First large study to find HIV epidemic among gays in the Middle East

HIV epidemics are emerging in several countries in the Middle East and North Africa among men who have sex with men, a term that encompasses gay, non-gay identified homosexual men, and transgendered and bisexual men.

Though levels were historically very low in the Middle East and North Africa, substantial levels of have been found, beginning in 2003, among men who have with men, a hidden and stigmatized population in this part of the world. These findings are published today in PLoS Medicine and represent the first study of its kind.

"The Middle East and North Africa can no longer be seen as a region immune to the HIV epidemic. Based on multiyear analysis of thousands of data sources, we documented a pattern of new HIV epidemics that have just emerged among men who have sex with men in the last few years in several countries of the region," said Ghina Mumtaz, main author of this study and senior epidemiologist in the infectious disease epidemiology group at Weill Cornell Medical College-Qatar.

The study reports that rates of HIV infection among men who have sex with men vary across the region but have already exceeded 5 percent, the threshold defining concentrated epidemics, in several countries such as Egypt, Sudan and Tunisia. In one area of Pakistan, the infection rate among men who have sex with men has already reached 28 percent. Moreover, by 2008, via anal sex among men was responsible for more than a quarter of reported cases of HIV in several countries in the region. Not all countries, however, conducted studies to assess the level of HIV infection among men who have sex with men, thereby limiting the understanding of the full scale of the problem in the region.

"The level of HIV infection among men who have sex with men tells only half of the story. We also documented 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 Assistant Professor of Public Health at the Infectious Disease Epidemiology Group at Weill Cornell Medical College–Qatar.

Roughly 2 percent of males were found to engage in anal sex with other males, a rate that is comparable to that in other regions. These males were typically involved in several types of HIV-related, high-risk behavior. For example, they had between 4 and 14 sexual partners in the past six months and their rates of consistent condom use were generally below 25 percent. In addition, between 20 and 75.5 percent of men who have sex with men exchanged sex for money, and these men commonly had several female sexual partners. The researchers also found a considerable level of intravenous drug use among men who have sex with men.

"There is a narrowing window of opportunity to prevent further epidemics. Policy-makers in the Middle East and North Africa should address this growing health challenge from a public health perspective. This will also limit the potential for HIV transmission to spread to other population groups," said Ms. Mumtaz.

A few countries in the region have started to develop creative means of dealing with this public health issue through the establishment of surveillance systems and support for non-governmental organizations that deliver HIV services. However, the authors emphasized that these programs need to be expanded in scale and initiated in all countries to achieve a substantial impact.

"There is no escaping that countries in the region need to massively expand HIV surveillance systems and access to HIV prevention, testing and treatment services. We need to be ahead of the epidemic, not trailing behind it and wishing we had acted earlier," stressed Dr. Abu-Raddad.

"This work by Dr. Abu-Raddad, Ms. Mumtaz, and their colleagues is of very high importance, not least because of its timeliness," remarks Dr. Alvin I. Mushlin, chairman of the Department of Public Health at Weill Cornell Medical College and the Nanette Laitman Distinguished Professor of Public Health and professor of medicine at Weill Cornell Medical College, and public health physician-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "As Dr. Abu-Raddad notes, effective public health efforts to prevent or curtail infectious disease epidemics depend on both understanding the epidemiology and putting into place proactive interventions based on the findings of these studies."

Key Scientific Findings of the Study

  • The fraction of men who have sex with men who are infected with HIV ranged between 0 and 28 percent across the Middle East – North Africa region.
  • The HIV epidemics among men who have sex with men have emerged after 2003 and some of them have grown rapidly. Increasingly, case notification reports document a rising contribution of anal sex between men as the mode of HIV transmission.
  • Roughly 2-3 percent of men engage in sexual relations with other men in this region, and these men are typically involved in several types of HIV-related high-risk behavior. This indicates a potential for further epidemics and HIV transmission among this population group.

Provided by New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

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dogbert
2.3 / 5 (3) Aug 03, 2011
The health costs of homosexual behavior to individuals and to whole societies is tremendous.

As the article notes, there is an urgent need for interventions in North Africa and the Middle East to limit these effects.
kevinrtrs
1 / 5 (2) Aug 03, 2011
n addition, between 20 and 75.5 percent of men who have sex with men exchanged sex for money, and these men commonly had several female sexual partners.

