Human Immunodeficiency Virus Epidemic among People Who Inject Drugs and Female Sex Workers in North Africa: A Systematic Review

Abstract

Background: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) remain major health problems worldwide, with high mortality and morbidity rates, particularly in developing countries. The United Nations Programme on HIV/AIDS (UNAIDS) reported that there were 38.4 million individuals globally who had HIV. Around 1.5 million new HIV infections were recorded in 2021, while approximately 650,000 individuals worldwide lost their lives due to AIDS-related illnesses. The prevalence of HIV in people who inject drugs (PWID) and female sex workers (FSWs) has not been widely investigated. Information on the epidemiology of HIV infection among PWID and FSWs in North Africa is limited. The aim of the present study was to review the status of the HIV epidemic among PWID and FSWs in North African countries by explaining HIV prevalence. Methods: A comprehensive literature search was performed on studies related to the prevalence of HIV infection in PWID and FSWs published between 1990 and 2024 using search engines such as PubMed, Science-Direct, Google scholar. Reports that are entirely on North Africa were considered, including studies reporting HIV infection in high-risk groups, particularly PWID and FSWs, with the data organized into a customized database. Results: A total of 3605 records were retrieved in the initial search, 10 relevant records HIV among PWID and FSWs were recognized and included in the study. The overall prevalence of HIV in PWID ranged from 0.15% to 87.1% and 0% to 15.7% in FSWs. Injection drug abuse and women engaged in sex work were commonly associated with HIV infection. Conclusion: The findings of this study showed that the prevalence of HIV among PWID and FSWs in North Africa is high. PWID and FSWs has been identified as the dominant method of transmission in various North African countries like Libya, Egypt, Morocco and Tunisia. The execution of initiatives designed to improve sanitation infrastructure, elevate educational standards, and enhance socioeconomic situations is crucial for decreasing the prevalence of HIV infections among PWID and FSWs.