighters. The virus initially disables or destroys these cells without causing symptoms.

What is meant by "Window Period"?

Many people express concern regarding the length of time following infection for an individual to develop detectable antibodies to HIV. This is known as the "Window Period". According to the CDC, most persons infected with HIV develop antibodies against the virus within three months after the infection. This time period for antibody development is based on the results of numerous studies of persons with haemophilia, persons who received transfusions from HIV-infected individuals, and spouses of both these groups; homosexual men; and occupationally exposed health-care workers. The CDC studies indicate that it is highly unlikely that HIV infection would go unrecognised for prolonged periods (over six months) in persons who are infected.

What is the primary impact of HIV on the immune system?

In a healthy person, the normal range of certain white blood cells called T4 lymphocyte cells (helper cells) is usually between 600 and 1200 (T4) cells per cubic millimetre (cells/mm3). (The range depends on the test used.) When HIV enters the bloodstream, it primarily infects T4 cells. Asymptomatic individuals infected with HIV usually have a lower than normal T4 cell count, and people with AIDS generally have between 0 and 500 T4 cells/mm3. The number of T8 lymphocyte cells (suppresser cells) in an HIV-infected person usually stays about the same. Because the number of T4 cells is low, the total T-cell count is lower than normal and the T4/T8 cell ratio is lower than the usual 2 to 1 ratio.

HIV infection not only reduces the number of T4 cells, it can also impair a T4 cell's functioning. HIV-infected individuals with very low T4 cell counts tend to have more serious infections. Therefore, regular immunologic tests to determine T4, T8, and total T-cell counts can be an important element in monitoring the health of an HIV-infected person.

How is HIV passed from one person to another?

These are the most common ways that HIV is transmitted from one person to another:

• by having sexual intercourse (anal, vaginal, or oral sex) with an HIV-infected person,
  
• by sharing needles or injection equipment with an injection drug user who is infected with HIV,
  
• from HIV-infected women to babies before or during birth, or through breast-feeding after birth.
  

Can I get infected with HIV from mosquitoes?

Time and again we have been educating our readers about the fact that mosquito bites do not cause AIDS, because the virus cannot survive in the saliva of a mosquito. Had this been possible, it would have caused havoc, especially in Asian and African countries where malaria is very common. After reading the news in papers many readers called up to clarify this fact. At the recent Hyderabad International Conference on parastic diseases, it was highlighted that the presence of malarial parasites in already HIV positive patients could lead to the rapid progression of full blown AIDS. Otherwise, it takes about 2-8 years before HIV positive persons get manifestations of the killer disease. Therefore, there is no need to get scared of catching the AIDS infection when you see a mosquito around.

Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)?

No. HIV is not transmitted by day-to-day contact in the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a doorknob, dishes, drinking glasses, food, or pets.

Can HIV be transmitted in swimming pool water?

HIV cannot be spread by sharing washing facilities or swimming in the same pool with an HIV-infected person. The body secretions, which would normally be washed off in a swimming pool (e.g., sweat or saliva), are not body fluids that transmit HIV. Blood, semen, and vaginal secretions would only enter a swimming pool under exceptional circumstances. Any virus that did get into a swimming pool would be greatly diluted, making it non-infectious. Most swimming pools also contain disinfective agents, such as chlorine, that inactivate HIV.

Can I get HIV through body piercing?

A risk of HIV transmission does exist if instruments contaminated with blood are either not sterilised or disinfected or are used inappropriately between clients.

If you are considering having your body pierced, ask staff at the establishment what procedures they use to prevent the spread of HIV and other blood-borne infections, such as hepatitis B virus.

How can I tell if I'm infected with HIV? What are the symptoms?

The only way to determine for sure whether you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.

The following may be warning signs of infection with HIV:

• rapid weight loss
  
• dry cough
  
• recurring fever or profuse night sweats
  
• profound and unexplained fatigue
  
• swollen lymph glands in the armpits, groin, or neck
  
• diarrhoea that lasts for more than a week
  
• white spots or unusual blemishes on the tongue, in the mouth, or in the throat
  
• pneumonia
  
• red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
  
• memory loss, depression, and other neurological disorders
  

However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again, the only way to determine whether you are infected is to be tested for HIV infection.

