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Pour the tahina into a bowl and stir in the lemon juice. Slowly add the milk, stirring until you have a mixture that is thick and creamy. Add the garlic, parsley, salt and pepper.
Bring a large saucepan half-filled with lightly salted water to the boil. Add the macaroni or spaghetti, stir and cook until just tender. Strain into a colander and rinse under cold water.
Return the macaroni or spaghetti to the saucepan, pour in the tahiniyeh and mix thoroughly.
This dish can be eaten hot or cold.