Positive Club

Positive Club
One of the goals of the *Millennium Development* initiative—endorsed by United Nations member states—was to halt and reverse the spread of HIV/AIDS by the end of 2015. However, progress toward this goal has fallen significantly short of expectations. Efforts have not advanced at the desired pace or scale, and many political commitments, including those made during the UN General Assembly Special Session on HIV/AIDS in 2001, remain unfulfilled.

In many areas, strong and committed leadership has led to meaningful progress in responding to HIV/AIDS. Pioneers can be recognized by their initiatives, attitudes, and actions. They become role models for others and persist in the face of challenges. Yet, pioneers are not always government officials. To overcome the global AIDS epidemic, leadership must emerge across all sectors—among individuals, schools, families, workplaces, religious institutions, nations, and at the international level.
In pursuit of these goals, Simaye Sabz Rahayi Harm Reduction Institute established the **Positive Club** in May 2009, dedicated to individuals living with HIV/AIDS. The club’s activities focus on education, awareness, and prevention of HIV/AIDS in the community, as well as providing psychological, social, and even material support to those affected.
As of March 1991 (Esfand 1369 in the Iranian calendar), the club has 78 active members. People living with HIV/AIDS face numerous social and cultural restrictions and often endure stressful experiences. The severe psychological and social consequences of AIDS are recognized as major threats to the health of those affected.
While it may not be possible to fully eradicate AIDS or its primary transmission routes—such as injection drug use and unsafe sexual practices—addressing the psychological, physical, and social dimensions of those living with HIV/AIDS can be a vital step toward improving their health and enhancing their hope for life

About AIDS
In 1981, eight severe cases of Kaposi’s sarcoma—a typically mild cancer found in elderly individuals—were reported among gay men in New York. Around the same time, an unusual rise in cases of a rare lung infection was observed in California and New York. Although the cause of these outbreaks was unknown at the time, these medical events are now considered the beginning of the AIDS epidemic.
Within a year, this unnamed disease spread rapidly. In 1982, it was officially named AIDS (*Acquired Immune Deficiency Syndrome*). As awareness grew, it became clear that the disease affected a broader population—not just gay men, but also hemophiliacs and intravenous drug users. Simultaneously, doctors in Africa began noticing a similar health crisis, locally referred to as “Slim,” meaning death due to gradual body wasting. Initially, Slim was not linked to AIDS, but later research revealed they were the same disease, affecting both heterosexual men and women.
In the midst of confusion and concern, global efforts to identify the cause and transmission of AIDS accelerated. In 1984, American researcher Robert Gallo announced the discovery of the virus responsible for AIDS—what we now call HIV. This claim was contested by French scientist Luc Montagnier, whose team had identified the virus months earlier. Despite the controversy, the race to find a cure began—a search that continues to this day.
Blood tests revealed that HIV had spread across all continents in a short time. Understanding the virus became an urgent priority, especially given its simultaneous emergence in Africa and the United States during the 20th century.
**Origin of HIV**
There is no doubt that AIDS is caused by the HIV virus. Understanding its origin is vital for developing effective vaccines and treatments. Genetic research shows that HIV likely emerged from a combination of two different *Simian Immunodeficiency Viruses* (SIVs) found in chimpanzees. This supports the theory that AIDS originated in the forests of West Africa over the past century.
In 1999, the journal *Nature* published a widely supported theory suggesting that HIV was first transmitted to humans via a subspecies of chimpanzees in Africa. Scientists believe that humans became infected through hunting and consuming chimpanzee meat—a tradition still practiced in parts of Africa. SIV entered the human body and mutated into HIV. The region of Guinea-Bissau in West Africa is considered the likely site of this transmission.
Researchers believe the virus may have crossed into humans multiple times, as different strains of HIV exist. Notably, none of the millions of Africans forcibly taken into slavery during the 19th century were infected, suggesting HIV emerged after 1860.
The earliest known HIV infection was detected in a blood sample from a man in Congo in 1959. Although the first AIDS cases in the U.S. were reported in 1981, evidence suggests the first American victim died in 1969 in St. Louis. Genetic divergence studies between HIV-1 and HIV-2 indicate that the virus likely jumped to humans around 1940, with a margin of error of about 20 years.
Further genetic studies published in *Science* revealed that two different SIVs from distinct monkey species combined in chimpanzees to form SIVcpz—the precursor to HIV. These monkeys, including the red-nosed mangabey and the spot-nosed monkey, are native to Central West Africa and are part of the chimpanzee diet. Elizabeth Bailes from the University of Nottingham and her colleagues emphasized that the dual origin of SIV in chimpanzees has significant scientific implications.