As in Southern Africa, this will inevitably result in very large scale HIV infections across the population groups.

The bible certainly has it right - "they will receive their due punishment in their bodies".
As was found in Uganda, total abstinence outside of marriage is the only way to cut down on this scourge. Now since homosexuals tend to ignore the biblical warnings for the very reason that it speaks out against them, they will have to bear the consequences of their behaviour. Unfortunately other innocents will also be pulled into the effects of that vice.

dogbert
1 / 5 (2) Aug 03, 2011
There are additional problems for societies associated with HIV. Poorly functioning immune systems allow the activation of latent TB and other hazardous infectious agents. The world is facing a crisis with essentially untreatable TB due to HIV immune system suppression coupled with failed treatment with antibiotics. Other disease agents are showing a similar rapid conversion to resistant varieties.
antialias_physorg
5 / 5 (2) Aug 03, 2011
The health costs of homosexual behavior to individuals and to whole societies is tremendous.

It's not the homosexuality that is the problem but the risky behavoural patterns. This is a problem that affects homosexuals and heterosexuals alike.

Being stigmatized and outcast doesn't really help, either (by way of creating a downward spiral for the individual that can lead to other risky behavior, like drug abuse)
dogbert
2.3 / 5 (3) Aug 03, 2011
antialias_physorg,
It's not the homosexuality that is the problem but the risky behavoural patterns. This is a problem that affects homosexuals and heterosexuals alike.


It is not politically correct to point out the health risks of homosexuality to either the individual or to society as a whole, but the risks are very real and very costly.

And yes, it is the risky behavior patterns associated with homosexuality which results in health problems.

Being stigmatized and outcast doesn't really help, either ...


Aberrent behaviors which harm others are, as a rule, stigmatized by society. Why would any sane society embrace behaviors which harm it?
antialias_physorg
3.7 / 5 (3) Aug 03, 2011
Why would any sane society embrace behaviors which harm it?

Smoking? Drinking? Having a military? Having religion? Having a non-elected government? Rampant communism? Rampant capitalism?...

There are plenty of behaviors which harm society which are widely embraced. And the above behaviors are things you can voluntarily change. Homosexuality is not something you can voluntarily change.

So to stigmatize something that isn't going to go away is a rather dumb behavior for a society as it solves nothing.

Of course, if HIV is concentrated in the homosexual and/or drug using communities then those are obvious areas to start education. But since there are a sizeable number of bisexual people (and prostitution) then the problem should not be made out to be a mainly homosexual one. this is something the entire society needs to be involved in (by using condoms as a matter of course or whatnot)
FrankHerbert
1.4 / 5 (10) Aug 03, 2011
HIV epidemics are emerging in several countries in the Middle East and North Africa among men who have sex with men, a term that encompasses gay, non-gay identified homosexual men, and transgendered and bisexual men.


All you have to do is read the title guys! I'll even shorten it for you.

HIV epidemics are emerging in several countries in the Middle East and North Africa


Meaning...?

HIV has already emerged in the predominantly christian areas of Africa.

So please, let's talk about the health costs of christian behavior.
barakn
2.3 / 5 (3) Aug 03, 2011
Homosexuals can engage in safer (oral) sex, and heterosexuals can engage in anal sex, and both groups can take appropriate measures to make any type of sex safer. This story has already attracted two pathetic trolls who have taken their discomfort of anal sex and perhaps repressed latent homosexual urges and misdirected it against a group of people rather than against one particular form of unsafe sex. That makes them bigots, the filthy swine.
dogbert
3 / 5 (2) Aug 03, 2011
barakn,
Homosexuals can engage in safer (oral) sex, and heterosexuals can engage in anal sex, and both groups can take appropriate measures to make any type of sex safer.


That is certainly true and certainly irrelevant. The fact is that homosexual and bisexual men account for most HIV spread simply because the do not choose to engage in safer sexual practices. In the U.S., two thirds of new HIV cases are homosexual or bisexual men. Forty years after HIV became known, there have been no significant behavior changes in homosexual and bisexual men to ameliorate the problem.

This story has already attracted two pathetic trolls ...
That makes them bigots, the filthy swine.


It is neither trolling nor bigoted to point out the truth.

I note you do not take exception to the article or its authors though the article points out the same truths.

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