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Considering an evolving HIV epidemic in concentrated high risk groups in Pakistan, it is highly likely that the prevalence of HIV in TB patients will also have increased with the maturation of this epidemic; a study done in rural parts of Pakistan in Sindh province found HIV prevalence of 0.5% in TB patients which is more than the estimated prevalence of < 0.1% in the general population [ 22].
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Incarcerating drug users also increases risk by concentrating high-risk people together.
Model results indicate that the relative risk for ASFV introduction through TAR in most of the EU countries (16) is low, although some countries, specifically Poland and Lithuania, concentrate high levels of risk, the returning trucks route being the analyzed TAR that currently poses the highest risk for ASFV introduction into the EU.
While bacterial STIs tend to be concentrated in high risk groups [16], HSV-2 transmission is sustainable in the general population, and therefore its prevalence can reach very high levels such as those observed in diverse regions around the globe [4], [17].
The HIV epidemic in Vietnam is still concentrated among high risk populations, including IDU and FSW.
Nevertheless, some countries concentrated very high risk of ASFV introduction associated to specific types of ships.
For cruise movements only five North European countries concentrated very high risk levels, although the relative importance of this type of movements was considered low by EO.
While bacterial STIs such as gonorrhea and syphilis, which also amplify the risk of HIV transmission [ 34], tend to be concentrated in high risk groups [ 35], the biological characteristics of HSV-2 allow this virus to be sustainable at high levels in the general population, as observed in sub-Saharan Africa [ 36].
The rates of HIV infection among pregnant women in Asia are not high, generally 1-21-2%6] and the epidemic is mainly concentrated in high risk populations, known to be injecting drug users, sex workers and their clients, and men who have sex with men.
However, the most interesting results are related with waste from cargo ships, for which, four countries concentrate very high risk (France, Italy, the Netherlands and Spain).
The results of the model indicate that the median risk of ASF introduction in EU countries is low and mainly associated to returning trucks, although some countries concentrate higher levels of risk such as Poland and Lithuania.
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