History of AIDS in Iran**
It is said that the first identified case of AIDS in Iran occurred a few years after the virus was discovered globally. The case involved a child with hemophilia who contracted the virus through a transfusion of contaminated blood. According to official statistics, approximately 12,000 individuals in Iran have been identified as HIV-positive. However, experts believe the actual number of people living with HIV/AIDS is significantly higher due to various factors.

In Iran, prior to the 1980s (the 1360s in the Iranian calendar), most cases were linked to imported contaminated blood products. During the 1990s (the 1370s), the primary modes of transmission shifted to shared needles among injecting drug users and unprotected sexual activity.

By 2004 (1383), the officially reported number of AIDS-related deaths stood at 894, although no reliable data on the total number of infections was available. Today, the United Nations representative for the AIDS crisis in Iran has reported a 100% increase in the disease’s prevalence. Mr. Ali Yazdan Setayesh emphasized that efforts to combat AIDS in Iran must be proactive and implemented before widespread transmission occurs.

Three main approaches are typically used to address diseases:
– **Prevention**
– **Diagnosis and Epidemiology**
– **Treatment**

Some experts argue that Iran faces challenges in all three areas. Dr. Mahboubeh Haj Abdolbaghi, a professor at Tehran University of Medical Sciences, has criticized current promotional and preventive policies and called for broader psychological interventions and educational outreach, especially among youth.

In terms of prevention, many people—particularly young individuals—still lack access to accurate information about HIV transmission and the importance of condom use during sexual activity. Numerous barriers also hinder the launch of large-scale media campaigns on this topic.

Regarding diagnosis, despite ongoing efforts, HIV testing is not yet available in all regions of the country, making reliable data collection and diagnostic access difficult.

In the area of treatment, most patients only receive basic medications aimed at slowing the progression of the disease. However, in many cases, the virus has developed resistance to these drugs, and patients require newer, more effective treatments. Additionally, HIV/AIDS treatment centers and clinics have not yet been adequately expanded across the country.

**The Red Ribbon**
The red ribbon is the international symbol of awareness and attention to AIDS. People often wear or display this symbol to raise awareness about HIV/AIDS and to remind others of the need for commitment, solidarity, and support.

**Correspondence and Preliminary Agreement with the Technical and Vocational Training Center**
Given the need for employment among individuals living with HIV/AIDS—and their limited physical capacity for strenuous labor—it was decided to provide vocational training tailored to each person’s interests and abilities. In November 2010 (Aban 1389), a formal letter was sent to the Tehran Technical and Vocational Training Organization. A few days later, a representative from the organization contacted the center requesting further information.

After outlining the needs and challenges faced by Positive Club members, it was agreed that a meeting would be held to present these issues to the organization’s officials. Following continued phone conversations, both parties agreed to hold an in-person meeting to discuss the matter in detail and draft a memorandum of understanding.

In late February (Bahman), the organization proposed two options to the institute:
1. Obtaining a license to establish a private training center for HIV-positive trainees in selected fields.
2. Equipping a space for vocational training in a chosen field by the institute, with the organization providing an instructor, conducting exams, and issuing official certificates. These proposals are currently under review.

**Correspondence with the Imam Khomeini Relief Committee for Financial Assistance**
In late November, a letter was sent to the local branch of the Imam Khomeini Relief Committee requesting non-repayable financial aid and support for several Positive Club members. After follow-up calls, the committee stated that due to budget constraints, they could not provide services to all club members. However, they expressed willingness to offer case-by-case assistance to individuals referred by the club.

**Distribution of Clothing to Economically Vulnerable Members**
Last autumn, a group of generous donors provided winter clothing for men and women to the Positive Club. After assessing the financial and living conditions of several members (PLHIV), the clothing was distributed to those in need.

Distribution of Nutritional and Antibacterial/Antifungal Medications to Positive Club Members**
Following correspondence with Pegah Distribution Company regarding the provision of various medications to the institute, a substantial quantity of nutritional supplements (multivitamins) and Clindamycin ointment (antibacterial and antifungal) was distributed among Positive Club members in need.

**Referral of Two Positive Club Members to the Imam Khomeini Relief Committee and Direct Financial Support from the Club**
After two members of the Positive Club requested financial assistance, their cases were reviewed individually. Both were referred to the local branch of the Imam Khomeini Relief Committee for case-based support. One member, who urgently needed funds to repay a loan installment, received a direct grant of 100,000 tomans from the club.

