Vulnerabilities: HIV and AIDS
By Amina Wadud
The following is the text of the presentation given at the 2nd
International Muslim Leaders Consultation on HIV and AIDS held in
Kuala Lumpur, Malaysia in May 2003. This is a draft of a paper in
process, and the author does not wish it to be quoted or further
referenced.
The spread of HIV/AIDS within families brings up an interesting
concern with addressing inconsistencies between intent and
experience within the family: How do certain family structures
create greater vulnerability? The first part of this presentation
will look at an interesting paradox: the family, that institution
through which human beings expect and receive their greatest
nurturing, is the same institution that can create the greatest
vulnerabilities in the spread of HIV/AIDS for women and children.
When the structure of family itself causes vulnerability, critical
examination is even more in order to construct ways that civil
society can empower family members to challenge the abuses that
occur within families. However, some see the very idea of
challenging “family” as a disruption in social well being.
Ultimately my question is: How can families empower all members
equally despite vulnerability due to age or gender.
The first part of this presentation will examine the terms and
experiences of vulnerability to HIV/AIDS for women and children as
members of existing family structures in the context of Islam and
Muslims. My objective is to disentangle or demystify “family” by
focusing on both its supportive and destructive aspects. Family as
a construct must be subjected to a rigorous analysis as part of
any agenda that seeks to fight against the spread of AIDS. As
such, combating AIDS will also contribute to reforms in Muslim
Personal Status Laws. One goal of these reforms will be to help
the family structure function as a comfort and support for all its
members equally. I will review some of the underlying assumptions
about family in Islamic law in as much as these historically
constructed assumptions are still implemented in Muslim societies
while allowing undue privilege for men and male desires. This
presentation uses the HIV/AIDS epidemic as evidence of dangerous
and untenable double standards in the face of modern social change
and experience. I will consider structural inconsistencies that
often go unchallenged when the word “family” is introduced. While
seeking to retain the family ideals of nurturance and support, I
will also focus on they way some family structures provide for
particular vulnerabilities.
The second part of this presentation will begin to think about
theological implications of combating the spread of AIDS,
increasing public awareness, and empowering both direct and
indirect victims of HIV/AIDS. Some family members have directly
contracted the virus through abuses and misunderstandings of other
members while some family members find their life style and future
indirectly affected by members with HIV/AIDS.
Thinking about HIV/AIDS gender and family in an Islamic
Perspective
In 2002, I had my first encounter with constructive organizational
level efforts to respond to the AIDS epidemic at a meeting in
Nairobi, Kenya. The World Conference on Religion and Peace (WCRP)
convened as part of the HACI program (HIV/AIDS Children
Initiative) launched specifically to address the needs of
increasing numbers of orphans of AIDS. Dr. Vendley will no doubt
provide details on WCRP’s particular project related to utilizing
community based religious organizations for information, advocacy
and assistance.
My experience at this WCRP meeting was important not only as a
context for learning but also as it sparked my interest in the
work needed in the context of Islam and Muslims with AIDS. On that
occasion, African Religious leaders also gathered for a summit.
The Muslim participants convened one morning to discuss the
initiatives and Islam. One of the “Imams” dominated the first half
of that 45-minute meeting by giving a khutbah (long speech) on the
importance of avoiding zina (fornication). This khutbah was
insignificant to our development of a clear “Islamic” position on
the particular initiative regarding AIDS orphans. Indeed, the
whole tenor of the speech was useless as a framework for
developing an Islamic theological response to HIV/AIDS. Yet, such
a response might be useful if developed in the future. During the
time since that meeting, I have begun to think about an Islamic
theological response and the problems that it might pose.
