Contents -- Acknowledgments -- Executive Summary -- Key Definitions and Abbreviations -- Chapter 1 Characterizing the HIV/AIDS Epidemic in the Middle East and North Africa: Why and How? -- Background and Rationale for This Report -- Conceptual Framework and Research Methodology -- Bibliography -- Chapter 2 Injecting Drug Users and HIV -- HIV Prevalence among IDUs -- Hepatitis C Prevalence as a Proxy Marker of Risky Behavior among IDUs -- Prevalence of Drug Injection -- Female Injecting Drug Users -- Injecting Drug Users and Risky Behavior -- Knowledge of HIV/AIDS -- Bibliography -- Chapter 3 Men Who Have Sex with Men and HIV -- HIV Prevalence among MSM -- Prevalence of Homosexuality -- Men Who Have Sex with Men and Risk Behavior -- Knowledge of HIV/AIDS -- Analytical Summary -- Bibliography -- Chapter 4 Commercial Sex and HIV -- HIV Prevalence among FSWs -- Context of Commercial Sex in MENA -- Forms of Commercial Sex -- Prevalence of Commercial Sex -- Commercial Sex and Risk Behavior -- Knowledge of HIV/AIDS -- Analytical Summary -- Bibliography -- Chapter 5 Potential Bridging Populations and HIV -- Context of Bridging Populations in MENA -- HIV Prevalence in Potential Bridging Populations -- Potential Bridging Populations and Risk Behavior -- Vulnerability of Sexual Partners of Priority Populations -- Analytical Summary -- Bibliography -- Chapter 6 General Population and HIV -- HIV Prevalence in the General Population -- General Population and Risk Behavior -- Male Circumcision -- Analytical Summary -- Bibliography -- Chapter 7 Further Evidence Related to HIV Epidemiology in MENA -- HIV and Sexually Transmitted Disease Clinic Attendees, Voluntary Counseling and Testing Attendees, and Suspected AIDS Patients -- HIV/AIDS among Tuberculosis Patients -- Further Point-Prevalence Surveys.

HIV-Positive Results Extracted from HIV/AIDS Case Notification Surveillance Reports -- Distribution by Sex of Reported HIV Cases -- Transmission Modes -- Pattern of Exogenous HIV Exposures in MENA -- Parenteral HIV Transmissions Other Than Injecting Drug Use -- HIV Molecular Epidemiology -- Bibliography -- Chapter 8 Condom Knowledge and Use and HIV/AIDS Knowledge and Attitudes -- Knowledge of Condom as a Prevention Method and Its Use -- HIV/AIDS Knowledge and Attitudes -- Bibliography -- Chapter 9 HIV/AIDS and Vulnerability Settings -- Prisoners and HIV -- Youth and HIV -- Population Mobility and HIV -- Street Children -- Vulnerability Settings: Analytical Summary -- Bibliography -- Chapter 10 Proxy Biological Markers of Sexual Risk Behavior -- HSV-2 as a Marker of Sexual Risk Behavior -- HPV and Cervical Cancer Levels as Markers of Sexual Risk Behavior -- Bacterial STIs as Markers of Sexual Risk Behavior -- Unsafe Abortions as Markers of Sexual Risk Behavior -- Biological Evidence on Proxy Measures of Sexual Risk Behaviors: Analytical Summary -- Bibliography -- Chapter 11 Analytical Insights into HIV Transmission Dynamics and Epidemic Potential in MENA -- Evolution of the HIV Epidemic in MENA -- Conceptual Framework: Dynamics of HIV Infectious Spread in MENA -- General Features of HIV Spread in MENA -- Future HIV Expansion in MENA -- Bibliography -- Chapter 12 Snapshot on Response to HIV Epidemic in MENA: Linking Evidence with Policy and Programmatic Action to Avert the Epidemic -- HIV Prevention in MENA -- Focused HIV Prevention Programs for People Exposed to Risk -- Access to Means of Prevention -- HIV Testing and Counseling -- Expanding Coverage -- Civil Society and People Living with HIV as Implementation Partners -- Blood Safety and Universal Precautions -- HIV Care and Treatment -- HIV Mother-to-Child Transmission.

