They report that the arrival of HIV in the gay community has been relatively recent compared with other regions of the world, but warn that it is on the rise. In Pakistan, for example, the prevalence of HIV in transgender male sex workers rose from 0.8 per cent in 2005 to 6.4 per cent just three years later.
Historically, HIV epidemics have often begun in minority, high-risk groups such as men who have sex with men or intravenous drug users, then spread to the general population. A problem in much of the Islamic world is that men having sex with men is illegal. That, coupled with homophobia, hampers efforts to contain the virus by making gay men too scared to seek treatment, a pattern that has been seen in eastern European countries, India and sub-Saharan Africa.
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