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{"title"=>"Are HIV epidemics among men who have sex with men emerging in the middle east and north Africa?: A systematic review and data synthesis", "type"=>"generic", "authors"=>[{"first_name"=>"Ghina", "last_name"=>"Mumtaz", "scopus_author_id"=>"57191452190"}, {"first_name"=>"Nahla", "last_name"=>"Hilmi", "scopus_author_id"=>"36238085400"}, {"first_name"=>"Willi", "last_name"=>"McFarland", "scopus_author_id"=>"35492450400"}, {"first_name"=>"Rachel L.", "last_name"=>"Kaplan", "scopus_author_id"=>"36473240000"}, {"first_name"=>"Francisca Ayodeji", "last_name"=>"Akala", "scopus_author_id"=>"12788216500"}, {"first_name"=>"Iris", "last_name"=>"Semini", "scopus_author_id"=>"36519704300"}, {"first_name"=>"Gabriele", "last_name"=>"Riedner", "scopus_author_id"=>"6506293023"}, {"first_name"=>"Oussama", "last_name"=>"Tawil", "scopus_author_id"=>"6507012744"}, {"first_name"=>"David", "last_name"=>"Wilson", "scopus_author_id"=>"55478279800"}, {"first_name"=>"Laith J.", "last_name"=>"Abu-Raddad", "scopus_author_id"=>"14032724700"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"sgr"=>"80052338884", "issn"=>"15491277", "doi"=>"10.1371/journal.pmed.1000444", "pmid"=>"21829329", "pui"=>"362471706", "scopus"=>"2-s2.0-80052338884", "isbn"=>"1549-1277"}, "id"=>"315b9203-be40-39ea-bca1-f435f350eb78", "abstract"=>"Men who have sex with men (MSM) bear a disproportionately higher burden of HIV infection than the general population. MSM in the Middle East and North Africa (MENA) are a largely hidden population because of a prevailing stigma towards this type of sexual behavior, thereby limiting the ability to assess infection transmission patterns among them. It is widely perceived that data are virtually nonexistent on MSM and HIV in this region. The objective of this review was to delineate, for the first time, the evidence on the epidemiology of HIV among MSM in MENA.", "link"=>"http://www.mendeley.com/research/hiv-epidemics-among-men-sex-men-emerging-middle-east-north-africa-systematic-review-data-synthesis-1", "reader_count"=>21, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Nursing and Health Professions"=>2, "Mathematics"=>1, "Medicine and Dentistry"=>9, "Agricultural and Biological Sciences"=>1, "Psychology"=>1, "Social Sciences"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>9}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>4}}, "reader_count_by_country"=>{"United States"=>1}, "group_count"=>1}

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• {"id"=>"227539856929210368", "text"=>"Research reveals startling info on #HIV Epidemics among #MSM in the #MiddleEast and North #Africa - http://t.co/3PrIg4HW", "created_at"=>"2012-07-23T23:05:04Z", "user"=>"InSTEDD", "user_name"=>"InSTEDD", "user_profile_image"=>"http://a0.twimg.com/profile_images/125984418/logo_normal.jpg"}
• {"id"=>"227546169641938944", "text"=>"\"@InSTEDD: Research reveals startling info on #HIV epidemics among #MSM in the #MiddleEast & North #Africa - http://t.co/0FIiMcRD\" #AIDS2012", "created_at"=>"2012-07-23T23:30:09Z", "user"=>"hellenotii", "user_name"=>"Hellen Otii", "user_profile_image"=>"http://a0.twimg.com/profile_images/2380205524/w8u7euj1kf6taecebtqb_normal.jpeg"}
• {"id"=>"259050817141743616", "text"=>"@HSM_Muslims Here is the original report. Stop being such a toddler. http://t.co/AKB1s8lP", "created_at"=>"2012-10-18T21:58:22Z", "user"=>"JustOneBullet", "user_name"=>"JustOneBullet", "user_profile_image"=>"http://a0.twimg.com/profile_images/2577252743/9891z69bwijw5mwhovlh_normal.jpeg"}
• {"id"=>"259052428614303744", "text"=>"@HSM_Muslims You are such a simpleton. You wouldn't know even if truth slapped you in the face. Read the report. http://t.co/AKB1s8lP", "created_at"=>"2012-10-18T22:04:46Z", "user"=>"JustOneBullet", "user_name"=>"JustOneBullet", "user_profile_image"=>"http://a0.twimg.com/profile_images/2577252743/9891z69bwijw5mwhovlh_normal.jpeg"}
