HIV epidemic emerges among gays in Middle East and North Africa

Epidemic levels of Aids found in Egypt, Sudan, Pakistan and Tunisia, and high levels of risky sexual behaviour threaten to spread Aids further in the region, researchers say.

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LONDON // Epidemics of HIV have emerged among gay and bisexual men in the Middle East and North Africa, while high levels of risky sexual behaviour threaten to spread Aids further in the region, researchers said on Tuesday.

In the first study of its kind in the region, researchers from Weill Cornell Medical College in Qatar found evidence for concentrated HIV epidemics.

Epidemics are said to be present when infection rates are above 5 per cent in a certain population group. The study found evidence of this in Egypt, Sudan, Pakistan and Tunisia.

In one setting in Pakistan, HIV rates reached up to 28 per cent, researchers said in a study in the Public Library of Science journal.

The researchers stressed the need for countries to act quickly to expand HIV surveillance and improve access to HIV testing, prevention and treatment services for men who have sex with men in an effort to halt further spread.

In 2009, an estimated 33.3 million people worldwide had HIV, according to the latest United Nations data, and 22.5 million of those live in sub-Saharan Africa.

There is little published data on the Middle East and North African regions and Ghina Mumtaz, who led the study with colleague Laith Abu Raddad, said this had been driving misconceptions that there is no reliable information at all.

"It's like the black hole in the global HIV map, and this has triggered many controversies and debates around the status of the epidemic," she said.

But when they looked more closely, the researchers found that data was indeed available, although it had been had not been made public.

After analysing various reports, they found "considerable and increasing epidemiological evidence on HIV and risk behavior among men who have sex with men" in the region.

"It's important to see what's there to get an evidence-based understanding of the dynamics of the epidemic," Ms Mumtaz said.

The findings were worrying, but not surprising, the researchers said. They found that by 2008, HIV transmission via anal sex among men was responsible for more than a quarter of notified cases of HIV in several countries in the region.

"All over the world there are actually newly emerging epidemics in men who have sex with men and this region is no exception," Mr Abu Raddad said.

He added that more testing, surveillance and access to HIV services would help limit the size of the epidemics and prevent HIV transmission from reaching other population groups such as women and heterosexuals. He stressed that this did not have to require uncomfortable public statements by governments.