- Home
- News
- Treatment & Care
- HIV Worldwide
- Living with HIV
- Preventing HIV
- Organisations
- HIV Basics
- About Us
- The Millennium Development Goals and the Declaration of Commitment on HIV/AIDS
- UNAIDS estimates for the next twenty years
- Africa
- Asia
- The Caribbean
- Eastern and Central Europe and Central Asia
- North America and Western Europe
- Australasia and the Pacific
- North Africa and the Middle East
- Latin America
- Access to Treatment - The 3 by 5 Campaign
North Africa and the Middle East
There were an estimated 540,000 people living with HIV/AIDS in North Africa and the Middle East at the end of 2004, about 0.3% of the population, according to UNAIDS, although it considers surveillance systems to be inadequate to be very confident about such estimates. An estimated 28,000 people died from AIDS in 2004 and 92,000 people were newly infected. Women constitute 46% of the infected adult population.
HIV/AIDS arrived late in these regions and infection rates remain at very low levels in most countries, however, in several places HIV infection rates are increasing and denial of the problem among social and political leaders in some countries may provide the epidemic with an ideal environment for continued growth.
Systematic surveillance remains inadequate, making it very difficult to deduce accurate trends in many countries. It is possible that hidden epidemics could be spreading in this region. Better surveillance systems (such as those introduced in Iran, Jordan, Lebanon and Syria) will enable more countries to accurately track the development of the epidemic and mount more effective responses.
The worst affected countries are
Sudan
Sudan straddles the divide between North Africa and sub-Saharan Africa, and this is reflected in its mixture of peoples, in its war-torn history and its HIV prevalence. Latest estimates show that more than 2% of the adult population were living with HIV at the end of 2003. Although the true number could be anything between 120,000 and 1.3 million, even the lower estimate means that more than 80% of people in the Middle East and North Africa are living in Sudan. HIV prevalence is up to eight times higher in the south of the country than in the capital, Khartoum. Sudan’s slow emergence from decades of civil war could unfortunately accelerate the spread of HIV as people resume normal patterns of travel and trade.
Libya
Libya has three times the HIV prevalence of its immediate neighbours, at 0.3%. This is due to a rapidly-growing epidemic among injecting drug users. Almost 90% of the officially-reported 5160 HIV infections among Libyans (as of December 2002) had occurred in 2000-02 alone. Over 90% of cases were attributed to injecting drug use and about 50% of drug users receiving treatment in the capital Tripoli were HIV-positive in 2003.
Iran
Iran’s epidemic is growing due to a dramatic rise in the number of people who inject drugs. The country’s health ministry said in 2002 that the number of drug injectors in Iran, estimated as 200,000–300,000, could be growing by 5% to 10% a year. High-risk behaviour is widespread in this largely male population: about half of the users share injecting equipment, and as many are believed to have extramarital sex. According to some estimates, a significant percentage (more than 30%) of them are married. Yet condom use remains very rare. Iran has taken steps towards harm reduction such as making syringes available over the counter in pharmacies, in contrast to its neighbours.
An estimated 10% of prisoners in Iran are believed to inject drugs and more than 95% of them share needles. HIV prevalence among imprisoned drug injectors was 12% in 2001.
Afghanistan
Because Afghanistan is just emerging form decades of war, we know absolutely nothing about HIV prevalence in the country. At present it is expected to be low; but Afghanistan is now the world’s number one producer of opium and heroin and there is no reason to think it will be spared the recent increases in HIV among injecting drug users recently seen in neighbours like Iran and Uzbekistan.
Saudi Arabia
Saudi Arabia’s HIV prevalence is low (about 8,000 people) and the majority of HIV cases (54%) are in migrant workers rather than in Saudi Nationals, concentrated in the port city of Jeddah. Saudi Arabia was recently criticised for its treatment of migrant workers with HIV following news reports that they were being locked in secure wards without access to ARVs till deported.
Israel
Israel is a low-prevalence country for HIV, with 4,300 people living with HIV. However there have been signs of a rapid increase recently, and a shifting of transmission patterns towards heterosexual sex. In 2004, Israel reported a rise of 9% in new HIV cases and the proportion of women rose from 20% to 30%. In 1998 the average age of women newly infected with HIV was 30 years but in 2004 was reported to be 19 years.