Contribution of injecting drug use as a mode of HIV transmission to the total HIV/AIDS cases by country as per various studies/reports and countries' case notification reports [126],[190].

<p>Only the most recent available report was used.</p>a<p>Except for Bahrain, Egypt, and Iraq (2010 report) and Pakistan (2008 report).</p><p><i>n</i>, number of positive cases that are PWID; <i>N</i>, total number of positive cases; Percent, percent of positive cases that are PWID out of the total number of positive cases; UAE, United Arab Emirates.</p

Characterization of the state of the HIV epidemic among people who inject drugs in the Middle East and North Africa based on the HIV biological data and quality and scope of the evidence.

<p>Countries are sorted by level of HIV prevalence, trend in HIV prevalence, geographical distribution, quality and scope of evidence, then alphabetical order.</p><p>UAE, United Arab Emirates.</p

HIV prevalence among people who inject drugs in the Middle East and North Africa as extracted from reports included in the systematic review.

a<p>Population-adjusted estimate.</p>b<p>Self-report.</p><p>CS, convenience sampling; ID, infectious disease; MSCS, multi-stage cluster sampling; RCS, random cluster sampling; RDS, respondent driven sampling; SBS, snow ball sampling; SRS, simple random sampling; TLS, time location sampling; VCT, voluntary counseling and testing.</p

Map of the Middle East and North Africa region.

<p>The defintion adopted in the review includes the following 23 countires: Afghanistan, Algeria, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, OPT, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan (including the newly established Republic of South Sudan), Syria, Tunisia, United Arab Emirates (UAE), and Yemen.</p

PRISMA flow chart of study selection in the systematic search.

<p>PRISMA flow chart of study selection in the systematic search.</p

Summary of the HIV biological evidence per country.

a<p>With reports available.</p><p>Afg, Afghanistan; Alg, Algeria; Bah, Bahrain; Dji, Djibouti; Egy, Egypt; Irn, Iran; Irq, Iraq; Jor, Jordan; Kuw, Kuwait; Leb, Lebanon; Lib, Libya; Mor, Morocco; Oma, Oman; Pak, Pakistan; QA, Qatar; SA, Saudi Arabia; Som, Somalia; Sud, Sudan; Syr, Syria; Tun, Tunisia; UAE, United Arab Emirates; Yem, Yemen.</p

Trend of HIV prevalence among people who inject drugs, and when available men who have sex with men, in repeated rounds of bio-behavioral surveillance surveys.

<p>These graphs display the trend of HIV prevalence in repeated rounds of bio-behavioral surveillance surveys using state of the art sampling techniques for hard-to-reach populations including respondent driven sampling and time-location sampling. Country level and aggregate data of multiple cities/provinces are displayed. For consistency between countries and between different rounds within a given country, unadjusted sample estimates are displayed. Three main patterns of HIV epidemics among PWID are depicted. A pattern of emerging concentrated epidemics is observed in Pakistan (A) and Egypt (B); a pattern of established concentrated epidemic is observed in Iran (B); and a pattern of low-level HIV epidemic is observed in Tunisia (D). In Afghanistan (E), there is an emerging epidemic among PWID in apparently only part of the country; the effect of which was diluted in the second round with the inclusion of new cities with still very limited prevalence. The potential overlap of the HIV epidemics among PWID and MSM is depicted in Pakistan and Egypt. In Pakistan, an emerging HIV epidemic among transgender sex workers is observed, but lags the epidemic among PWID (A). In Egypt, the concentrated epidemic among MSM seems to have preceded the epidemic among PWID (B). In Tunisia, the potential link between the MSM and PWID epidemics is not clear because the studies were conducted after the epidemics had already risen.</p

Percentage distribution of FSWs by type of spot by state, Nigeria, 2012.

<p>Percentage distribution of FSWs by type of spot by state, Nigeria, 2012.</p

Number of FSW spots by state.

<p>Number of FSW spots by state.</p

Number of Key Informant Interviews by State, Sex and Educational level.

<p>Number of Key Informant Interviews by State, Sex and Educational level.</p