Doha: HIV epidemics are emerging among people who inject drugs in several countries in the Middle East and North Africa (Mena) region.
Though HIV infection levels were historically very low in the Middle East and North Africa, substantial levels of HIV transmission and emerging HIV epidemics have been documented among people who inject drugs in at least one-third of the countries in the region, according to findings published in PLOS Medicine.
HIV epidemics among people who inject drugs (PWID) are recent overall, starting largely around 2003, and continuing to grow in most countries.
However, they vary across the region. In countries such as Afghanistan, Bahrain, Egypt, Iran, Morocco, Oman and Pakistan, on average between 10 and 15 percent of PWID are HIV-positive.
HIV epidemics in these countries appear to be growing; in Pakistan, for example, the fraction of PWID who are HIV-infected increased from 11 percent in 2005 to 25 in 2011.
In Iran, the epidemic among PWID has stabilised at about 15 percent.
There are, however, other countries where limited HIV transmission was found among PWID, such as Jordan, Lebanon, Palestine and Syria.
“Not only have we found a pattern of new HIV epidemics among PWID in the region, we have also found indications that there could be hidden HIV epidemics among this marginalised population in several countries with still limited data,” said Ghina Mumtaz, lead author of the study and Senior Epidemiologist at Infectious Disease Epidemiology Group at Weill Cornell Medical College-Qatar.
“For example, in Libya, the first study among people who inject drugs was conducted only recently and unveiled alarmingly high levels of HIV infection, suggesting that the virus has been propagating unnoticed among this population for at least a decade.
“Eighty-seven percent of PWID in Tripoli, the capital of Libya, were infected with HIV, one of the highest levels reported among PWID globally.”
The study estimated that there are about 626,000 people who inject drugs in the Middle East and North Africa.
This translates into 24 people who inject drugs for every 1,000 adults. They are typically involved in several types of behaviour that expose them to HIV infection, such as sharing of needles or syringes, a behaviour reported by 18 to 28 percent of drug users during their last injection across these countries.
“The levels of HIV infection among people who inject drugs tell only half the story. We also see high levels of risky practices that will likely expose this population to further HIV transmission in the coming years,” said Dr Laith Abu Raddad, Principal Investigator of the study and Associate Professor of Public Health in the Infectious Disease Epidemiology Group at Weill Cornell Medical College–Qatar.
“We found that nearly half the people who inject drugs are infected with hepatitis C virus, another infection of concern that is also transmitted though sharing of needles and syringes.”
“Since HIV epidemics among people who inject drugs in the Middle East and North Africa are still overall in an early phase, there is a window of opportunity to prevent them from further growth. This will also limit the potential for HIV transmission to be bridged to other population groups” said Mumtaz.
The Peninsula