• {"id"=>"259053154035986434", "text"=>"@HSM_Muslims Have you read the report? Why are you so scared of the truth? http://t.co/AKB1s8lP", "created_at"=>"2012-10-18T22:07:39Z", "user"=>"JustOneBullet", "user_name"=>"JustOneBullet", "user_profile_image"=>"http://a0.twimg.com/profile_images/2577252743/9891z69bwijw5mwhovlh_normal.jpeg"}
• {"id"=>"259053461763653632", "text"=>"@HSM_Muslims Truth hurts doesn't it? These are facts in the report that completely refute ur hallucinations --> http://t.co/AKB1s8lP", "created_at"=>"2012-10-18T22:08:52Z", "user"=>"JustOneBullet", "user_name"=>"JustOneBullet", "user_profile_image"=>"http://a0.twimg.com/profile_images/2577252743/9891z69bwijw5mwhovlh_normal.jpeg"}
• {"id"=>"837962168914038785", "text"=>"#phidmena17 Are HIV Epidemics among Men Who Have Sex with Men Emerging in MENA? Systematic Review and Data Synthesis https://t.co/xoU92UpsrN", "created_at"=>"2017-03-04T09:45:24Z", "user"=>"aliciad3", "user_name"=>"Alicia D", "user_profile_image"=>"http://pbs.twimg.com/profile_images/558709595783168002/_Mdq5Gvm_normal.jpeg"}

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/749393"], "description"=>"<p>These studies present the best available evidence on the prevalence of HIV among MSM as most of them are integrated bio-behavioral surveillance surveys and use state of the art sampling methodologies for hidden and hard to reach populations. A description of the different sampling methodologies displayed in the table can be found in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000444#pmed.1000444.s006\" target=\"_blank\">Table S6</a>. All studies were cross-sectional by design.</p>a<p>Sample proportion.</p>b<p>Average of different cities (range).</p>c<p><i>Banthas</i>: biological males with a male gender identity; <i>Giryas</i>: husbands of <i>hijras</i>; <i>Hijras</i> and <i>khusras</i>: transgender people; <i>Khotkis</i>: biological males who dress as men but have “female souls” and feminized traits.</p><p>CS, one-stage cluster sampling; CvS, convenient sampling; RDS, respondent-driven sampling; SBS: snow-ball sampling.</p>", "links"=>[], "tags"=>["prevalence", "MSM", "mena", "reported", "studies", "well-defined"], "article_id"=>419753, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.t003", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_HIV_prevalence_among_MSM_in_MENA_as_reported_by_studies_with_well_defined_methodologies_/419753", "title"=>"HIV prevalence among MSM in MENA as reported by studies with well-defined methodologies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-08-02 02:42:33"}
• {"files"=>["https://ndownloader.figshare.com/files/749046"], "description"=>"<p>This chart, adapted from PRISMA 2009 flow diagram, displays the flow of article selection for the specific MSM in MENA search of scientific databases, namely PubMed, Embase, and regional databases. Further relevant studies included in the review, mainly in the form of country-level reports, were identified through the comprehensive search of the MENA HIV/AIDS Epidemiology Synthesis Project.</p>", "links"=>[], "tags"=>["MSM", "mena"], "article_id"=>419412, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.g001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_of_article_selection_for_the_specific_MSM_in_MENA_search_of_scientific_databases_/419412", "title"=>"Flow of article selection for the specific MSM in MENA search of scientific databases.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-08-02 02:36:52"}
• {"files"=>["https://ndownloader.figshare.com/files/749319"], "description"=>"<p>This graph displays available HIV point-prevalence measures (from <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000444#pmed-1000444-t003\" target=\"_blank\">Tables 3</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000444#pmed.1000444.s002\" target=\"_blank\">S2</a>) and 95% confidence intervals among MSM in all MENA countries with available measures, irrespective of study methodology. Studies with sample size of less than 100 were excluded because of very wide confidence intervals. Countries with available data include Egypt, Iran, Iraq, Jordan, Lebanon, Morocco, Pakistan, Sudan, Syria, and Tunisia. Each blue dot represents one HIV prevalence measure among MSM from one of the listed MENA countries for the specific year, while the bars around it define the limits of the 95% confidence interval around the prevalence measure. The graph indicates limited transmission until after 2003, when considerable HIV prevalence started to be apparent in most studies and surveys.