A systematic review of the research literature on honor killings in the Middle East and North Africa (MENA) indicates a paucity of studies relative to the presumed magnitude of the problem. Forty articles were reviewed and critically appraised, of which only 9 contained primary data and 11 presented original secondary analyses. Despite a recent increase in published studies, persistent methodological limitations restrict the generalizability of findings. Most studies focus on legal aspects, determinants, and characteristics of victims and perpetrators. Victims are mostly young females murdered by their male kin. Unambiguous evidence of a decline in tolerance of honor killings remains elusive.

Background: Micronutrient deficiencies occur commonly in people infected with the human immunodeficiency virus. Since aflatoxin exposure also results in reduced levels of several micronutrients, HIV and aflatoxin may work synergistically to increase micronutrient deficiencies. However, there has been no report on the association between aflatoxin exposure and micronutrient deficiencies in HIV‐infected people. We measured aflatoxin B₁albumin (AF‐ALB) adduct levels and vitamins A and E concentrations in the plasma of HIV‐positive and HIV‐negative Ghanaians and examined the association of vitamins A and E with HIV status, aflatoxin levels and hepatitis B virus (HBV) infection.Methods: A cross‐sectional study was conducted in which participants completed a demographic survey and gave a 20 mL blood sample for analysis of AF‐ALB levels, vitamins A and E concentrations, CD4 counts, HIV viral load and HBV infection.Results: HIV‐infected participants had significantly higher AF‐ALB levels (median for HIV‐positive and HIV‐negative participants was 0.93 and 0.80 pmol/mg albumin, respectively; p <0.01) and significantly lower levels of vitamin A (‐16.94 μg/dL; p <0.0001) and vitamin E (‐0.22 mg/dL; p <0.001). For the total study group, higher AF‐ALB was associated with significantly lower vitamin A (‐4.83 μg/dL for every 0.1 pmol/mg increase in AF‐ALB). HBV‐infected people had significantly lower vitamin A (‐5.66 μg/dL; p = 0.01). Vitamins A and E levels were inversely associated with HIV viral load (p = 0.02 for each), and low vitamin E was associated with lower CD4 counts (p = 0.004).Conclusions: Our finding of the significant decrease in vitamin A associated with AF‐ALB suggests that aflatoxin exposure significantly compromises the micronutrient status of people who are already facing overwhelming health problems, including HIV infection.