The 2005 UNAIDS/WHO Epidemic Update reports that the number of people living with HIV last year worldwide was 40.3 million (1). In 2005, approximately 3.2 million people became newly infected by HIV in Sub-Saharan Africa, the region of the world that is considered the epicenter of the AIDS epidemic (2).
Although the rates of HIV are much less in the Middle East and North Africa (MENA) than in Sub-Saharan Africa, some experts believe that without appropriate implementation of surveillance and prevention services, the epidemic will spread to the general population (3). Reportedly, 67,000 people in MENA became infected with HIV in 2005; there are approximately 510,000 people living with HIV in the region (2). Because of cultural and social taboos surrounding the discussion of the acquisition of HIV around the world in general, and in MENA in particular, it is difficult to develop a clear representation of HIV's presence and risk in countries in the Middle East. Based on the information that is available, the main mode of transmission of HIV is sexual contact, with injecting drug use recognized as the second mode of increasing prevalence (2). Without sufficient implementation of surveillance in the region, however, estimated rates of infection may indeed be lower than the actual number of people infected with HIV (4).