limited inroads into the general population.115 This further indicates limited potential for a sustainable HIV epidemic in the general population. At a global level, there is no evidence for a sustainable general population HIV epidemic apart from specific parts of sub-Saharan Africa.116 It is inconceivable that MENA will be the exception to this pattern after consistently very low HIV prevalence in the general population over the two decades since the virus’s introduction into the MENA population in the 1980s. All of the above considerations affirm that it is unlikely that the MENA region will experience a sustainable or substantial HIV epidemic in the general population in at least the foreseeable future, if ever. Nevertheless, prevention resources in MENA continue to be focused among the general population, as opposed to priority groups, despite its lowest risk of HIV exposure of all HIV risk groups. HIV programs focused on the general population in MENA should stress stigma reduction, rather than personal risk reduction, and prevention efforts should be focused on priority populations.
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