First large study to find HIV epidemic among gays in the Middle East

HIV epidemics are emerging in several countries in the Middle East and North Africa among men who have sex with men, a term that encompasses gay, non-gay identified homosexual men, and transgendered and bisexual men.

Though HIV infection levels were historically very low in the Middle East and North Africa, substantial levels of HIV transmission have been found, beginning in 2003, among men who have sex with men, a hidden and stigmatized population in this part of the world. These findings are published today in PLoS Medicine and represent the first study of its kind.

“The Middle East and North Africa can no longer be seen as a region immune to the HIV epidemic. Based on multiyear analysis of thousands of data sources, we documented a pattern of new HIV epidemics that have just emerged among men who have sex with men in the last few years in several countries of the region,” said Ghina Mumtaz, main author of this study and senior epidemiologist in the infectious disease epidemiology group at Weill Cornell Medical College-Qatar.

The study reports that rates of HIV infection among men who have sex with men vary across the region but have already exceeded 5 percent, the threshold defining concentrated epidemics, in several countries such as Egypt, Sudan and Tunisia. In one area of Pakistan, the infection rate among men who have sex with men has already reached 28 percent. Moreover, by 2008, transmission of HIV via anal sex among men was responsible for more than a quarter of reported cases of HIV in several countries in the region. Not all countries, however, conducted studies to assess the level of HIV infection among men who have sex with men, thereby limiting the understanding of the full scale of the problem in the region.

“The level of HIV infection among men who have sex with men tells only half of the story. We also documented high levels of risky practices that will likely expose this population to further HIV transmission in the coming years,” said Dr. Laith Abu-Raddad, principal investigator of the study and Assistant Professor of Public Health at the Infectious Disease Epidemiology Group at Weill Cornell Medical College–Qatar.

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