In her bright orange clothing, South African Riana Jacobs, 31, stands out from the crowd at the recent International Consultation on Islam and HIV/AIDS, organised by the charity, Islamic Relief Worldwide (IRW), in Johannesburg, South Africa.

She has been HIV-positive for the last 10 years and is not intimidated by the audience of Muslim religious and academic leaders, mostly men. When she declared her status in 2004, compassion from her religious leaders was hard to come by.

"People accept it when it's not their problem," she said. "But leaders don't want to see that seroprevalence is increasing among Muslims."

This picture of intolerance is slowly changing as more initiatives throughout the world educate imams - Muslim religious leaders - about HIV and AIDS, so that they can teach their congregations.

"The imams are more effective than television or the radio in certain areas because of their authority and influence ... imagine the impact if all imams dedicate time in their sermons to talk about HIV," remarked IRW president Dr Hany El Bana at last week's meeting.

According to UNAIDS, although prevalence in Islamic communities is relatively low, it is growing in countries like Algeria, Iran, Libya and Morocco.

In Mozambique, where a quarter of the population is Muslim, 19.8 percent of the adult population is living with the virus; in Guinea Bissau, where 4 in 10 of the country's 1.4 million inhabitants follow the Islamic religion, the national seroprevalence rate is 3.8 percent.

Data from the National AIDS Commission in Indonesia - the world's most populous Islamic country, with 225 million inhabitants - show that HIV cases have been reported in almost all its 33 provinces, mainly among intravenous drugs users.

Allah Yar Qadri, once an imam and now a consultant on community development, HIV/AIDS and Islamic issues in Malawi, warned that imams could not afford to distance themselves from the issue. "If the imams remain silent, others will take the lead and speak to our communities, but far from Islamic principles."

Do female condoms exist?

In Muslim communities, HIV has been associated with infidelity or promiscuous behaviour, so many people have viewed infection as a well-deserved divine punishment, but this perception is slowly being replaced by a more tolerant attitude.

An effective change in mentality would require not only education about the pandemic, but also more information on sex and risky behaviour, which scholars do not always have. "I'm sorry, but do female condoms exist?" asked Amna Nosseir, a specialist in Islamic philosophy who hosts a television programme in Egypt.

To a certain extent the lack of knowledge can be traced back to the madrassas (Islamic schools), which are reluctant to deal with more current themes. "The curriculum in the madrassas needs to be revised," Qadri said. "Islam is a religion in progress, so it's necessary to incorporate contemporary aspects into curricula, and sex is an important chapter of the Quran."

Economic factors also matter. In Malawi, for example, many imams are contracted by a committee of community businessmen, so they may not always be able to preach about what they see as most pertinent. "If the imam talks about HIV and AIDS without the committee's approval, the next day he could lose his job," Qadri explained.

Back to school

Some Islamic countries are solving the problem by educating imams about HIV/AIDS. Sheikh Mohamed Bashir Joaque, who was born in Sierra Leone and lives in the United Kingdom, is part of the African Muslim Communities Campaigns Against HIV/AIDS initiative, and the growing success of his courses in London have led to the creation of a manual on HIV/AIDS for religious leaders.

He says the secret is to transmit information gradually, from an Islamic perspective. "We need to adapt. We don't start talking about condoms right from the beginning. We emphasise that the best thing is still abstinence before marriage and faithfulness during marriage," he explained.

"But we also say that we're all human and can all have moral lapses, and if this happens, condoms should be used. If we're too direct, they leave."