LAHORE - HIV/AIDS epidemic is taking hold in Pakistan, mostly among drug addicts, male/female sex workers and repatriated migrants. Though the number of confirmed HIV patients are not that high, really alarming situation is that majority of these are unidentified either due to lack of awareness about the condition or social stigma attached to the disease.
A huge gap between the number of identified and actual HIV positive people is posing serious challenge for the health managers.  So far about 7,000 people have been tested HIV/AIDS positive in the country and majority of these belong to big cities. The United Nations, however, estimated that the HIV/AIDS patients in Pakistan are from 87,000 to 120,000. As such majority of the patients are yet to be identified that poses threat of transmission of virus to healthy individuals through matrimonial and extra marital relations, unscreened blood transfusion and reuse of syringes.  The overall prevalence of HIV infection in adults aged 15 to 49 is 0.1 per cent. Officials say that the majority of cases go unreported due to social taboos about sex and victims’ fears of discrimination.
“There is a huge gap between the number of reported and actual HIV patients. So far around 7000 people have been tested positive for HIV. At present over 4500 registered patients including 164 children are getting free medicines, testing facilities from AIDS centres at teaching hospitals in nine cities. The government is focusing on identifying people living with HIV. Over 300 people living with HIV were identified last year. This year 400 more will be identified”, said Additional Secretary (Technical) Health Dr Salman Shahid who is heading Punjab Aids Control Program.
“We are creating awareness among high risk groups regarding preventive measures against HIV. Involvement of targeted community and civil society organizations has helped giving positive results. NGOs are providing syringes to registered drug addicts, condoms to female/transgender sex workers to check transmission of HIV. From amongst high risk groups, female sex workers are relevantly difficult to approach”, he said, adding, the government has screened inmates of jails in Punjab for HIV. Last year, he said, 300 prisoners in different jails were tested positive for HIV. He said that the government was providing medicine to these HIV patients in jails and at specified centres after their release. He said that establishment of Blood Transfusion Authority and registration of blood banks would help reducing unscreened blood transfusion, a major factor in transmission of HIV. He said that the government launched project of screening of pregnant women for HIV in selected districts to check transmission of virus to newborns.
“So far 96 pregnant women carrying HIV has been identified. Out of these, 63 have delivered babies. Owing to provision of regular treatment during pregnancy, 61 newborns are not carrying HIV. Only two newborns are HIV positive as mothers could not get regular treatment due to domestic reasons. As such this program is yielding 100 per cent desired results”, Dr Salman Shahid claimed. He said that the government has provided sufficient funds for running Aids Control Program. The government was providing diagnosis and treatment facilities free of cost, he said.
At least 54 NGOs are involved in HIV/AIDS public awareness and in the care and support of persons living with HIV/AIDS. These NGOs also work on education and prevention interventions targeting IDUs, sex workers, truck drivers, and other high‐risk groups.
Pakistan enjoyed a low prevalence phase of epidemic. Different studies and the national HIV surveillance have confirmed an escalating epidemic among IDUs and more recently among male and transgender sex workers.
Currently the national average prevalence of HIV among IDUs is nearly 20 per cent. Several cities also show concentrated epidemic among MSWs/TSWs as well. Major factor in the overall HIV transmission scenario is the rampant use of therapeutic injections, often with non-sterile injection equipment. There are an estimated 800 million therapeutic injections given annually in Pakistan or approximately 4.5 per capita, the highest in the World. A small but significant proportion of these are reused. The prevention efforts received a major boost when a World Bank loan/grant allowed the Ministry of Health and the provincial governments to start a program to provide HIV prevention services to IDUs, sex workers and truckers; perform advocacy and communication for the general public and covers significant proportion of the national blood supply for HIV screening.
Although overall HIV prevalence is low, HIV is well established among IDUs and epidemic is also spreading among transgender (6 per cent) in a few cities. HIV among female sex workers has remained negligible. Given the protective effect of circumcision, a generalized sexually transmitted epidemic is unlikely but evidence of significant linkages between sex work and injecting drug use point to the potential for the spread of the epidemic far beyond these groups.