HIV/AIDS and Vulnerability
In effect, what I present here emphasizes the ways that Islam and
Muslims exacerbate the spread of AIDS and that a traditional
Islamic theological response can never cure AIDS. AIDS exists as
an immune deficiency syndrome. It has spread to epidemic
proportions; over 42 million people are affected with an estimated
3 million deaths per year. Of particular interest to my thesis is
the consequence and spread of AIDS among children (under the age
of 15), with additional infections of over one half million
annually. In addition to its fatality, consequences here include
children who become orphaned each year due to the death of their
primary care takers from AIDS. The estimates are 14 million
children orphaned by AIDS. What does a theological premise “la
taqrabuna ‘l-zina” avail these children? How has Islam in
particular assisted them towards living a life of dignity and how
has it prevented them from experiences of dignity and worth,
un-stigmatized by our ostrich theology and law? My experiences at
the Nairobi meeting included a visit to an orphanage run by a
women’s church group. To be sure, these women were also concerned
with the spiritual health and development of the children in this
home. What happens when religious groups, be they Muslim or
otherwise, take in a child? What happens if the child had Muslim
or Christian parents? Do we only take in those children who are
members of our own religion? Can we raise any child with true
religious choice once we take them in? It presents an interesting
case vis-à-vis the concerns for these 14 million children. If we
save an endangered child is the child then further endangered by
loss of religious choice?
The other group that is of concern here are monogamous wives.
Especially in the context of Islam, where a Muslim wife is not
only expected to be, but defined in terms of her being
unconditionally sexually available to her husband. Properly
fulfilling this role of wife is fatal to some women, with
estimates as high as 80%. That is 80% of the heterosexual women
with AIDS are monogamous and have only ever had sex with their
husbands. What does a theological premise “la taqrabuna ‘l-zina”
avail these women? How has Islam in particular assisted them
towards living a life of dignity and how has it prevented them
from experiences of dignity and worth, un-stigmatized by our
ostrich theology and law?
Ultimately the solutions to the problems of AIDS will not be
limited to victims in the two particular sub-groups of my
examination. However, I am interested in how these two groups
demonstrate how empty religious platitudes are in addressing the
problem and how, even when those responses are based on the Qur’an
and Sunnah they are ineffective to resolve the problem.
HIV/AIDS and Sexuality in Islam
With regard to the 80% heterosexual women who contract AIDS in
monogamous relations, a direct look at Islam and sexuality is
called for. According to Shari’ah if a Muslim man desires
intercourse with his wife, she must comply. If she does not, she
is guilty of nushuz, recalcitrance. A wife who is nashizah is no
longer eligible for nafaqah: maintenance or financial support. In
addition, in various degrees of interpretation and application,
the Qur’an asserts that the husband of such a woman may beat her.
In the face of this, the vast majority of Muslim wives, those with
gentle husbands, husbands of polygyny: open or secret, husbands of
violence and abuse, upright husbands of moral standing and
husbands of AIDS, open their legs to their men as they are not
only expected, but commanded to do by that which is most popularly
understood as “Islam”. Women turn towards men who have contracted
AIDS and open their legs to their own death and destruction. It
matters little if the men have contracted AIDS by either legal and
moral or illegal and immoral means. By legal and moral means, I
refer to the husband who has contracted AIDS by marrying younger
more sexually virile women as confirmation of their masculine
sexuality and then turn to the demure and compliant wife of longer
standing. In turn, she may then give birth to or infect at birth
their innocent child. The consequences for the muhsinat and
qaanitat are the same: they will die because they are “good”. How
does a statement, “la taqrabuna ‘l-zina” apply to them? How does
“Islam” resolve this problem?
Sexuality
One of the underlying concerns for fully addressing HIV/AIDS is a
hard and fast look at sexuality in Islam. To do this, I remind us
first about sexuality and gender in general. My references here
are to research by western feminists. In particular, I am
interested in work done on the tyranny of patriarchal domination
through heterosexuality or the sexual politic of domination. For
the most part, marriage in shari’ah is marriage of the woman’s
subordination. Whatever choice she may have in contracting
marriage to a particular prospective husband, her choice is then
limited within the structures of marriage and family that prevail
once the marriage is consummated. There is a considerable lack of
reciprocity vis-à-vis what happens in the marriage itself.
