HIV rising in the Middle East

World Aids Day in the Middle East and North Africa is marked by modest levels of publicity, if at all. This may be indicative of the low HIV rates in the region, but also suggests complacency about the virus, as well as the stigmatisation of HIV sufferers.

There are believed to be fewer people living with HIV and fewer Aids-related deaths in the region than in any other in the world. However, this masks the fact that the region is one of only two in which HIV is increasing.

UNAids estimates that approximately 35 million people were living with Aids worldwide in 2013. Of these, 24.7 million were in sub-Saharan Africa and 1.6 million in North America and western and central Europe.

The 230,000 people living with HIV in MENA is a comparatively low figure, both in real terms and in proportion to the population. However, between 2001 and 2012, the rate of those living with HIV increased by a staggering 73 percent, and the number of new HIV infections grew by 52 percent.

This is clearly a step backwards for the region, particularly since the annual number of new HIV infections has fallen worldwide.

This is clearly a step backwards for the Middle East and North Africa, particularly since the annual number of new HIV infections has fallen worldwide by 38 percent since 2001 - and by 58 percent among children - while the number of Aids-related deaths has fallen by 35 percent since their peak in 2005.

Social norms

A report by the Population Reference Bureau points out that the relatively low rates in the region are attributed to social, cultural and religious norms which discourage, for instance, premarital sex.

But the Bureau also points out that cultural and religious practices that might have kept HIV rates low have also have led to a culture of denial as well as complacency about the presence of Aids in the region. Some governments even denied any existence of Aids at all in their countries during the 1990s.

Furthermore, there is discrimination against sex workers, drug users and those in same-sex relationships - those who are most at risk of contracting HIV and whose activities are stigmatised socially and sometimes criminalised by religious doctrine.

This puts more people in danger of infection and prevents people coming forward to get testing and care.

Refused access

Those who are infected are often denied care altogether.

This puts more people in danger of infection and prevents people coming forward to get testing and care.

Human Rights Watch has found, in Yemen, people with HIV are routinely denied hospital care.

The MENA region has the lowest rate of access to treatment. Only 18 percent of adults who need antiretroviral treatment are able to receive it.

HIV is on the rise in all MENA countries, but it affects different countries in different ways. In Iran, Libya and Morocco, for instance, the largest proportion of infections occurs among those who inject drugs.

In Somalia, South Sudan and Djibouti, HIV is present predominantly among female sex workers, while in Tunisia HIV infections are mostly spread through the activities of men who have sex with men or with female sex workers.

There have been a number of governmental, civil society and faith-based initiatives to combat Aids in various countries.

Most recently, Algeria, which has one of the higher Aids rates among MENA countries, started a drive to tackle Aids and gender equality, in collaboration with the Arab League and UN Women. Female leaders from MENA met on 10 November to discuss an Arab Aids strategy aiming to eliminate Aids from the region by 2030.

Neverthess, the recognition and treatment of Aids in MENA lags behind other regions.