</p>", "links"=>[], "tags"=>["prevalence", "MSM"], "article_id"=>419682, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.g003", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_HIV_prevalence_among_MSM_in_MENA_1990_8211_2010_/419682", "title"=>"HIV prevalence among MSM in MENA, 1990–2010.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-08-02 02:41:22"}
• {"files"=>["https://ndownloader.figshare.com/files/377636", "https://ndownloader.figshare.com/files/377684", "https://ndownloader.figshare.com/files/377729", "https://ndownloader.figshare.com/files/377778", "https://ndownloader.figshare.com/files/377841", "https://ndownloader.figshare.com/files/377896", "https://ndownloader.figshare.com/files/377934", "https://ndownloader.figshare.com/files/378002", "https://ndownloader.figshare.com/files/378068"], "description"=>"<div><h3>Background</h3><p>Men who have sex with men (MSM) bear a disproportionately higher burden of HIV infection than the general population. MSM in the Middle East and North Africa (MENA) are a largely hidden population because of a prevailing stigma towards this type of sexual behavior, thereby limiting the ability to assess infection transmission patterns among them. It is widely perceived that data are virtually nonexistent on MSM and HIV in this region. The objective of this review was to delineate, for the first time, the evidence on the epidemiology of HIV among MSM in MENA.</p><h3>Methods and Findings</h3><p>This was a systematic review of all biological, behavioral, and other related data on HIV and MSM in MENA. Sources of data included PubMed (Medline), international organizations' reports and databases, country-level reports and databases including governmental and nongovernmental organization publications, and various other institutional documents. This review showed that onsiderable data are available on MSM and HIV in MENA. While HIV prevalence continues at low levels among different MSM groups, HIV epidemics appear to be emerging in at least few countries, with a prevalence reaching up to 28% among certain MSM groups. By 2008, the contribution of MSM transmission to the total HIV notified cases increased and exceeded 25% in several countries. The high levels of risk behavior (4–14 partners on average in the last six months among different MSM populations) and of biomarkers of risks (such as herpes simplex virus type 2 at 3%–54%), the overall low rate of consistent condom use (generally below 25%), the relative frequency of male sex work (20%–76%), and the substantial overlap with heterosexual risk behavior and injecting drug use suggest potential for further spread.</p><h3>Conclusions</h3><p>This systematic review and data synthesis indicate that HIV epidemics appear to be emerging among MSM in at least a few MENA countries and could already be in a concentrated state among several MSM groups. There is an urgent need to expand HIV surveillance and access to HIV testing, prevention, and treatment services in a rapidly narrowing window of opportunity to prevent the worst of HIV transmission among MSM in the Middle East and North Africa.