Table 2.2 HCV Prevalence among IDUs in MENA Country
Survey results for HCV prevalence among IDUs
Afghanistan
36.6% (Todd et al. 2007)
Egypt, Arab Republic of
63.0% (Saleh et al. 2000; El-Ghazzawi et al. 1995)
Iran, Islamic Republic of
30.0% (injecting and noninjecting drug users; Alizadeh et al. 2005) 60.0% (Rahbar, Rooholamini, and Khoshnood 2004) 52.0% (Zamani et al. 2007) 59.4% (incarcerated IDUs; Rahbar, Rooholamini, and Khoshnood 2004) 78.0% (local prison; Nassirimanesh 2002) 47.4% (Khani and Vakili 2003) 45.3% (Zali et al. 2001) 11.2% (Imani et al. 2008) 14.48% (mainly noninjecting drug users; Talaie et al. 2007) 25.4% (Altaf et al. 2009) 19.2% (Altaf et al. 2009)
Lebanon
< 20.0% (Aceijas and Rhodes 2007) 25.0% (HIV infected; Ramia et al. 2004) 49.0% (Mishwar 2008) 80.0% (incarcerated IDUs; Kheirandish et al. 2009) 7.35% (injecting and noninjecting drug users; Mohammad et al. 2003)
Oman
11%–53% (Oman MOH 2006)
Pakistan
88.0% (Kuo et al. 2006) 89.0% (UNODCP and UNAIDS 1999) 60.0% (Achakzai, Kassi, and Kasi 2007) 87.0% (Pakistan National AIDS Control Program 2005c) 91.0% (Pakistan National AIDS Control Program 2005c) 17.3% (Platt et al. 2009) 8.0% (Platt et al. 2009)
Saudi Arabia
69.0% (Iqbal 2000) 75.0% (Njoh and Zimmo 1997a)
Syrian Arab Republic
60.5% (Othman and Monem 2002) 21.0% (self-reported; 51% of sample are IDUs; Syria Mental Health Directorate 2008)
Tunisia
39.7% (HIV infected; Kilani et al. 2007)
to other regions.24 The prevalence from IDU globally is at 0.363%, with a range from 0.056% in South Asia to 1.5% in Eastern Europe.25 This translates into 15.9 million people injecting drugs around the world.26 Table 2.3 provides estimates of the number of IDUs in a number of MENA countries as extracted from a global review of IDU.27 In another study, Aceijas et al. estimated that there are 0.3 to 0.6 million IDUs in MENA.28 Further studies estimate that there are 7,500
24
Aceijas et al., “Global Overview”; Mathers et al., “Global Epidemiology”; Aceijas et al., “Estimates of Injecting Drug Users.” 25 Mathers et al., “Global Epidemiology.” 26 Ibid. 27 Mathers et al., “Global Epidemiology”; Aceijas et al., “Estimates of Injecting Drug Users.” 28 Aceijas et al., “Global Overview.” 14
Characterizing the HIV/AIDS Epidemic in the Middle East and North Africa
(400 in Kabul) IDUs29 in Afghanistan; 400,00030 in the Arab world; 112,000,31 137,000,32 at least 166,000,33 200,000,34 300,000,35 and 70,00036 in the Islamic Republic of Iran; and 60,00037 and 180,00038 in Pakistan. The average prevalence of IDU has been measured to be 4.7 IDUs per 1,000 men in a number of cities in Pakistan.39 29
Action Aid Afghanistan, “HIV AIDS in Afghanistan”; World Bank, HIV/ AIDS in Afghanistan; Ryan, “Travel Report Summary.” 30 UNODC, World Drug Report 2004. 31 Aceijas et al., “Global Overview.” 32 Gheiratmand et al., “Uncertainty on the Number of HIV/AIDS Patients.” 33 Razzaghi, Rahimi, and Hosseini, Rapid Situation Assessment. 34 Razzaghi et al., “Profiles of Risk.” 35 Wodak, “Report to WHO/EMRO.” 36 Ghys et al., “The Epidemics of Injecting Drug Use and HIV in Asia.” 37 United Nations Drug Control Programme, “Drug Abuse in Pakistan.” 38 Haque et al., “High-Risk Sexual Behaviours.” 39 Pakistan National AIDS Control Program, HIV Second Generation Surveillance (Round I).