Availability of HIV surveillance data in key populations in the countries of the World Health Organization Eastern Mediterranean Region

Abstract

Objectives: To present an assessment of key components and results of HIV surveillance activities relevant for understanding HIV epidemics in the countries of the World Health Organization (WHO) Eastern Mediterranean Region among key populations (KPs), which include men who have sex with men (MSM), sex workers, people who inject drugs and transgender people.

Methods: We examined HIV surveillance data submitted by the National AIDS Programmes of all 22 countries of the WHO Eastern Mediterranean Region via an online database hosted by the WHO since 2011. We also examined journal articles available on PubMed and technical reports on surveillance activities.

Results: Recent (i.e., since 2017) estimates of HIV indicators from integrated bio-behavioral surveys (IBBS) were available from only four countries (Lebanon, Morocco, Somalia, and Tunisia) and population size estimates from two (Afghanistan and Morocco). IBBS indicated an increase in HIV prevalence among KPs in Pakistan, among people who inject drugs and female sex workers in Tunisia, and among MSM in Lebanon. Information on size estimations of KPs was available from 11 countries, and population size estimation data since 2017 had been collected in only Afghanistan and Morocco.

Conclusion: Although some countries have been able to progressively expand HIV strategic information systems, there were still few or no HIV data on KPs in almost a third of the countries.

Keywords: HIV surveillance; Key populations; Middle East; North Africa; Population size estimation; Surveys.

Fig. 1

Number of countries of the WHO Eastern Mediterranean Region where specific components of HIV surveillance systems as recommended by WHO were available ANC, antenatal care; IBBS, integrated bio-behavioural surveys; PMTCT, prevention of mother-to-child transmission; STI, sexually transmitted infections; WHO, World Health Organization.