</p><h3></h3><p><em>Please see later in the article for the Editors' Summary</em></p></div>", "links"=>[], "tags"=>["are", "hiv", "epidemics", "men", "systematic", "synthesis"], "article_id"=>134621, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000444.s001", "https://dx.doi.org/10.1371/journal.pmed.1000444.s002", "https://dx.doi.org/10.1371/journal.pmed.1000444.s003", "https://dx.doi.org/10.1371/journal.pmed.1000444.s004", "https://dx.doi.org/10.1371/journal.pmed.1000444.s005", "https://dx.doi.org/10.1371/journal.pmed.1000444.s006", "https://dx.doi.org/10.1371/journal.pmed.1000444.s007", "https://dx.doi.org/10.1371/journal.pmed.1000444.s008", "https://dx.doi.org/10.1371/journal.pmed.1000444.s009"], "stats"=>{"downloads"=>27, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Are_HIV_Epidemics_among_Men_Who_Have_Sex_with_Men_Emerging_in_the_Middle_East_and_North_Africa_A_Systematic_Review_and_Data_Synthesis/134621", "title"=>"Are HIV Epidemics among Men Who Have Sex with Men Emerging in the Middle East and North Africa?: A Systematic Review and Data Synthesis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-08-02 01:17:01"}
• {"files"=>["https://ndownloader.figshare.com/files/749168"], "description"=>"<p>Summary of the synthesis and triangulation of biological, behavioral, and contextual data about HIV among MSM in MENA corroborating emerging epidemics and HIV epidemic potential.</p>", "links"=>[], "tags"=>["infectious diseases/epidemiology and control of infectious diseases", "infectious diseases/hiv infection and aids", "infectious diseases/sexually transmitted diseases"], "article_id"=>419531, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.g002", "stats"=>{"downloads"=>3, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Data_synthesis_/419531", "title"=>"Data synthesis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-08-02 02:38:51"}
• {"files"=>["https://ndownloader.figshare.com/files/749480"], "description"=>"<p>This table summarizes available data on the prevalence of anal sex between males in select populations at varying levels of risk of exposure to HIV.</p>a<p>Unspecified male-to-male sexual contacts.</p>b<p>With a MSW.</p>c<p>Forced anal sex.</p>d<p>Before incarceration.</p><p>VCT, voluntary counselling and testing.doi:10.1371/journal.pmed.1000444.t001</p>", "links"=>[], "tags"=>["anal", "males", "populations"], "article_id"=>419845, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.t001", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_anal_sex_between_males_in_select_populations_in_MENA_/419845", "title"=>"Prevalence of anal sex between males in select populations in MENA.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-08-02 02:44:05"}
• {"files"=>["https://ndownloader.figshare.com/files/749445"], "description"=>"<p>When more than one country report was available, only the most recent one was used.</p><p>A comparison of the percentage of notified infections that is due to MSM transmission between the most recent available report and cumulatively up to that report hints at recent trends (whether increasing, decreasing, or similar) in the contribution of MSM mode of transmission in each country.</p><p>Notes: MSM Includes homosexuals and bisexuals. Cumulative: Since the beginning of the epidemic and until the most recent available report. n, number of positive cases among MSM; N, Total number of positive cases; %, percentage of MSM HIV-positive cases out of the total number of HIV positive cases.</p>", "links"=>[], "tags"=>["MSM", "diagnosed", "notified", "cases", "notification"], "article_id"=>419807, "categories"=>["Medicine"], "users"=>["Ghina Mumtaz", "Nahla Hilmi", "Willi McFarland", "Rachel L. Kaplan", "Francisca Ayodeji Akala", "Iris Semini", "Gabriele Riedner", "Oussama Tawil", "David Wilson", "Laith J. Abu-Raddad"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000444.t002", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Contribution_of_MSM_mode_of_transmission_to_the_total_diagnosed_and_notified_HIV_AIDS_cases_by_country_as_per_countries_case_notification_reports_/419807", "title"=>"Contribution of MSM mode of transmission to the total diagnosed and notified HIV/AIDS cases by country as per countries' case notification reports.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-08-02 02:43:27"}

PMC Usage Stats | Further Information

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Relative Metric

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F1000Prime