Ethiopian Falash Mura who wait in urban compounds in Gondar
and Addis Ababa
several years to get approval for their immigration from Israeli authorities are three times more likely to contract the AIDS virus there than those who have to wait less than a year.
This disturbing phenomenon was proven by Prof. Shlomo
Ma'ayan, director of the Hadassah
University Medical Center's AIDS Center in Jerusalem's Ein Kerem
, who has just completed a two-year study with the Jerusalem District Health Office.
"Policymakers must take into account the much greater danger of contracting HIV while they wait for bureaucratic matters to be worked out," Ma'ayan told The Jerusalem Post
in an interview on Thursday. "It is manageable, a man-made problem, since the vast majority of the Ethiopians eventually get approval for immigration to Israel
. Not only do many unnecessarily become HIV carriers, but the government pays for the anti-AIDS drug 'cocktail,' which is very, very expensive."
Ma'ayan added that, based on his research, he reached the conclusion that more must be done by the American Jewish organizations that support the Falash Mura in their urban compounds to teach them about AIDS and how to avoid it, and to persuade them to use condoms during chance sexual encounters in the cities.
He added that it was even more important for the would-be immigrants to get approval for aliya in their villages, without them having to live and wait in the urban centers. "We found that when the Ethiopians departed from the village of Quara, and did not have to wait, those immigrants had the lowest rates of HIV transmission."
The study was carried out on 658 Falash Mura immigrants age 15 and up. Falash Mura are not halachically Jews, but they are of Jewish ancestry and were forced to convert to Christianity in recent generations. Once they come to Israel, they undergo conversion to Judaism.
There are 20,000 Falash Mura waiting to come, and about 300 to 350 are brought here each month. The government recently committed itself to double the number to 700 a month.
Ma'ayan and his team conducted medical examinations on the immigrants in their absorption center. "Intuition tells you that the longer they are in the cities, the higher their risk of infection, but no one has ever proven this. We are the only ones to test the immigrants for HIV and correlate the amount of time they stayed in the compounds with their risk for infection," he explained.
HIV infection among Falash Mura is almost always due to sexual activity, as there is no drug use and no homosexual activity, and infection by contaminated needles is almost unknown. Ma'ayan said. He did not know whether some of the sex was forced (rape).
When, using skilled interpreters, the Hadassah researchers asked the immigrants how long they had to wait until they left Ethiopia
and compared it with the rate of infection, they found that 6.1% of all the immigrants they studied were infected with HIV - 6.3% of the women and 5.8% of the men. Ma'ayan explained that for anatomical reasons women are more at risk of getting infected in a sexual encounter than men.
The infection rate was only 2.3% among those who spent less than a year in the cities; 2.8% for those one to two years, 1.3% between two and three, and 10.2% among those who waited three years or more. Thus the waiting time was a statistically significant factor, he added. Not only the younger immigrants were sexually active: among those 45 to 54, 8% had been infected in the compounds, while over 65, the rate was an astonishing 4.8%. All of those diagnosed here are given the protease inhibitor drugs at state expense, and none of the 40 immigrants
with HIV died of AIDS or its complications.
Now that he knows what he does, Ma'ayan said he will send his findings to Health Ministry director-general Prof. Avi Yisraeli, Hadassah Medical Organization director-general Prof. Shlomo Mor-Yosef and others in the hope that they will influence government decision-makers.