To Zanzibar, With Love: Researching AIDS in the Muslim World

Zanzibar (Africa’s “Spice Islands”) is better known for its clove, cinnamon, and pepper than high transmission rates of HIV and AIDS, which has devastated most of Sub-Saharan Africa. This island, an archipelago in Tanzania off the east coast of Africa, actually consists of a series of islands, but is referred to by its two largest islands, Unguja and Pemba, with a population of around a million people.

Zanzibar is mostly Muslim and an island, which may explain why there are lower transmission rates of HIV and AIDS here. However, public health officials have also noticed that the rate of transmission is much higher here for the island’s high risk groups than for its general population. Zanzibar AIDS Control Programme (ZACP) and the government want to keep the disease from bridging into the general populations, so they are gathering information from its hidden populations, where the behaviors are not only risky and unspoken, but also illegal.

Leigh Ann is getting her PhD in Public Health through Tulane University and is the lone foreign researcher on the ground with the ZACP study. We spoke over Skype (and a ten hour time difference) to talk about her work with the people in these high risks groups, how a government like Zanzibar’s can be a model of service when it comes to HIV/AIDS research, and the cultural differences between those groups in Africa compared to America.

In their study, the ZACP has called in three populations for their study: men who have sex with men (but who don’t believe themselves to be gay), injective drug users, and female sex workers. Many men will have sex with other men in order to make money to buy heroin or cocaine, but would not be considered gay. The surveys consist of close-ended questions as well as anonymous testing for HIV, Syphilis, and Hepatitis B and C. So far they have been able to test nearly 350 people, which is a large response for a study like this one. Leigh Ann notes a big draw has been that many want their HIV results, since the study tests them anonymously. ZACP wants to look at the different conduits of transmission, while the government wants the information to be available in a non-judgmental, yet informative, way so that they can decide what to do with programs and intervention in order to keep the people of Zanzibar safe.

“The biggest stigma in a country like Zanzibar is that homosexual sex acts and behaviors are stigmatized in their culture,” Leigh Ann said.