In 2008, an estimated 35,000 [24,000–46,000] people in the Middle East and North Africa became infected with HIV, and 20,000 [15,000–25,000] AIDS-related deaths occurred. The total number of people living with HIV rose from 200,000 [150,000– 250, 000] in 2001 to 310,000 [250,000–380,000] in 2008.

The acute shortage of timely and reliable epidemiological and behavioural data has made it difficult to obtain a clear picture of the state of the epidemic in the Middle East and North Africa.

Although the epidemics in the region do not compare with those in sub-Saharan Africa, there is a need to strengthen the AIDS response in the region.

Throughout the region, HIV prevalence remains low. Exceptions are evident in Djibouti and southern Sudan, where HIV prevalence among pregnant women exceeds 1%.

Studies show that an increasing number of people are becoming infected with HIV while living abroad, exposing their sexual partners to infection on their return to their home country.

A large number of South Asian men who are guest workers in the Middle East and North Africa risk becoming infected through contact with sex workers in the region.

Coverage of antiretroviral therapy remains low throughout the region, with 14% of people in need of treatment receiving it in 2008.

Some progress has been reported in promoting HIV testing, although the number of people tested remains low. Between 2007 and 2008, the number of people receiving HIV testing and counselling in Yemen increased 18-fold—from 121 to 2176. In Morocco, there was a 24-fold rise in the number of people tested between 2001 and 2007—from 1,500 to 35,458.

Epidemics in the Middle East and North Africa are largely concentrated among injecting drug users, men who have sex with men and sex workers and their clients. Exceptions are Djibouti and southern Sudan, where transmission is also occurring among the general population.

Elevated levels of HIV infection have been detected in networks of drug users in several countries—with prevalence estimates of 6.5% in Morocco, 2.9% in Israel, 2.6% in Egypt and 2.6% in Turkey.

In surveys, between 7.8% and 9.3% of men who have sex with men were found to be infected with HIV in Sudan, 6.3% in Egypt, 4% in Morocco and 1% in Lebanon.

Although studies have not found high levels of HIV infection among female sex workers in the region, HIV prevalence rates of 26% have been found among female sex workers in Djibouti. In Yemen, the prevalence ranges from 1.3% to 7%.