AIDS is on the rise in many Muslim countries, driven by men having sex with other men in secret because of homophobia, religious intolerance and fear of being jailed or executed, according to a new study

About 2% - 3% of men in the region have sex with other men, consistent with global averages, the study found. But condom use is low, gay and bisexual prostitution is common, and many married men hide their bisexuality and risk infecting their wives. In some countries, even male prostitutes often marry for appearances’ sake. Truck drivers, prisoners and street children often have high rates of H.I.V. infection; in Pakistan, infection rates are rising rapidly among transgender prostitutes known as hijra. The lowest rates of condom use were reported in populous countries like Egypt and Pakistan, while they were highest in Sudan, Oman and Lebanon. To fight their nascent epidemics, some countries have adopted compulsory H.I.V. testing for marriage licenses and work visas. Because of religious taboos, accurate statistics on some aspects of health are hard to get from Middle Eastern governments. For example, international health authorities say that the world’s highest rates of birth defects are in Muslim countries where cousins are encouraged to marry but that governments are reluctant to admit it.