Understanding the epidemiological HIV risk factors and underlying risk context for youth residing in or originating from the Middle East and North Africa (MENA) region: A scoping review of the literature

Abstract

Introduction HIV is the second leading cause of death among young people globally, and adolescents are the only group where HIV mortality is not declining. Middle East and North Africa (MENA) is one of few regions seeing rapid increase of HIV infections (31.0%) since 2001. MENA youth are at particular risk of HIV due to dearth of research and challenges in accessing services. Objective The purpose of this scoping review is to establish the epidemiological HIV risk factors and underlying risk context for youth residing in or originating from the MENA region. Methods Online database searches were conducted using combination of search terms. Screening 5,853 citations, published between 1990–2019 with age groups 16 to 29, resulted in 57 studies included across 18 MENA countries. Results ‘Key populations’ engage in risky behaviors, including: overlapping risky behaviors among youth who inject drugs (PWID); lack of access to HIV testing, condomless sex, and multiple sex partners among young men who have sex with men (MSM); and high and overlapping risk behaviors among young sex workers. Challenges facing other youth groups and bridging populations include: peer pressure, inhibition about discussing sexual health, lack of credible sex education sources, low condom use, and lack of access to HIV protection/prevention services, especially testing. Conclusion Poor surveillance coupled with scarcity of rigorous studies limit what is known about epidemiology of HIV among youth in MENA. Homophobia, stigma around PWID, and illegal status of sex work promote non-disclosure of risk behaviors among youth and curtail serving this population.

Progress of the Gulf Cooperation Council (GCC) Countries Towards Achieving the 95-95-95 UNAIDS Targets: A Review

“…Epidemiologic investigations of the global burden of HIV/AIDS have shown the disproportionate toll of the disease in various regions of the globe, the WHO African region contributing to nearly 60% of the new global HIV infections in 2020 [ 2 ]. Additionally, some regions including the Eastern Europe, Central Asia, Western and Central Africa and the Middle East North Africa (MENA) region are still trailing in terms of controlling HIV infections and the scarcity of reports investigating HIV/AIDS [ 3 – 5 ], demonstrates difficulties in ART connection and retention.…”

Prevalence of Human Immunodeficiency Virus Infection and Risky Sexual Behaviours among Clients Attending HIV Testing Service in Ogun State, Nigeria

“…[4] This study shows that a significantly higher proportion of the females were involved in risky sexual behaviours and several studies corroborated this finding. [8][9][10][11][12] Women are more affected by the defining feature of the epidemic with policy implications for the prevention of mother-to-child transmissions of HIV. Therefore, addressing gender inequality is crucial in the control of the epidemic.…”

Sexuality Education for Youth and Adolescents in the Middle East and North Africa Region: A Window of Opportunity

“…5 Youth in the MENA region are at particular risk of HIV due to challenges in accessing services, inhibition about discussing both sexual and reproductive health (SRH), and lack of credible sex education sources. 6 These demographic and socioeconomic transformations, coupled with evidence about the rise of HIV and STIs among young people in the region, led to concerns about protecting these vulnerable young people against these threats. The Sustainable Development Goals target 3.7 calls on countries to ensure universal access to SRH services, including information and education, by 2030.…”

“…The culture of silence surrounding sexual health in the MENA region increases the vulnerability of young people to HIV, STIs, unintended pregnancies, and unsafe abortion. 6,9 The situation is further aggravated by the current political turmoil and conflict zones where young people may resort to transactional sex for survival. Thus, sexuality education of young people in the MENA region is timely and critical yet not easy to achieve.…”