The Silent Rise of HIV in the Middle East

Fall 2023

The state of HIV today is far better than it was during the epidemic’s early decades. Death rates and new infections have significantly declined, and some researchers believe a vaccine against the virus is feasible. Unfortunately, these gains do not hold true for the Middle East and North Africa (MENA).

HIV, or human immunodeficiency virus, is a virus that attacks the immune system and, if left untreated, can lead to acquired immune deficiency syndrome (AIDS). Recent data from the World Health Organization found that the MENA region, though burdened with the lowest rates of HIV in the world, is seeing an increase in new infections. Whereas globally, rates of new HIV infections have decreased by 32 percent between 2010 and 2021, the MENA region has seen a 33 percent increase in new infections during that same time.

While treatment is available in the MENA region, the stigma around HIV hinders many people from getting tested and seeking treatment. “According to UNAIDS, only 67 percent of people living with HIV in the MENA region are aware of their HIV status, with 50 percent of those on treatment, ” says Associate Professor Nada Melhem of AUB’s Faculty of Health Sciences. These are alarming figures, given the advances in the prevention, detection, and treatment of the disease.

So why is HIV on the rise in the Middle East? The primary culprits are the structural barriers that key populations face. Sex workers, men who have sex with men, and intravenous drug users are most affected by the HIV epidemic. In many MENA countries, these communities are stigmatized and often criminalized, making it difficult for individuals to access prevention and treatment services. “The problem we have is the stigma that hinders easy access to prevention and treatment services, especially for key populations, ” says Dr. Nesrine Rizk, physician and researcher at AUBMC.

Multifaceted public health policies are needed for a holistic approach to facing the epidemic. “Financial, legal, and political barriers lead to exclusion and heightened rates of violence, consequently hampering our ability to detect, treat, or prevent HIV from spreading, ” says Professor Melhem. To better serve populations at risk of HIV, public awareness campaigns, human rights reforms, and reducing barriers to healthcare are vital in containing the virus.

The HIV epidemic in the MENA region is a reminder that viruses know no borders and are a global public health issue requiring a coordinated and comprehensive response. “COVID-19 was like wind on an already burning flame. We knew the fire of the HIV epidemic was not well controlled in our region, but as a result of the pandemic, treatment and prevention services were significantly affected in many parts of MENA, ” says Dr. Rizk. The region now faces the challenge of extinguishing the flames of this growing epidemic. The time to act is now, before it burns larger and becomes even more challenging to control.