CAIRO -- As the delivery date neared for the birth of her first child, Rose was stuck between her conscience – she didn’t want to lie – and the practical necessity of giving birth to a healthy child.

Rose thought about telling her doctor that she was HIV-positive – the routine blood tests her obstetrician had ordered didn’t screen for HIV – but she knew the risk of that: When she sent a friend to pretend that she was HIV-positive and pregnant, the doctor told the friend he didn’t deliver the babies of HIV patients.

So on her delivery date, she told the doctor she was a hypochondriac and that it was important to her that the doctors take extra precautions during her delivery.

“Every pregnant woman usually feels excited and can’t wait to get her baby delivered, except me; I was panicking,” she said. “It was a horrible feeling to go to a doctor and tell him that I am not infected. I felt dishonest.”

HIV education has become an international cause throughout Africa, where the rate of infection devastated many sub-Saharan nations but is being brought under control by concerted efforts on prevention and treatment. Similar efforts, however, are largely nonexistent in North Africa and the Middle East, and AIDS activists now worry that the rise of a conservative Islamic government in Egypt, where former longtime Muslim Brotherhood member Mohammed Morsi became the country’s first democratically elected president over the summer, will make matters worse.

AIDS is still considered a disease of homosexuals and prostitutes here. Doctors are taught that it’s a foreigner’s disease, and they receive little training in how to treat such patients. Most doctors refuse to treat HIV patients or to deliver their children. Egyptian officials continue to insist that there’s no AIDS problem here; to do otherwise would force the government to confront such taboo subjects as homosexuality, safe sex and what Muslim ethics say about how to treat the ill, however the disease is contracted.

“When the government becomes more religious, they believe AIDS is a punishment from God. But being religious starts with respecting human rights,” said Noor, Rose’s husband, who contracted AIDS from a blood transfusion when he was a child. “We are not a part of the revolution. They isolated us. We did not isolate them.”

Egypt’s attitude toward AIDS and HIV can be summed up in its movie industry. There have been only three films that featured HIV patients. In the first, when a man finds out that he’s HIV-positive, he kills himself. In the second, a man kills his HIV-positive son. The third, in which the protagonist toys with publicizing her HIV status, has had limited distribution.

Rose sheepishly explained, her veiled head bowed and looking at the ground as her son tried to teach himself to walk, that when she told her best friend early on that she was HIV-positive, she never heard from her friend again. Rose and Noor, who live in a five-story walk-up apartment, live in fear that their neighbors will learn of their infections. They agreed to share their story only if their real names weren’t used.

Rose’s family doesn’t know that she’s HIV-positive or that her first husband infected her eight years ago. They don’t know that Rose and Noor met at an AIDS seminar or how miraculous it is that their two young children are HIV-negative because Rose demanded cesarean births and didn’t breastfeed.