“A prime theoretical contribution of the contemporary analysis of
women’s oppression can be captured in the slogan “the personal is
political”. What this means is that the subordination of women by
men is pervasive, that it orders the relationships of the sexes in
every area of life, that a sexual politic of domination is as much
in evidence in the private spheres of the family, ordinary social
life, and sexuality as in the traditionally public spheres of
government and the economy. The belief that things we do in the
bosom of the family or in bed are either “natural” or else a
function of personal idiosyncrasies of private individual is held
to be an “ideological curtain that conceals the reality of women’s
systematic oppressions”. For the feminist, two things follow upon
the discovery that sexuality too belongs to the sphere of the
political. The first is that what ever pertains to sexuality—not
only actual sexual behavior, but sexual desire and sexual fantasy
as well—will have to be understood in relation to a larger system
of subordination; the second, that the deformed sexuality of
patriarchal culture must be moved from the hidden domain of
“private life” into an arena of struggle, where a “politically
correct” sexuality of mutual respect will contend with an
“incorrect” sexuality of domination and submission”. (Sandra Lee
Bartky “Feminine Masochism and the Politics of Personal
Transformation” in Living With Contradictions: Controversies in
Feminist Social Ethics”, edited by Alison M. Jaggar, Westview
Press, 1999; pg. 519.)
According to the article “Sexuality, Diversity, and Ethics in the
Agenda of Progressive Muslims” by Scott Siraj al-Haqq Kugle in a
recent volume entitled Progressive Muslims from One World
Publication, Muslim scholars apparently were already ahead of the
feminist here:
“In comparison with many other religious traditions, it has often
been noted that Islam is a religion that has evaluated sexual life
positively. Articulating the integral relationship between
spirituality and sexuality is one way that the Prophet Muhammad
challenged his society. It remains for us, today, to continually
struggle with that challenge. The system of norms, rules, and laws
created by Muslims in the past (a collective body we call Shari’ah)
does not absolve us of this challenge. It may, in fact, create
complexities that drive us to reinvestigate the topic while
presenting obstacles to a just resolution of those complexities.
Scholars in the contemporary period have not lived up to the
standards and frankness of pre-modern Islamic scholars, and much
work has yet to be done on the question of sexuality in Islamic
scripture, law, and society. Many scholars and Islamic leaders in
the present shy away from honest discussions of sex and sexuality,
with all its promise and problems. Muslims in pre-modern times
certainly were not shy about discussing matter of sex and
sexuality, so why should we be so prudish? The most basic goal of
this essay is to return to us the contemporary Muslims, the “awe
and bewilderment” that al-Ghazali felt when considering sexual
pleasure.
Sexuality is connected not just to spirituality, but to politics
as well. What is required of us in political situations is an
acute sense of justice, but we often ignore or obscure justice
when it comes to matter of sex and sexuality. We need to think
more clearly about “intimate citizenship”, how personal,
emotional, and sexual dimensions of our lives (which are often
locked away as “private”) actually have very public and often
political consequences.” (Scott Siraj al-Haqq Kugle ,“Sexuality,
Diversity, and Ethics in the Agenda of Progressive Muslims” in
Progressive Muslims from One World Publication, 2003, pg 191.)
Coincidently this article takes a thorough look at the issue of
homosexuality and presents the reader with various classical
interpretations of the story of Lut from the Qur’an. Yet even in
the new territory being forged by this article, Siraj never
manages to disentangle his compliments of the past and critique of
the present, from the extent to which even his struggle to look
more affirmatively at sexuality is based primarily on male
sexuality. What is considered here as Islam’s lack of prudishness
in the classical period was still on the basis of the predominant
notion of human being, i.e. the male human. Furthermore, the
Qur’an itself, as well as the shari’ah is founded upon male sexual
experience. I have looked elsewhere at how the Qur’an seems to
affirm masculine pleasure and experience. In the Qur’an I point to
three specific incidents that give a cross section of male
sexuality and fantasies without ever responding in an equivalent
manner to women and women’s sexuality.
