Narrow Window To Avert HIV Epidemics Among MSM in Middle East and North Africa

Via AIDSMap, by Michael Carter.

HIV epidemics are emerging among men who have sex with men (MSM) in a number of Middle Eastern and North African countries, an international team of investigators report in the online journal PLoSMedicine.

Prevalence of HIV was as high as 28% among some populations of MSM in Pakistan, and in 2008 over 50% of new HIV infections in Lebanon were in men who reported anal sex with another man.

High levels of risk behaviour in many countries suggested that there was the potential for further spread of HIV.

Alarmed by their findings, the investigatorssuggest “there is an urgent need to expand HIV surveillance and access to testing, prevention, and treatment services in a rapidly narrowing window of opportunity to prevent the worst of HIV transmission among MSM in the Middle East and North Africa.”

Worldwide, MSM are one of the groups most affected by HIV. The epidemic in most industrialised countries is focused on MSM, and research conducted in sub-Saharan Africa has found evidence of large but generally hidden MSM epidemics. Moreover, epidemics in MSM are well established and growing in Latin America and South East Asia.

In contrast, little is known about the MSM HIV epidemic in Middle Eastern and North African countries. Sex between men is often highly stigmatised in this setting, and in five countries homosexuality is punishable by death.

Given this lack in knowledge, a team of investigators lead by Dr Ghina Mumtaz undertook a systematic literature review to gain a better understanding of the HIV prevalence in MSM, their risk behaviour and knowledge of HIV in 23 North African and Middle Eastern Countries.

The authors believe their study “provides an integrated analysis and synthesis of the evidence to address the gap in our knowledge of what could potentially materialise as the key risk group for HIV sexual transmission in this region in the next decade.”

A total of 26 studies were included in the investigators’ analysis. They defined MSM as men who had insertive or receptive anal sex. However, the researchers emphasised that there was a huge diversity in MSM self-identity, role and behaviour in the region.

Overall, the prevalence of MSM behaviour was consistently between 2-3%. However, in some populations such as truck drivers (9%-49%) or street children (15%-77%) it was considerably higher.

Read the rest here.

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