World AIDS Day: HIV infections on the rise in Arab countries

While some believe the rise in new HIV infections in the Middle East and North Africa region is due to more widespread use of HIV testing than before, experts believe the problem may be more complex.

“The positive cases we’re discovering through increased testing are not old cases,” says Dr. Nisreen Rizk, an HIV specialist at the American University of Beirut. Most of them are newly infected people, he adds, “and this indicates our failure to stop the spread of HIV in the region.”

“There is certainly increased awareness of HIV in the Middle East and North Africa region, but it is still not enough.”

According to Rizk, the region lacks “accurate scientific information” when it comes to HIV.

An Arab team from BBC News took to the streets of Beirut and Cairo to poll people on what they know about HIV and what they think is the reason behind the rise in cases.

More than half of respondents said they “don’t know much about HIV and AIDS”. One attendee said they’ve never heard of it. Some added that they are not interested in learning more about the disease, as it is only linked to “illegal dealings”.

In the Arab region – and around the world – people who inject drugs, men who have sex with men, transgender people and prostitutes are among the most vulnerable to contracting the virus. But does this mean that the rest of the groups are far from the disease?

Sherine El-Feki, regional director of the United Nations AIDS Programme, responds in her interview with BBC News Arabic: “These vulnerable groups are not isolated groups from society and they are in contact with all other groups, and now we see the spread of the virus in several countries, especially among young people, so we are making efforts to spread awareness on the issue ”.

Not only is the Middle East and North Africa region one of three regions with a growing number of new HIV cases, but the region also has the lowest HIV treatment coverage rate in the world.

According to the latest report by the United Nations Program on AIDS (UNAIDS), only 50% of people living with HIV in the Middle East and North Africa region have access to treatment. This number is lower for women, with a rate no higher than 44%, and for children, with only 40%.

While treatment is widely available, the stigma around HIV is a barrier to people wanting to get tested or seek treatment. As a result, according to the UNAIDS report, only 67% of people living with HIV know they have it.

The United Nations program warns that ineffective testing and suboptimal treatment lead to underdiagnosis, continued transmission of infection, delayed treatment and a high mortality rate.

Ahmed (not his real name) told the BBC he suspected he had HIV for 5 years before finally daring to take a test last year when he confirmed he had the disease.

“I’m still healthy as of now, and will continue to do so as long as I get my treatment,” says Ahmed. “But an early diagnosis could have made a difference in my mental and physical health.”

In countries where same-sex sexual relationships are criminalized, many people like Ahmed consider the prospect of prosecution and potentially life-threatening stigma before considering HIV testing.

“Some people see HIV as a death sentence,” Elfeki says. But, she adds, thanks to modern medicine and public health, “HIV is now preventable, coexisting and treatable.”

As part of its efforts to raise awareness of the disease, the United Nations is commemorating the International Day of Unbelief, which occurs this year under the slogan of equality.

Al-Feki says that currently the biggest obstacle in the global fight against HIV is inequality.

“Inequality prevents people from getting the best treatment for testing and prevention.”

“move the kaleidoscope”

While one of the most important forms of inequality is poverty and lack of access to educational and medical services, strict laws and the suppression of personal freedoms are another form of discrimination.

In some sub-Saharan African countries where same-sex relationships are criminalised, such as many countries in the Middle East and North Africa region, gay men were 5 times more likely to contract HIV than in other countries in the same region that have no such relations Laws.

“How do you come forward and disclose your condition when you’re exposed to dangerous practices? … Gender inequality is a real vulnerability for women and girls dealing with HIV,” says El-Feki .

UNAIDS is working with the World Health Organization on a campaign in December 2022 to help 5,000 people in the Middle East and North Africa region get tested for the virus and access treatment confidentially, while ensuring their privacy.

“The HIV problem in the Middle East and North Africa is like a kaleidoscope, you can look at it – as many governments have done – and see that there are relatively fewer cases than in other parts of the world…but we encourage governments to act,” Elfeki says. This is a kaleidoscope and they see that because we have relatively fewer HIV cases than the rest of the world, we can be among the first to get rid of it.”