aInfectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar bRegional Office of the Eastern Mediterranean, World Health Organization, Cairo, Egypt cDepartment of Public Health, Weill Cornell Medical College, Cornell University, New York, New York, USA dVaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Curr Opin HIV AIDS. 2014 Mar;9(2):183-91. doi: 10.1097/COH.0000000000000038.
A volume of quality HIV data has materialized recently in the Middle East and North Africa (MENA). This review provides a thematic narrative of the patterns of HIV infection transmission in this region in light of these data.
Tens of integrated bio-behavioral surveillance surveys among hard-to-reach key populations at higher risk have been conducted in MENA in the recent years. Many of the studies reported appreciable and growing HIV prevalence. A few studies found alarming prevalence of as much as 87.2% HIV prevalence among people who inject drugs in Tripoli, Libya. The discovery of these hitherto hidden epidemics was unsettling to some authorities after years in which the importance of a focus on HIV prevention among key populations was not recognized.
The new data from MENA indicate growing HIV epidemics among key populations across the region. There is heterogeneity, however, as to which key populations are affected and in what proportions in different countries. In a few countries, HIV appears to affect only one key population and often there is substantial geographical heterogeneity in HIV transmission. Data are indicative of a growing HIV disease burden in this part of the globe, in contrast with the declining epidemics in most other regions.
综述目的：近期，中东和北非（MENA）地区出现了大量高质量的 HIV 数据。本综述根据这些数据，对该地区 HIV 感染传播模式进行了主题叙述。
最新发现：近年来，MENA 地区对高危重点人群进行了数十项综合性生物行为监测调查。许多研究报告称 HIV 流行率相当高且呈上升趋势。少数研究发现，利比亚的黎波里注射毒品者的 HIV 流行率高达 87.2%，令人震惊。经过多年的努力，人们认识到了重点人群预防 HIV 的重要性，而这些此前隐藏的疫情的发现，令一些当局感到不安。
总结：MENA 的新数据表明，该地区的重点人群中 HIV 疫情正在蔓延。然而，不同国家受影响的重点人群以及感染比例存在异质性。在少数国家，HIV 似乎只影响一个重点人群，而且 HIV 传播在地理上也存在很大差异。与大多数其他地区 HIV 流行率下降的情况形成鲜明对比的是，这些数据表明该地区的 HIV 疾病负担正在增加。
