Trends in reported HIV diagnoses, exposure patterns, and AIDS-related mortality in the Eastern Mediterranean Region, 2014–2023

• Article
• Open access
• Published: 08 October 2026


• Rasoul Ebrahimi,
• Mehra Fekri,
• Seyed Aria Nejadghaderi,
• Farzin Tahmasbi Arashlow,
• Maliheh Sadat Bazrafshani,
• Ahmed S. Alaama,
• Muhammad S. Jamil,
• Mohammad Karamouzian &
• Hamid Sharifi

Scientific Reports  Cite this article

Abstract

The Eastern Mediterranean Region (EMR) continues to face a substantial HIV burden, with increasing numbers of reported diagnoses, heterogeneous exposure patterns, and persistent AIDS-related mortality. Despite global progress, countries of EMR remain far from achieving the UNAIDS 95-95-95 targets. This analysis of regional HIV surveillance data presents trends in reported diagnoses, exposure patterns, and AIDS-related mortality across EMR countries from 2014 to 2023. We analyzed country-level aggregated HIV surveillance data submitted annually to the WHO Regional Office for the EMR from 2014 to 2023. Data included new HIV diagnoses, exposure modes, demographic characteristics, and AIDS-related deaths. Descriptive analyses were performed to assess temporal trends, country-level disparities, and reporting completeness. Newly reported HIV diagnoses in the EMR increased sevenfold, from 3,717 in 2014 to 26,314 in 2023, with men accounting for nearly three-quarters of diagnoses. Exposure data, available for 73.6% of cases in 2023, indicated heterosexual contact as the most frequently reported route, followed by injecting drug use, same-sex contact, and blood exposure, though substantial proportions remained unknown. Exposure patterns varied markedly across countries, reflecting both epidemiological context and surveillance limitations. Over the study period, 22,569 deaths were reported, with greatest numbers from Pakistan, Egypt, Saudi Arabia, and Somalia. Mortality disproportionately affected men over the study period, though sex-disaggregated data were incomplete in several settings. HIV in the EMR is characterized by rising diagnoses, heterogenous reported exposure, and significant mortality, with major reporting gaps in coverage and completeness. Strengthening surveillance systems, expanding diversified testing strategies, and scaling up culturally sensitive prevention and treatment services are critical to improve epidemic control. Regional collaboration and integration of harm reduction, sexual health, and stigma reduction strategies remain essential for improving outcomes and achieving HIV control targets.

Acknowledgements

None.

Funding

The authors received no financial support for this research.

Author information

Authors and Affiliations

1. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

   Rasoul Ebrahimi, Mehra Fekri, Seyed Aria Nejadghaderi, Farzin Tahmasbi Arashlow, Maliheh Sadat Bazrafshani & Hamid Sharifi

2. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

   Rasoul Ebrahimi & Mehra Fekri

3. Knowledge Hub for Migrant and Refugee Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

   Seyed Aria Nejadghaderi

4. Medical Students Research Centre, Iran University of Medical Sciences, Tehran, Iran

   Farzin Tahmasbi Arashlow

5. World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt

   Ahmed S. Alaama & Muhammad S. Jamil

6. Centre on Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada

   Mohammad Karamouzian

7. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

   Mohammad Karamouzian

Corresponding authors

Correspondence to Seyed Aria Nejadghaderi or Hamid Sharifi.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates via CrossMark

Cite this article

Ebrahimi, R., Fekri, M., Nejadghaderi, S. et al. Trends in reported HIV diagnoses, exposure patterns, and AIDS-related mortality in the Eastern Mediterranean Region, 2014–2023. Sci Rep (2026). https://doi.org/10.1038/s41598-026-74587-0

Download citation

• Received18 April 2026

• Accepted30 September 2026

• Published08 October 2026

• DOIhttps://doi.org/10.1038/s41598-026-74587-0

---

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

---

Source: Nature
https://www.nature.com/articles/s41598-026-74587-0



Back to…
Positively Positive - Living with HIV/AIDS:
HIV/AIDS News




For more HIV and AIDS News visit…

Positively Positive - Living with HIV/AIDS: HIV/AIDS News Archive
HIV and AIDS News sorted by Month & Year

…positive attitudes are not simply ‘moods’

Site Map

Contact Bradford McIntyre.

Copyright © 2003 - 2026 Bradford McIntyre. All rights reserved.

DESIGNED TO CREATE HIV & AIDS AWARENESS