Foremost however is the Qur’anic affirmation of marriage in
general, which can be said to be gender neutral. The underlying
assumption of an overwhelmingly heterosexual social order is that
women and men should be engaged in healthy sexual exchanges.
However, the first indication that there are some disproportionate
elements in this general gender neutral formula is in the
attention given to men’s “right to satisfaction” from the verse on
women as tilth, then the conditional permission to multiple wives
and concluding in the afterlife with meticulous details concerning
the huris of paradise. Not only do no equivalent articulations
exist in the Qur’an about women’s sexual satisfaction, the Qur’an
refers to post-menopausal women as being “beyond want” despite
ample evidence to the contrary. Following closely upon this, the
emphasis on sexuality in the law is overwhelmingly on male
heterosexual satisfaction.
An HIV positive woman is not an indictment of the promiscuity of
the woman, since: “Men are qawwamun” (4:34) can be seen as
recognition of the unequal power dynamics of masculine and
feminine sexuality. It is not in the command form implying perhaps
the idea that it is an edict, to be fulfilled by the mere nature
of being a man. It is stated in the form of an active participle
recognizing agency and being. A man may fulfill qiwamah. Therefore
women must yield sexually to this Qa’im, whether he is acting in a
manner mustaqim (straight) or crooked. An anology could be made
between the sexual moralities of an HIV positive married Muslim
woman and pregnancy in an unmarried Muslim woman. Neither is proof
of a woman’s indiscretion. With today’s fertilization sciences,
pregnancy is not even proof of intercourse. Surely evidence shows
that there are multiple causes of pregnancy other than a woman’s
consent. However, both cases lend themselves well to the idea that
women are more vulnerable in Muslim societies.
Vulnerability and Gender
Much of my information in the following was taken from the World
Health Organization. Their data was as old or as recent as
December 2001. “In most societies, girls and women face heavier
risks of the HIV infection than men because their diminished
economic and social status compromises their ability to choose
safer and healthier life strategies.” Gender roles powerfully
influence the course and impact of the epidemic and affect the
extent to which AIDS affects vulnerability. Gender inequalities,
the different attributes and roles assigned to women and men in
society affects their ability to protect themselves and cope with
its impact. “Reversing the spread of HIV therefore demands that
women’s rights are realized and that women are empowered in all
spheres of life”, especially sexually. The factors that increase
the vulnerability of women and girls to HIV “include social norms
that deny women sexual health knowledge and practices that prevent
them from controlling their bodies and deciding the terms on which
they have sex.” In addition to this are “women’s limited access to
economic opportunities and autonomy, and the multiple household
and community roles they are saddled with.”
The proportion of women living with HIV/AIDS has risen steadily.
Women are often affected at an earlier age than men. Girls are
five or six times more likely to be infected than teenage boys.
There is also growing evidence that a large share of new cases of
HIV infection is due to gender based violence in homes, schools,
the workplace and other social spheres, to say nothing of
situations of civil disorder and war where women and girls are
systematically targeted for abuse, including sexual abuse. HIV
positive women are also discriminated against when trying to
access care and support. Meanwhile the burden of caring for ill
family members rests mainly with women. Discrimination in care
support and women’s own indispensable support roles often mean
that many will seek assistance for their own illness much later
than will positive men. Without women-specific programs being
integrated with other services such as ob-gyn, social support,
substance abuse, nutrition and the like, women’s particular needs
and vulnerabilities will not being formulated and will render any
agenda said to effectively assist in the reduction of the spread
of AIDS hopelessly problematic.
The “la taqrabuna ‘l-zina” agenda is one such problematic agenda.
It does manage to increase the stigma of all HIV positive cases.