**Distribution of Hygiene Supplies to Positive Club Members**
During and after the World AIDS Day event, 40 hygiene kits—including toothpaste, soap, and shampoo—provided by Pakhsan Company were distributed among Positive Club members.

**Distribution of 5,250 Condoms to Peer Educators and Clients**
Following HIV/AIDS awareness classes for individuals engaged in high-risk sexual behaviors, those who completed the training and became peer educators received condom packages for personal use and distribution. Notably, several Positive Club members participated as facilitators in these sessions. Additionally, any club member in need of condoms can receive them free of charge. In the second half of 2010 (1389), a total of 5,250 condoms were distributed by the club.

**Consultation with HIV/AIDS Experts for World AIDS Day Planning**
In late summer 2010 (1389), Simaye Sabz Rahayi’s Positive Club held a planning meeting for World AIDS Day initiatives. Before finalizing proposals, the club sought expert input to ensure the selected activities aligned with its mission to support members. Consultations were held with:
– Dr. Nematí (Health Affairs, Shahid Beheshti University of Medical Sciences)
– Mr. Mahmoudi (HIV/AIDS Expert, Iran University of Medical Sciences)
– Ms. Esfahani (AIDS Control Committee, State Welfare Organization)
– Dr. Mohsenifar (UNODC, Iran Office)

Among the proposed ideas, publishing a book featuring personal stories of individuals living with HIV/AIDS was strongly supported. Organizing a public event with active participation from club members was also recommended.

**World AIDS Day Event in Collaboration with Tehran District 5 Municipality**
On December 5, 2010 (14 Azar 1389), a World AIDS Day event was held at the amphitheater of Bagh-e-Feyz Community Center in collaboration with the District 5 Municipality of Tehran. Thirty Positive Club members attended. Key speakers and guests included:
– Dr. Mohsenifar (UNODC, Iran Office)
– Ms. Tira (HIV/AIDS Expert, Ministry of Health)
– Mr. Tolouei (Mayor of District 5)
– Mr. Babazadeh (Deputy of Social and Cultural Affairs, District 5 Municipality)
– Mr. Amouei (Director of Social Services Center, District 5 Municipality)
– Other municipal officials and NGO representatives

In addition to speeches by Mr. Babazadeh, Dr. Mohsenifar, and Ms. Tira, one Positive Club member living with HIV/AIDS gave a heartfelt talk on stigma and discrimination. A theatrical performance was also part of the program and was well received by attendees. A side workshop on HIV awareness was held specifically for women attending the event.

**Formation of a Promotional Campaign Meeting with Graphic Designers and Writers**
Following the decision to publish a book of personal reflections addressed to officials in honor of World AIDS Day, a meeting was held with artistic and technical contributors to coordinate the book’s layout and illustrations. After discussions with several designers and publishers, one of the country’s prominent graphic artists—who expressed strong interest in volunteering for PLHIV-related projects—joined the initiative. It was agreed that a group of volunteer designers and graphic artists would handle the artistic and technical aspects of the book. Additionally, the meeting included discussions about future promotional efforts aimed at attracting sponsors, which are expected to continue into the following year.

**Presentation of Positive Club Services to Graphic Designers and Artists**
During the meeting, an overview of the services provided by the Positive Club to individuals living with HIV/AIDS was shared with the designers and artists to help them better understand the context and purpose of the project.

**Production and Distribution of the Book “I Tell You My Pain – Writings from People Living with HIV/AIDS”**
With the support of the Tehran Province Welfare Organization and in recognition of World AIDS Day, the book “I Tell You My Pain – Writings from People Living with HIV/AIDS” was compiled and published. After collecting content from club members, the campaign team handled editing, illustration, and layout. The book was distributed among relevant officials, club members, writers, and contributors, and received a warm reception. It was also handed out to attendees during the World AIDS Day event.

**Dinner Gathering with 30 Positive Club Members in Kan-Suleqan to Share Ideas and Needs**
Recognizing the importance of emotional well-being for individuals living with HIV/AIDS, the Positive Club invited 30 members to a dinner gathering at a restaurant on Kan-Suleqan Road. The event took place on Thursday, February 10, from 7:00 to 10:30 PM. In addition to enjoying the meal, members exchanged experiences to support newer participants. A student from the Institute for Cognitive Science Studies, affiliated with Shahid Beheshti University, organized a competition during the event, with prizes awarded to the top three winners.