Prevention and Control of STIs: Current Response and Challenges -- Concluding Remarks and Summary of Findings -- Bibliography -- Chapter 13 Summary of Recommendations -- Recommendation 1: Increase and Expand Baseline and Continued Surveillance -- Recommendation 2: Expand Scientific Research and Formulate Evidence-Informed Policies -- Recommendation 3: Focus on Risk and Vulnerability, Not on Law Enforcement -- Recommendation 4: Strengthen Civil Society Contributions to HIV Efforts -- Recommendation 5: An Opportunity for Prevention -- Bibliography -- Appendixes -- Index -- Boxes -- 9.1 Youth, Drug Use, and Marginalization in Lebanon -- 9.2 Iraqi Women Refugees and Commercial Sex in Syria -- Figures -- 1.1 Heterogeneity in Risk of Exposure to a Sexually Transmitted Infection -- 1.2 Schematic Diagram of the Concept of R0 -- 1.3 Two Patterns of HIV Infectious Spread in a Population -- 7.1 Fraction of HIV Tests That Are Positive in Different Population Groups in MENA -- 7.2 Distribution of HIV Tests in MENA by Population Group -- 10.1 HSV-2 Prevalence for Selected Populations, by Age Group in Morocco -- 10.2 Age-Stratified Cervical Cancer Incidence in Select MENA Populations Compared to the Global Average -- 10.3 A Schematic Diagram of Two Different Kinds of Sexual Networks with Different Connectivity -- 10.4 The Natural History of HPV Infection and Cervical Cancer -- 10.5 Trend in STI Notified Cases in Morocco, 1992-2006 -- 10.6 Estimated Annual Incidence of Unsafe Abortions per 1,000 Women Aged 15-44 Years, by United Nations Subregions in 2000 -- 11.1 Analytical View of HIV Epidemiology in MENA -- 11.2 A Schematic Diagram of the Overlap between Priority Populations in MENA -- 11.3 Simulation of a Typical HIV Epidemic among an MSM Population -- 12.1 ART Scale Up in Somalia and Southern Sudan between 2005 and 2008 -- Tables.

2.1 HIV Prevalence among IDUs in MENA -- 2.2 HCV Prevalence among IDUs in MENA -- 2.3 Estimates of the Number and Prevalence of IDUs, Selected MENA Countries -- 2.4 Levels of Nonsterile Needle or Syringe Use among IDUs in Several MENA Countries -- 2.5 Measures of Overlapping Injecting and Sexual Risk Behaviors of IDUs in MENA -- 3.1 HIV Prevalence among MSM in MENA -- 4.1 HIV Prevalence among FSWs in MENA -- 5.1 HIV Prevalence in Potential Bridging Populations in MENA -- 6.1 HIV Prevalence in Population-Based Surveys in MENA -- 6.2 HIV Prevalence among ANC Attendees and Other Pregnant Women in MENA -- 6.3 HIV Prevalence among Blood Donors in MENA -- 7.1 HIV Transmission Modes for a Number of MENA Countries -- 7.2 HIV Prevalence among Populations at Risk of Parenteral HIV Infection (excluding IDUs) -- 8.1 General Knowledge of Condoms including HIV Prevention, in Different Populations Groups in MENA -- 8.2 Condom Use among Different Population Groups in MENA -- 9.1 Imprisonment Rates and HIV Prevalence in Select MENA Countries -- 10.1 HSV-2 Prevalence in Different Population Groups -- 10.2 HSV-2 Prevalence in the General Population in Different Regions of the World Compared to MENA -- 10.3 Age-Standardized Rates of Cervical Cancer Incidence and Mortality -- 10.4 Age-Standardized Rates of Cervical Cancer Incidence and Mortality at Specific Surveillance Sites or Population Groups -- 10.5 HPV Prevalence in Different Population Groups in MENA -- 10.6 Syphilis Prevalence in Different Population Groups -- 10.7 Gonorrhea Prevalence in Different Population Groups -- 10.8 Chlamydia Prevalence in Different Population Groups -- 11.1 Status of the HIV Epidemic in MENA Countries -- 12.1 Number of PLHIV on ART in Selected Countries, 2006-08 -- A.1 Estimated Number of People Living with HIV in MENA Countries.

B.1 Threshold for Sustainable Transmission and Transmission Probability per Partnership for Key STIs -- C.1 HIV Prevalence of Different Population Groups in MENA -- D.1 HIV Prevalence among STD Clinic Attendees, VCT Attendees, and People Suspected of Living with HIV -- D.2 HIV Prevalence of Tuberculosis (TB) Patients -- D.3 Point-Prevalence Surveys on Different Population Groups -- D.4 Hepatitis C Virus Prevalence in Different Population Groups -- E.1 Levels of HIV/AIDS Basic Knowledge in Different Population Groups -- E.2 MENA Populations with Low Levels of Comprehensive HIV/AIDS Knowledge -- E.3 MENA Populations with High Levels of HIV/AIDS Misinformation -- E.4 Nature of Attitudes toward People Living with HIV/AIDS by Different Population Groups -- E.5 Television as the Main Source of HIV/AIDS Knowledge, by MENA Population Groups.