middle east & north africa

trends

Abstracted from UNAIDS AIDS Epidemic Update: December 2003

HIV prevalence in the Middle East and North Africa is very low--it was between 0.2% and 0.4% in 2003. Surveillance in this area is not systematic, therefore, there has been concern over the reliability of the trends. UNAIDS estimates that between 43,000 and 67,000 people acquired HIV in 2003, bringing the total to between 470,000 and 730,000 of the estimated number of people living with HIV/AIDS. The epidemic claimed between 35,000 and 50,000 lives in 2003.

Sudan is the most affected country in this region where the virus is mainly spread by heterosexual transmission. Data gathered from this region indicates a national adult HIV prevalence of more than 2%, but conflict in this country is seriously hampering the surveillance of the epidemic and the implementation of a potentially effective response.

There also appears to be significant movement of HIV-infected persons between some countries. More than half of those officially reported to have HIV in Tunisia , for example, are believed to have crossed the border from Libya to seek antiretroviral treatment and/or to undergo drug rehabilitation. Tunisia has been providing free and universal antiretroviral treatment since the turn of the century.

Despite universal precautions and blood screening efforts to curb the spread of the epidemic, transmission of the virus through infected blood collection and transfusions continues to be a concern.

Also of concern is the rise in HIV infections among injecting drug users, particularly in Bahrain and Libya , while HIV infections linked to this mode of transmission have been reported in Algeria , Egypt , Kuwait , Morocco , Oman and Tunisia . To date, the HIV epidemic among adults in Libya has been driven by injecting drug use, with 90% of all known HIV infections occurring among injecting drug users.

Egypt is one of the few countries to have monitored the transmission of HIV in groups of men who have sex with men, among whom HIV prevalence appears to have been around 1% at the turn of the century. The proportion of AIDS cases attributed to men who have sex with men was reported to be 21% in 2000. A review of HIV epidemiology in Morocco similarly found that sexual transmission among men accounted for over 7% of cumulative cases of HIV infection in the previous decade.

analysis:trends