**Engaging PLHIV Members as Operational Staff in PPUS and IDU Classes**
Due to physical limitations, some Positive Club members do not have stable employment. To support their involvement and provide financial assistance, several were invited to participate as operational staff in peer educator training sessions (PPUS and IDU classes). These individuals contributed actively during the fall and winter sessions, strengthening their connection to the club and receiving modest compensation for their efforts.

Conducting 71 Educational Sessions for Individuals Engaged in High-Risk Sexual Behavior (PPUS) and High-Risk Injection Practices (IDU)**
In the summer of 2010 (1389), ten sessions were held for women engaged in high-risk sexual behavior. These sessions covered general information about AIDS, definitions, stages of the disease, modes of HIV transmission, safe sex practices, proper condom use, and concluded with a Q&A segment. Participants in these sessions were later engaged as peer educators in collaboration with Simaye Sabz Rahayi’s Positive Club.

In the fall of 2010, six additional sessions were held for women in the same category, and fifteen sessions were organized for men engaged in high-risk injection practices. The men also received training on safe injection techniques. In winter, twenty sessions were held for women and twenty for men, all aimed at preparing peer educators.

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**Sample Report from a PPUS Session**
One of the key strategies for HIV/AIDS prevention is proper education and raising awareness. It is evident that various methods exist for delivering information, and their effectiveness depends on the target audience. Peer education is particularly valuable when working with high-risk groups. Peer educators often work within their own communities to promote behavioral change, increase awareness, and shift attitudes. Today, peer-led instruction is considered one of the most effective strategies in HIV/AIDS prevention.

Simaye Sabz Rahayi Harm Reduction Institute has actively implemented this approach through its educational programs. Below is a detailed report from one of the sessions:

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**Session Report**
This session was organized with the help of a female member of the Positive Club (a person living with HIV). After contacting several women engaged in high-risk behavior, six agreed to attend, and four were present on the day of the session. The class was held on November 7, 2010 (16/8/89), from 10:00 AM to 3:00 PM in the Positive Club room.

The session began with an introduction to the concept of peer educators. Participants asked questions, which were addressed in detail. Pre-assessment forms were distributed, followed by discussions on the following topics:
– General overview of AIDS
– Differences between HIV and AIDS
– Modes of HIV transmission
– Myths and misconceptions about transmission
– Stages of AIDS
– Safer sexual practices

Participants received hands-on training in proper condom use. After the Q&A, post-assessment forms were distributed. The peer educator assisting in this session also explained how to complete Form 7 and encouraged participants to adopt safer sexual behaviors, which was well received.

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**Session Facilitation**
All logistical aspects of the session—including registration, preparation, distribution and correction of pre- and post-assessment forms, and delivery of content on safer sex—were managed by a Positive Club member living with HIV/AIDS. This initiative aimed to boost morale through active participation and provide modest financial support.

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**Evaluation**
Based on the session’s evaluation, a 27% increase in participant awareness was recorded.

As emphasized earlier, proper education and awareness are essential for HIV/AIDS prevention. Peer-led outreach remains one of the most impactful methods for engaging high-risk groups and promoting sustainable behavioral change.

Simaye Sabz Rahayi Harm Reduction Institute continues to implement these educational sessions, with detailed reports available for each.

**Training Session Report**
This session was held on November 16, 2010 (25/8/89), at 10:30 AM for 12 individuals who use drugs and had visited the Drop-In Center (DIC) to receive services. As with previous sessions, the class began with an introduction to the role and responsibilities of peer educators. Participants asked questions about peer educator activities, which were addressed by the instructor.

Pre-assessment forms were then distributed by the assistant and collected after completion. The educational content covered the following topics in detail:
– General overview of AIDS
– Differences between HIV and AIDS
– Modes of HIV transmission
– Myths and misconceptions about transmission
– Stages of AIDS
– Safer sexual practices

Additionally, practical demonstrations were provided on safe injection techniques and correct condom use by the assistant. Participants’ questions were answered throughout the session. At the end, post-assessment forms were distributed. Instructions were also given on how to complete Form 7, and each participant received a hygiene kit.

**Session Facilitation**
All logistical and operational aspects of the session—including preparation, participation in discussions, explanation of peer educator roles, distribution and correction of pre- and post-assessment forms—were managed by a Positive Club member living with HIV/AIDS. This initiative aimed to boost morale through active involvement, foster collaboration, and provide modest financial support.

**Evaluation**
Based on the comparison of pre- and post-assessment forms, the session resulted in a 20% increase in participant awareness.