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While sub-Saharan Africa has long been a major focus of efforts
against HIV/AIDS, the impact of the epidemic in the neighboring
region of the Middle East and North Africa (sometimes called the
"MENA region") has received far less attention. Although, at
0.3%, HIV prevalence is comparatively low in this region,
countries from Morocco to Iran nonetheless must contend with
many AIDS-related challenges, often exacerbated by the gender
inequality found throughout the region.
UNAIDS estimates that there are 380,000 adults and children
living with HIV/AIDS in the region, with 35,000 new infections
and 25,000 deaths annually. According to the
2008 Status of the
Global HIV Epidemic Report, in several countries "increasing
numbers of women are being infected with HIV, most of them
infected by husbands or boyfriends who had acquired HIV through
injecting drug use or paid sex."
Women's risk is an emerging area of focus for HIV/AIDS researchers in the Middle East and North Africa, including in the great metropolis of Cairo (pictured above). (Photo: Robert Remien)
As part of an effort to enhance the capacity of these nations
to address HIV prevention, as well as care and treatment, the HIV
Center has begun a series of new initiatives throughout
the MENA region over the past two years. "Because HIV seroprevalence is still believed to be relatively low in most of
the Middle East and North Africa, we have an opportunity to try
to get ahead of the epidemic in a way that has not been possible
in other parts of the world," noted HIV Center Director
Anke A.
Ehrhardt, Ph.D. "However, the region also faces a number of
significant challenges, including an exceptionally young
population and considerable gender inequality. Our goal is to
work with the many excellent behavioral scientists in the region
to help improve prevention interventions and to assist with
crafting
effective public policies."
The first major undertaking was the participation of Dr.
Ehrhardt in a high-level workshop in Tunis, Tunisia from May 1-3,
2007
on the theme of "Behavioral and Social Sciences Research on
HIV/AIDS in the Middle East and North Africa (MENA)." Sponsored
by the
Office of AIDS
Research (OAR), the National Institute of Mental Health (NIMH),
and other branches of the National Institutes of Health (NIH), the workshop brought together scientists from
Morocco, Algeria, Libya, Tunisia, Egypt, Lebanon and Jordan with
a focus on multidisciplinary approaches to prevention and
management of HIV/AIDS. Discussions at the workshop focused on
behavioral and social science research on HIV/AIDS in the
region, with the goal of identifying a research agenda and
establishing collaborations between US and MENA investigators.
Next, from April 13-16, 2008, the HIV Center and the
UCLA
Program in Global Health (Director: Thomas J. Coates, Ph.D.)
co-sponsored an international workshop on “Gender and HIV:
Policy Lessons for Low Prevalence Scenarios.” The event, held at
the American University in Cairo, built upon the earlier meeting in Tunisia and helped to define a research
agenda in the region. The international workshop provided a
venue for identifying and highlighting cutting-edge work on the
role of gender in the global AIDS epidemic, particularly in the
MENA region. |
Participants in the Cairo workshop included, from left to
right, Dr. Sanna Abbas Filemban of the National AIDS
Program of Saudi Arabia, HIV Center Associate
Director
Dr. Wafaa El-Sadr, and Dr. Fouzia Gharama of
the National
AIDS Control Program of Yemen.
(Photo: Robert Remien)
During the Cairo workshop, key opinion leaders and researchers
from countries including Morocco, Egypt, Yemen, Jordan,
Lebanon, Saudi Arabia and the US worked through the most
promising ways to concretely link AIDS, feminism, and the
women's movement while expanding notions of masculinity. Panels
included discussion of global HIV prevalence and gender status;
research surveillance, data needs, and barriers to policy
development; connections between gender, women’s empowerment;
and access to care.
The Cairo meeting produced action items and concrete
recommendations that other prevention researchers, clinicians,
and policymakers can use as they plan their work in this area.
The workshop also offered an opportunity for HIV specialists
from the region to meet their counterparts, compare their
experiences working in the field, and explore differences and
similarities among the countries. The papers resulting
from the meeting are pending publication in a 2009 supplement of the
Journal of AIDS.
The most recent development was a two-day planning meeting for
an upcoming MENA Think Tank on Stigma and HIV Prevention.
Co-sponsored in New York with the L'Institut National d'Hygiène
du Maroc (Director: Rajae El Aouad, M.D.) the meeting included experts in the behavioral,
social, and biomedical sciences from Morocco, the HIV Center
and
UCLA. The focus
of the workshop, planned for October 2009, will be on improving
existing regional programs and strategies that target stigma
reduction, and developing programs for the scientific
characterization and measurement of HIV/AIDS stigma in the
region.
In the Middle East and North Africa, intraregional
collaborations with regard to HIV/AIDS have only rarely
occurred, and it is hoped these meetings will spur a new
network in the MENA nations concerning issues of HIV and
gender. "By forming strategic partnerships throughout the
region," said Dr. Ehrhardt "our goal is to help to improve the
quality of HIV prevention science while fostering productive
new collaborations among researchers in the US, in the MENA
region, and beyond."
- For the perspective of one of the participants in the
Cairo conference, Dr. Sherine Shawky, please visit this
issue's
Voice of the Community column.
- For a UNAIDS factsheet about HIV/AIDS in the MENA region,
click here.
- To view the complete UNAIDS regional summary of the MENA
region,
click here.
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