In the Middle East and North Africa, the latest estimates indicate 75,000 people acquired HIV in the past year, bringing the number of people living with HIV to 480,000. Last year, AIDS killed a further 24,000 people. There is the potential for a considerable rise in HIV in this region.
Sudan is the region's most seriously affected country, with an HIV prevalence of 2.3 percent. The epidemic is most severe in the southern part of the country, where HIV prevalence among pregnant women is reported to be six-to-eight times higher than around Khartoum in the north.
In Sudan, heterosexual intercourse is the principal transmission route. The virus is also spreading in the general population, infecting women faster than men.
With the exception of a few countries, the region's systematic surveillance is not well developed. Furthermore, there is inadequate monitoring of higher-risk populations, including injecting drug users and men who sex with men. This means that potential epidemics in these populations are being overlooked, the UNAIDS reported.
Morocco has expanded its surveillance system based on pregnant women and patients attending sexually-transmitted-infection clinics to include sex workers and prisoners. In 2003, prevalence was 0.13 percent among pregnant women, 0.23 percent among patients at sexually-transmitted-infection clinics, 0.83 percent among prisoners, and 2.27 percent among female sex workers.
A recent report from Yemen suggests 7 percent of sex workers are HIV-positive.
In Bahrain, Libya, and Oman, HIV also appears concentrated among injecting drug users. However, there is insufficient behavioural and surveillance data among this population, resulting in an incomplete picture of the epidemic's spread.
Male-to-male sexual behaviour is illegal and widely condemned in the region, and there is little surveillance.
In some countries, unsafe blood transfusions and blood-collection practices still pose a HIV-transmission risk; efforts are under way to expand blood screening and sterile procedures in health-care settings.
UNAIDS said effective prevention is needed, designed to target both vulnerable groups and groups that could be drawn into the next phase of HIV spread, such as migrant workers, refugees and displaced persons, transport route workers, tourists, and young people generally. However, at present, even basic activities such as condom promotion are largely absent.
But there are encouraging exceptions to what appears to be a general pattern of official denial. Algeria, Lebanon, and Morocco are developing more substantial prevention programs, while some countries (notably Libya) appear more willing to acknowledge and tackle epidemics associated with injecting drug use. (albawaba.com)
© 2004 Al Bawaba (www.albawaba.com)