Muslim women who are described in the Qur’an in terms particular
to their sexual virtues especially feel the concern for moral
propriety. The significant role played by stigma in reducing the
gains of a battle against HIV/AIDS needs its own attention. Like
rape, women are more clearly the ones most victimized, but they
are also the ones more likely to be stigmatized by its occurrence
and as such will more than likely hide their experience in order
to avoid the negative social and spiritual consequences of such a
confession. On the other hand, when a woman stands forward to
pronounce her opposition to those factors that increase women’s
vulnerability, she herself may be cast in a negative light with
suspicions about her morality being whispered behind her back. In
this force of stigma, it is no wonder that women are still among
the minority of those who have worked comprehensively to help
construct a more compassionate paradigm, including the “Islamic”
religious paradigm, to confront such an issue.
Yet only with women’s full participation and empowerment can the
disease actually be arrested. In this regard, an Islamic
perspective on HIV/AIDS is impossible without simultaneously
addressing women’s empowerment, including their sexual empowerment
in the context of the patriarchal paradigm that still predominates
our notions about sexuality in Islam. A new paradigm that promotes
women’s rights to know (i.e. be informed) to say no (i.e. refuse)
or otherwise determine independently the exact nature of their own
sexuality and their responses to the predominance not only of
heterosexuality, but to the tyranny of it.
How does “Islam” resolve this problem?
There are no Qur’anic verses on epidemics, whether of the immune
deficient or SARS type. Yet Muslims must address these problems.
Furthermore, if a Muslim is efficient at bringing about a cure, or
resolving the issue of the spread of these diseases, we might want
to associate his or her “Islam” with the consequence of their
research or medical findings. If we do make this association,
however, it will at best be indirect. Even if the successful
researcher makes an explicit or direct statement that the work was
accomplished as a result of his or her being Muslim, it will be
impossible to refer to a specific Qur’anic verse or prophetic
ahadith that can stand as the foundation of the technical skills,
medical know how or research methods that could actually prove to
bring about the solution. In a sense this gives us, as Muslims,
the greater freedom in participating fully and responsibly in the
search for a cure. If we fail, we cannot be indicted as bad
Muslims. On the other hand, if we are successful, we cannot
associate our success explicitly to Islam, even as we take
inspiration from it.
Likewise, we cannot blame a failure of Islam as the cause for
AIDS. If we address shortcomings within family law, as conditional
upon the safety and security of those whose lives suffer from
existing family structures, then we can help to reconstruct the
law to remove those factors which help the spread of AIDS.
Although these structural problems may be seen as secondary causes
of the spread of the virus, the process of reducing the spread of
it has shown the need to address all causes. Furthermore, these
structural changes have other positive results in formulating more
egalitarian families and society.
As a non-medical person, and one who does not contribute to
disease research, I am clear that I cannot propose a solution to
HIV/AIDS. My concern here is to address the ways that hollow
Islamic theological rhetoric is made hallow or sacred by
authoritarian means. Religious leaders, scholars and medical
personnel cannot resort to these empty platitudes to excuse them
from dealing directly with a problem of this catastrophic
proportion.
HIV/AIDS and Zina
If HIV/AIDS was merely the result of immoral or un-Islamic
behavior then non-Muslim countries should have a higher percentage
of cases. However, highly industrialized countries like the United
States have more active measures to curtail the spread of the
disease perhaps because they do not resort to such an equation.
When the emphasis is on reducing the spread of AIDS and not on
taking a moral high ground, then more effective means for its
reduction has resulted. Again, the underlying presumption that
this disease can be directly linked to some un-Islamic level of
moral behavior precludes the efficacy of other factors to
determine the actual spread or safety and protection from its
fatalities. The United States began its campaign against the
spread of AIDS without the religio-moral high ground that can
thwart an effective response to the epidemic. Without
name-calling, isolation, silence and denial, it was able to
address the spread. Simultaneously, the U.S. also launched the
first ever such public campaign to promote celibacy among American
youth. Commercials show popular and sophisticated young people
engaged in a number of activities, going to school, earning and
saving money, or creatively engaged in the arts, articulating
their reasons for abstaining from sex until they are married.
