Egypt remains a low HIV prevalence country with evidence of a concentrated epidemic among people who inject drugs and men who have sex with men in Cairo and Alexandria.
Some HIV professionals presume that vulnerable populations may include prisoners, migrants, and children in street. This hypothesis is not evidenced by any serological studies conducted among these populations but self-reported behaviour hints that some members of these populations may be vulnerable.
While the estimated number of people living with HIV in Egypt remains relatively low (11,000 by the end of 2016) compared to the total population, Egypt is reported to have the fastest growing epidemic in the Middle East and North Africa Region (MENA) by a 76% increase in number of cases between 2010 and 2016.
This, coupled with the witnessed alarming trend in number of new confirmed cases by 25-30% annually is seen as worrying signs that point into a dire need for increasing investments to avoid further epidemic growth and a failure in controlling the epidemic.
It is very challenging to provide prevention services to the key vulnerable populations who are at highest risk foremost because their behaviors are considered as crimes under Egyptian law. When it comes to providing testing, care, support and treatment services for people living with HIV, most of the affected people are not tested early enough. Furthermore, there is a high treatment drop out in the first year of treatment due to several personal and structural reasons including lack of treatment knowledge and support. All these factors lead to increased mortality rates. In 2016, the estimate number of deaths due to AIDS among children aged 0 to 14 is less than 100 and number of orphans due to AIDS aged 0 to 17 are 2200.
A robust national strategic plan was developed to cover the period 2015-2020 with ambitious targets aligned to global targets of 90-90-90 (90% of those living with HIV knowing their status, 90% of those knowing their status are enrolled to treatment and 90% of those on treatment sustained on treatment to reach viral suppression) set and endorsed globally through the 2016 political declaration for Ending AIDS by 2030.
The strategy implementation has faced several challenges. While Egypt’s government has pledged national resources to support the procurement of treatment, several gaps in areas of prevention, care, support and the enabling environment persist.