Status of the HIV epidemic in key populations in the Middle East and north Africa: knowns and unknowns

中东 医学 人类免疫缺陷病毒(HIV) 发展中国家 全球卫生 柱头(植物学) 大流行 传输(电信) 东北 人口学 入射(几何) 和男人发生性关系的男人 环境卫生 公共卫生 社会经济学 2019年冠状病毒病(COVID-19) 地理 经济增长 疾病 病毒学 传染病(医学专业) 精神科 考古 病理 社会学 工程类 光学 物理 护理部 电气工程 经济 梅毒
作者
Ghina R. Mumtaz,Hiam Chemaitelly,Sawsan AlMukdad,Aisha M. M. Osman,Sasha Abdallah Fahme,Nesrine Rizk,Shereen El Feki,Laith J. Abu‐Raddad
出处
期刊:The Lancet HIV [Elsevier]
卷期号:9 (7): e506-e516 被引量:13
标识
DOI:10.1016/s2352-3018(22)00093-5
摘要

The Middle East and north Africa is one of only two world regions where HIV incidence is on the rise, with most infections occurring among key populations: people who inject drugs, men who have sex with men, and female sex workers. In this Review, we show a trend of increasing HIV prevalence among the three key populations in the Middle East and north Africa. Although the epidemic continues at a low level in some countries or localities within a country, there is evidence for concentrated epidemics, with sustained transmission at considerable HIV prevalence among people who inject drugs and men who have sex with men in over half of countries in the region with data, and among female sex workers in several countries. Most epidemics emerged around 2003 or thereafter. The status of the epidemic among key populations remains unknown in several countries due to persistent data gaps. The HIV response in Middle East and north Africa remains far below global targets for prevention, testing, and treatment. It is hindered by underfunding, poor surveillance, and stigma, all of which are compounded by widespread conflict and humanitarian crises, and most recently, the advent of COVID-19. Investment is needed to put the region on track towards the target of eliminating HIV/AIDS as a global health threat by 2030. Reaching this target will not be possible without tailoring the response to the needs of key populations, while addressing, to the extent possible, the complex structural and operational barriers to success.
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