319 chapter 13 An epidemic of meanings: HIV and AIDS in Iran and the significance of history, language and gender Orkideh Behrouzan As if it was just a disease – a very serious one, but just a disease. Not a curse, not a punishment, not an embarrassment. Without ‘meaning’, and not necessarily a death sentence. Susan Sontag (1989, p. 102) [AIDS is] a nexus where multiple meanings, stories and discourses in- tersect and overlap, reinforce and subvert each other. Paula Treichler (1987) In 2004, the World Health Organization (WHO) awarded ‘best practice certi fi - cation’ to the HIV and AIDS programmes of the Islamic Republic of Iran. How this certification was obtained, and indeed the recognition it re flected, is a story of considerable interest. While it is a truism that any global set of policy goals is localized in very different ways, this case is both a dramatic illustration and a model for Iranian health care practitioners and international policy-makers about negotiating meaning and discourse across social strata and in a highly complex and sensitive political setting. Given the Islamic legal codes that have been in effect since 1979, some of the health policies of the Islamic Republic of Iran, such as providing heroin addicts with syringes and methadone treatment or making available free HIV testing, counselling and treatment in govern- ment clinics, have been considered radical and progressive by the international community. But how these policies were negotiated demonstrates yet another truism: one size does not fit all – neither across societies, nor within complex national societies.