Despite the rise in HIV cases in the region, Lebanon has remained at a plateau for the past 10 years in terms of the number of new cases of the infection, largely due to better access to education and protective resources relative to its neighbors, experts said Monday.
“We have been at a plateau for the past 10 years,” Dr. Mostafa al-Nakib, director of Lebanon’s National AIDS Control Program, affiliated with the Health Ministry, told The Daily Star. “The number of new cases has remained between 85-110 new cases annually.”
HIV/AIDS rates have been declining worldwide, but the Middle East and North Africa region is moving in the opposite direction,
At a meeting in Tunisia, bringing together the region’s top experts on HIV/AIDS, UNAIDS chief Michel Sidibe warned over the weekend of a dramatic increase in infections in the MENA region. “In just a few years, we’ve gone from 10,000 people infected to 225,000,” he told AFP.
“The only trend now is an increase in MSM [men having sex with men] and a decrease in age,” said Nakib.
He attributes the rise in HIV/AIDS rates among young people to high risk behavior among 18-25-year-olds. “We have high knowledge about protection, especially among the younger generation, but the practice and behavior do not match the knowledge,” Nakib said.
He added that, while the number of new cases increases slightly each year, this is commensurate with increase in population.
Elie Araj, president of the Regional Arab Network Against AIDS, agreed. Comparing Lebanon with other MENA countries, Araj said, “relatively, we are good, however, since two years, we have seen bigger numbers. This can be attributed to more people who are getting tested at NGOs.”
Health Ministry statistics from 2013 show that 60 percent of the cumulative reported cases in 2013 have HIV, while 12 percent have contracted AIDS. Of the 1,671 new and existing HIV/AIDS cases, 90 percent were sexually transmitted, and 45 percent of those occurred from homosexual behavior. The ratio of men to women with HIV/AIDS is 8:2, said Nakib.
Over the past several years, more NGOs have surfaced in Lebanon to meet its sexual health needs.
One of the most prominent is MARSA sexual health center, located in Hamra.
The center’s team of doctors offer testing and counseling at discounted rates, promotes safe sexual health and offers a safe space for marginalized populations such as Lebanon’s LGBT community.
In cases where medication is needed for patients with HIV/AIDS, clinic doctors provide referrals.
Although HIV/AIDS rates have remained steady, Cynthia al-Khoury, MARSA’s program coordinator, has seen a steady uptick in the detection numbers of those who have tested positive at the clinic.
She said that misconceptions about the spread of HIV are common, and the lack of sexual education in schools and societal shame surrounding sexual activity leaves young people unaware and at risk.
“Young people rely on peers. They miss the details of how HIV is spread. There is so much confusion around a healthy sexual lifestyle,” Khoury said.
The Health Ministry provides free medical treatment to those eligible diagnosed with HIV/AIDS, including citizens and long-term refugees.
While HIV/AIDS numbers have remained steady over the past 10 years, Nakib expects prevalence to become more concentrated among the most vulnerable population: men who have sex with men.
Compared to other countries in the region, he said Lebanon has more resources for those with HIV/AIDS, in the form of psychosocial and medical services.
“We have many NGOs for MSM, for sex workers,” he said.
Over the past two years, Nakib has been working with activists and lawmakers in the country to improve the rights of those living with HIV/AIDS.
“Sometimes there are self-esteem issues or the feeling of being stigmatized,” Nakib said, but with greater media coverage and dialogue in the country, civil society is breaking the barriers of stigma while raising awareness about HIV/AIDS transmission and protection methods.
Araj said that solutions to rising rates across the MENA region should not be limited to the healthcare sphere; they should also address the shortcomings of the social and political environments.
The MENA region is for the third year in a row carrying the highest number of new registered cases, said Araj. Of the region’s MSM population, he said, “This group of people is highly discriminated against,” which contributes to difficulties in seeking help for HIV/AIDS.
Of solutions at the national level, Araj said, “We need to amend some laws to be a more inclusive society. We also need to have a budget for more targeted preventions.”