The Middle East region remains an area of high risk despite low HIV prevalence. It is an area of increasing concern, especially regarding new infections and AIDS-related deaths.

The first cases of AIDS in the Middle East and North Africa region were reported in the mid-1980s. During the 1980s and 1990s, a number of the MENA governments denied incidences of HIV amongst their people. Yet between 2001 and 2012, the number of adults and children living with HIV increased by 73% and cases of new infections rose by 52% – resulting in the highest rates of increase amongst world regions.

In 2013, a study into HIV prevalence in the Middle East revealed that AIDS-related deaths continued to grow whilst rates dropped by 16% throughout the world. In the past decade, deaths in the MENA region have doubled amongst adults and children. The rise in cases was believed to be due to the low levels of antiretroviral therapy (ART) across the Middle East and North Africa. Available data also reveals:

  • Only one in five people who need ART are actually getting it
  • 29% of people living with HIV are receiving HIV treatment
  • Less than 10% of pregnant women living with HIV receive ART to prevent transmission to their child

The low prevalence of HIV in MENA countries is seen to be the result of religious and cultural norms that discourage sex before marriage, as well as encouraging commitment within marriages and male circumcision. Despite this, there is an increasing amount of evidence showing that people are engaging in unsafe sex, including not using a condom, with those most at risk unwilling to seek help due to stigma and discrimination.

Getting tested for HIV in the Middle East raises a number of serious concerns. The laws can be harsh towards people diagnosed as HIV positive but the only thing that really matters is taking care of your health and not passing on the infection to others. The only way to know your status is to get tested and tests are now available throughout the Middle East but also in most countries around the world.

Mike Asher, CEO and Chairman of Better2Know

In the Middle East, the key populations that are at high-risk of catching HIV are also the people that are often condemned by society for engaging in activities that go against religious and cultural norms. Sex outside of marriage is just one example – women are particularly affected by this. In the past decade, the total number of women living with HIV has risen in the MENA region, yet most women were infected by their partners or husbands who were unaware of their own infections.

The idea that a large proportion of HIV infections in women are a result of transmission in marital relationships is still not widely understood or accepted. Therefore, women are suffering from HIV stigma and discrimination more than their male counterparts – leading to a culture of silence which prevents women from accessing HIV care.

HIV carries associations of sexual or social ‘transgression’, illness and death despite medical advances in the treatment of AIDS and the suppression of the HIV virus. 

Luisa Orza, the International HIV/Aids Alliance charity

Ms Orza continues saying that many women fear revealing their HIV status as this can potentially trigger violence from a partner or other family members. This contributes to the barrier that prevents women from accessing and receiving treatment for their own condition. Women from the Middle East and North Africa region speak out, agreeing with this perception.

When you live in violence, you do not really realise it. That is what gets me thinking, but in this kind of life, the last of your worries is HIV and how to protect yourself. When it comes and when you discover it, you are shocked and that is it. Then at some point, personally, I told myself that I deserved it.

Anonymous woman in the Middle East

More effort needs to go into training health providers who specialise in HIV care, as well as a heightened focus on empowering women living with HIV to combat stigma. Preventative measures for women who have married men that engaged in risky sexual behaviours should be made more prominent and accessible.

How can Better2Know help?

Our Middle East clinics offer testing for HIV and a wide range of sexually transmitted infections, each of which can be tested for individually or combined with others as part of a comprehensive sexual health screen.

Book your STI test or screen

All Better2Know’s tests, screens and services in the Middle East are performed in line with national regulations. To book your test or screen online, select the Book Now button at the top of the page and follow the instructions. Alternatively, you can telephone our highly trained and discreet Patient Services team at any time, day, or night, on the telephone number displayed above.

Sources

[1] Al Jazeera: What’s being done to fight HIV/AIDS stigma in MENA?

[2] Population Reference Bureau: HIV in the Middle East: Low Prevalence but Not Low Risk

[3] The Lancet: Women living with HIV in the Middle East and north Africa

[4] The Independent: Women who have HIV more likely to face gender-based violence, report shows

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