Number of people with Aids rises in Mena region

The number of people living with HIV/Aids in the Middle East and North Africa (Mena) region increased from 87,000 in 2003 to 152,000 in 2005, according to United Nations' estimates.

While these numbers may look small compared to about 40 million people who are living with HIV worldwide, the number of infections appears to be increasing rapidly in the region.

More importantly, the low number of HIV infections does not mean low risk. Mena's conservative culture — in which sexual relationships outside marriage are forbidden — has been partly responsible for keeping the rates of HIV infection relatively low.
The same conservative norms, however, often contribute to a general attitude of denial, combined with strong stigmatisation and social ostracism of people living with

HIV/Aids, Washington-based Population Reference Bureau says in a report.

Because HIV infection is concentrated for now among people who are often perceived as socially deviant, the Aids epidemic has been shrouded in ignorance-and that ignorance does not help prevent the spread of the infection.

The purpose of this policy brief is to raise awareness among Mena's decision-makers and opinion leaders about the urgent need for action by presenting some of the warning signs, risks, and vulnerabilities that face the region.

The current low rates of HIV infection and concentration among specific groups in Mena offer the opportunity to develop policies and programs to prevent an epidemic that could have far-reaching social and economic implications.

Mena's relatively low HIV prevalence rate-estimated to be around 0.1 per cent to 0.2 per cent among adults ages 15 to 49-can be attributed in part to the region's conservative social and cultural norms, which discourage premarital sex, encourage faithfulness within marriage, and include the universal practice of male circumcision.

Researchers have long noticed that countries with higher rates of male circumcision have lower rates of HIV infection. The role of male circumcision as a prevention measure is confirmed in recent clinical studies in South Africa, showing that circumcised men were 60 per cent less likely than uncircumcised men to contract the virus from HIV-infected partners.

MENA's conservative cultural practices, however, do not mean that Mena countries are at low risk of a generalised HIV/Aids epidemic, as some people do engage in risky behaviors. The HIV infection is now spreading in every country in the region and at alarming rates in countries such as Algeria, Iran, and Tunisia, where the number of people living with HIV is estimated to have doubled between 2003 and 2005.

In Mena countries, HIV/Aids generally appears to be concentrated in groups that practice high-risk behaviors, such as sex workers, men who have sex with men, and injecting drug users. However, global experience has shown that the spread of the HIV infection from these groups to the general population can occur fairly rapidly, because individuals engaging in high-risk behaviors can pass the infection to their spouses and other sexual partners.

The limited data on HIV/Aids in Mena point to the expansion of HIV in the region. During 2002-2004, for example, levels of HIV infection among tuberculosis patients in the region were rising-reaching 3.3 per cent in Yemen, two per cent in Oman, and 1.8 per cent in Iran.