Whether this is true or not seems to be beside the point: it has
more effectively advocated for abstinence.
HIV and Shari’ah
My concluding remarks are based on the impossibility of an
exclusively Islamic theological response to HIV/AIDS. I don’t mean
to sound pessimistic or un-Islamic here, but I have already stated
that:
“Even if the successful researcher makes an explicit or direct
statement that the work was accomplished as a result of his or her
being Muslim, it will be impossible to refer to a specific
Qur’anic verse or prophetic ahadith that can stand as the
foundation of the technical skills, medical know how or research
methods that could actually prove to bring about the solution. In
a sense this gives us, as Muslim, the greater freedom in
participating fully and responsibly in the search for a cure. If
we fail, we cannot be indicted as bad Muslims. On the other hand,
if we are successful, we cannot associate our success explicitly
to Islam, even as we take inspiration from it.”
Indeed, I see Islam as inspiration for making my comments here as
forceful and hard hitting as I could in order perhaps to jolt my
own soul out of any tendency towards what Faisal Abdul Rauf calls
the “ostrich approach” to Islamic theology in the face of
seemingly insurmountable odds that do find an explicit and
simplistic textually based solutions. In his book Islam: A Sacred
Law: What every Muslim Should Know About Shari’ah, Abdul Rauf
reminds us that Shari’ah is the “operative formula by which the
Muslim determines what is good and ethical”. What is good conforms
to divine intent. “The primary focus of the shari’ah is on
humankind’s journey towards intimacy with our Creator… It protects
the religion from the vicissitudes of history.” Furthermore he
considers that “it is the law of Islam that is arguably the most
important element in the struggle waged between traditionalism and
modernism..” and recommends that we draw our temporal into the
eternal… and “think about the morality of issues that were not
posed to us before …” Indeed, if the “Islamic point of view” has
not yet been established,” he asserts there “ought to be”.
Yet he refers to the three responses by Muslims to modern
dilemmas. Number one is the “ostrich approach”: bury our heads in
the sand and quoting ahadith and Qur’an, especially those to imply
Muslims are on a moral high ground and thus unaffected by these
new dilemma. The second is to build a Muslim society by
establishing standards adhering to divinely ordained values. The
third is to develop a methodology to integrate us into the society
at large without losing our religious integrity and identity.
Clearly this third option will be the most affirmative one in
response to HIV/AIDS.
The nuts and bolts of any affirmative action on legal reforms will
be drawn from a variety of sources of Islamic law, textual and
ijtihadic. How they have been used and can be use vis-à-vis
HIV/AIDS is not fixed, yet using them is essential. Differences in
their usage need to be plainly spelled out, showing the ways of
using the various criteria and our own sense of moral imperative
to achieve optimal opportunities to benefit HIV/AIDS sufferers and
to prevent further spread. We must be honest, however, that this
is a process. For something like HIV/AIDS there is no simple
precedent. AIDS is an indiscriminant, equal opportunity killer: it
matters little if you pray everyday or never pray at all.
Therefore we will not be able to resolve the problem by the
ostrich logic that pretends good Muslims don’t contract AIDS, let
alone die from it.
With respect to legal reforms I am intentionally deferring to
those experts on matters of jurisprudence with this one important
caveat gleaned from my experiences addressing issues of Islam and
gender for several decades. No interpretation, application or
positive development can proceed without every effort to include
the ones whose agency is most directly affected by the case
presented. HIV positive persons and victims of AIDS from all
sectors of society must be included in the process of resolving
the problem if we hope to achieve effective results. In this
respect it is the reality of the ones who experience it, which
determine not only the nature of the experience, but the positive
responses to it for the goals
