CAIRO: The number of reported cases of Human Immunodeficiency Virus (HIV) in Egypt increased six fold from 1994, when it was first detected in the country, to 2008, according to the Population Status in Egypt 2009 report by state-affiliated Information and Decision Support Center (IDSC). By the end of 2008, there were 3,375 HIV reported cases, out of which 25.8 percent developed Acquired Immune Deficiency Syndrome (AIDS), the clinical and last stage of HIV, where the immune system is totally destroyed. The government report says that HIV is of "minor concern in Egypt and is not a priority health issue. This was evidenced by the fact that the HIV/AIDS issue was not brought up in Egypt's National Population Conference in 2008. Even though Egypt's conservative culture has helped contain the spread of the disease, there is debate over whether the country has a low grade HIV epidemic or is stepping towards a concentrated epidemic. There are two opposing outlooks on the HIV epidemic in Egypt, says IDSC. The first calls for keeping HIV low on the health agenda as there is a widespread belief that it is not a threat and that national strategies are sufficient enough to deal with the low prevalence. The second calls for prioritizing it on the health agenda even if there is relatively low number of HIV cases in order to protect the country, since the biomedical interventions and the conservative culture can no longer resist the HIV epidemic growth. UNAIDS, however, says that the numbers could be much more than the reported national statistics. HIV's prevalence in Egypt is considered relatively low, with around 0.02 percent of the general population, which is approximately 9,213 people, by the end of 2008. But preconditions for a wider epidemic exist, according to the UNAIDS office in Egypt. High risk factors create an ideal environment for the rapid spread of HIV. These factors include overpopulation, especially in the 15-24 age bracket, which constitutes 50 percent of HIV patients; as well as poverty, illiteracy, particularly among women, and a weak health system despite its huge infrastructure. The underestimation in the national statistics is attributed to the national surveillance system which mainly relies on mandatory HIV testing, according to the IDSC report. The HIV virus has appeared in all Egyptian governorates except North and South Sinai. The highest numbers of HIV cases have been reported in Cairo, Alexandria, Giza and Gharbia. The New Valley, Red Sea, Marsa Matrouh and Luxor governorates have reported the lowest numbers. This could be due to the difference in population density as well as the concentration of the HIV programs in the big cities, especially when the virus first appeared in Egypt. The report calls for the government to start taking action as the HIV epidemic is now "a national threat even with the low number of cases at the moment; it is growing and "there is no reason for the lack of recognition or denial, says the report.
