Highest global rise in HIV and AIDS reported in Middle East
By Louise Redvers
Rates of new HIV infections and AIDS-related deaths are rising faster in the Middle East and North Africa than anywhere else globally. According to the latest data available from the Joint UN Programme on HIV and AIDS (UNAIDS), there are 230,000 people living with HIV in the 21 countries that make up the organization’s definition of the Middle East and North Africa (MENA).
This is still a very low prevalence of 0.1 percent - compared to parts of southern Africa where one in four people have HIV. Yet while the most-affected regions are now reducing their new infection rates and AIDS-related deaths, and increasing their treatment reach, the opposite is happening in MENA.
In 2013 the region lost 15,000 people to the disease, a 66 percent increase on 2005, and despite new infections declining globally by 38 percent since 2001, in MENA they have risen over the same period. “It’s not the absolute level of HIV in the region that we should be concerned about - serious though it is - but it’s the slope of the growth curve that is alarming,” said Shereen El Feki, a leading HIV activist and former vice-chair of the Global Commission on HIV and the Law.
“For the moment HIV in MENA is a concentrated epidemic among certain key populations - such as men-who-have-sex-with-men, female sex workers, people who use drugs,” she explained. “They are engaged in practices and behaviours that are socially and religiously condemned, and in the vast majority of countries in the region, all three are illegal.”
“These populations are in the shadows, and governments have difficulties engaging with them because even if the Ministry of Health stretches out one hand, then the Ministry of Interior may stretch out the other and put them in prison,” El Feki, the author of Sex and the Citadel, a book exploring sexuality in the Arab world, added.
Stigmatisation of at-risk groups
Owing to stigmatization around the behaviours that expose people to HIV/AIDS in MENA, there are no totally reliable figures on infection rates, and even UNAIDS gives a range of between 160,000 and 330,000 of people living with HIV. “It’s very difficult to know the actual incidence and prevalence rates because people are afraid to be tested if they are in those risk categories for all sorts of reasons, including that they may end up in prison,” Paul Galatowitsch, an adjunct professor in the School of Public Health at New York Medical College and executive director of New York-based disease strategies consultancy Health Clear Strategies (HSC), told IRIN.
Dr Ali Feizzadeh, regional strategic information adviser with UNAIDS MENA acknowledged there were surveillance gaps. “Syria, Lebanon and Iraq, plus a few others in the region, have not been able to have any estimation of the size of their HIV epidemic, and for the case of Syria and Iraq even any report on the actual number of people receiving treatment,” he said.
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