Sex among men is responsible for more than a quarter of new HIV infections in parts of the Middle East, North Africa and Pakistan, according to a study. High-risk sex between truck drivers in Morocco and Pakistan, prisoners in Lebanon and street children in Egypt are fueling the spread of HIV, researchers in Qatar found in a study of data from 23 nations published by the Public Library of Science in its journal. The survey is the first to describe the state of HIV among gay and bisexual men in a region where same-sex intercourse is often criminal and the stigma associated with it can hinder efforts to prevent transmissions, the researchers said. They hope the findings will spur governments to curb the epidemics, said Laith Abu-Raddad, an associate professor of public health at the Weill Cornell Medical College in Qatar who led the study. Only a few countries have started in the right direction, Abu-Raddad said in a telephone interview from Doha, citing Morocco, Pakistan and Lebanon. The majority of countries still havent really acted. He declined to say which nations are lagging behind, saying the matter is sensitive. Abu-Raddad and colleagues compiled data from 95 studies and articles. In most countries, fewer than 10 per cent of gay and bisexual men have HIV, they found, less than western nations such as the US, where the rate is 21 per cent. Infections were highest among eunuchs in Pakistan, where 28 per cent have the virus. Its really time for action, for policy makers to think about it and also for them to know there are creative ways to dealing with the issue, even within the socially conservative context of this region, Abu-Raddad said. The study was funded by the World Bank, UNAIDS and the World Health Organization. Weill Cornell Medical College in Qatar is a partnership between the Qatar Foundation and Cornell University in Ithaca, New York.