Similarly, you cannot rely on symptoms to establish that a person has AIDS. The symptoms of AIDS are similar to the symptoms of many other illnesses. AIDS is a medical diagnosis made by a doctor based on specific criteria established by the CDC.

How long after a possible exposure should I wait to get tested for HIV?

The tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within 3 months after infection, the average being 25 days. In rare cases, it can take up to 6 months. For this reason, the CDC currently recommends testing 6 months after the last possible exposure (unprotected vaginal, anal, or oral sex or sharing needles). It would be extremely rare to take longer than 6 months to develop detectable antibodies.

What if I test positive for HIV?

If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:

• See a doctor, even if you do not feel sick. Try to find a doctor who has experience treating HIV. There are now many drugs to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.
  
• Have a TB (tuberculosis) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
  
• Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as cocaine) can weaken your immune system. There are programs available that can help you reduce or stop using these substances.
  

There is much you can do to stay healthy. Learn all that you can about maintaining good health.

Who should get an HIV test?

Counselling and early diagnosis of HIV infection are recommended for:

• persons attending sexually transmitted disease and drug treatment clinics,
  
• the spouses and sex or needle-sharing partners of IV drug users,
  
• women of childbearing age who are at risk of infection,
  
• tuberculosis patients, and
  
• selected patients who received transfusions of blood or blood components between early 1978 and mid-1985.

In addition, persons considering marriage should have ready access to information and educational materials about AIDS, voluntary counselling and testing.

How do I prevent getting HIV?

To prevent the HIV infection:

• Do not have unprotected sex.
  
• Do not share needles or syringes to inject drugs.
  

To prevent the spread of HIV infection:

• Avoid behaviour that might result in contact with blood, semen, or vaginal secretions.
  
• Avoid sex with anyone who might be infected with HIV
  
• Do not share "injecting drug works."

What is The Council of Europe’s Stance on HIV and AIDS?

We urge all member Jamaats to adopt the World Federation Executive Council resolution of 3rd October 1998 and establish the necessary modality for implementation of the resolution before Nikah is recited.

To our community we strongly recommend abstinence from sex and drugs for unmarried teenagers and mutually faithful monogamous relationships for adults as primary ways of preventing the spread of HIV.

Adolescents need to be informed about the risk of HIV infection and encouraged to say "no" to sex and drug use. Younger children need to be given factual answers to their questions so that they do not harbour unnecessary fears or false information about HIV infection and AIDS. The type of educational programs that we support would provide this information to young people at an appropriate level in their development so that they will have accurate information when they need it but not before they are capable of understanding the nature of such information. The scope and content of this education effort should be determined by Madressa Teachers, parents, and others in a manner appropriate to our community's needs.

We believe in education that informs community members about how HIV is spread, who is at risk, and what actions can be taken to prevent infection, will save lives and help to halt the spread of HIV in our community.

We believe that education about sexuality is the responsibility of the parents, and it is our sincere hope that parents will live up to that responsibility. However, many lives may well depend on children receiving and understanding correct information. The type of education program that we support at Madressas would be sensitive to a child's level of awareness and maturity.

Realistically speaking, the ability to imagine a better future for ourselves is the only survival tool we have. All the other terms people use for safe sex discussions - "education," "support", "outreach", "prevention", "Just say no" - succeed or fail to the extent that they increase a person's capacity for hope or imagination. And, just as with any talent, some people have very little of it. And so they will fall by the wayside.

The Islamic life style - chastity before and fidelity within a marriage - is a safeguard against acquiring this disease. We have to live within the bounds of The Islamic Shariah and adhere to the injunctions prohibiting homosexuality and extramarital sexual relations. Despite the alarming aspects of this illness it is reassuring to know that we have the ability to choose to avoid AIDS and the answer lies in 'living within the precincts of the moral code' as prescribed by Islam and upholding the values of chastity and morality. Being faithful to ones wife or husband is the best way of prevention.

To strengthen our own capacity, we should study the world around us, find several people who have the capacity to push our growth, and attach ourselves to those persons. We have to move to another country if that's what it takes.