HIV on the rise in Pakistan: Survey

Islamabad - A survey has revealed that the Human Immunodeficiency Virus (HIV) is rising in the country with no signs of decline.

The survey also revealed that the devolution of health ministry and AIDS Control Program resulted in an indentation of the national HIV response in the country and has adversely affected the HIV response.

Moreover, lack of national coordination, data analysis and utilisation at a national level, non-availability of national guidance and monitoring showed negative impact on the results of surveillance.

The Ministry of National Health Services and Regulations (NHSR) held Integrated Biological & Behavioural Surveillance (IBBS), which suggested that the outbreak of HIV in the country is following the similar pattern of Asian countries where the disease is rapidly propagating.  As per the survey, conducted in the entire country, Sindh province is leading in numbers of HIV patients.  The survey tested the samples from the key population areas including People Who Inject Drugs (PWID), Transgender Population (TGs), Female Sex Workers (FSWs) and Men having Sex with Men (MSM).

The survey covered 23 districts of the country where the number of populated cities was not included.

According to report, the HIV dissemination in PWID remained dominant with the overall prevalence of 38.4 per cent and all cities were reported with a concentrated epidemic.

In the survey, a total of 4062 PWIDs were interviewed including 99.4 per cent males. Approximately 50 per cent PWIDs were unmarried with the maiden monthly income around Rs 10,000.

In TG category, the overall HIV prevalence was reported 7.5 per cent. The high prevalence for TGs was reported from Larkana with 18.2 per cent, followed by Bannu with 15 per cent and Karachi with 12.9 per cent.

The report said approximately 39 per cent of TGS were aware of HIV prevention programs, however, only 15.1 per cent ever utilised these services.

In FSM key population the HIV prevalence was lowest amongst all other categories, however, within dissemination in the group was high as compared to others. The overall weighted prevalence was 2.2 per cent.

The overall HIV prevalence in MSM key population was reported 5.4 per cent. The MSM were divided into two types including Male Sex Workers (MSW) and Non-Sex Workers (Non-SW). The predominant proportion of MSMs interviewed, identified themselves as homosexual men with 68.7 per cent.  The report said that a significant proportion of PWID regularly share needles and syringes, sex workers continue to be involved in unprotected sex and same holds true for MSM and TGs. There is overlap between PWID, sex workers and MSM which is an alarming feature.

The survey said overall HIV burden on the country is 0.1 per cent and amongst general population the prevalence of the disease is static.

The Joint Secretary NHS said that ministry is fully cognizant of the epidemic trends in the country and there is a need to check the spread of the epidemic on war footings.

The ministry with the support of development partners like UNAIDS, WHO and the active participation of the PLHIV community, is combating the HIV AIDS epidemic on war footings.

Resident, Coordinator United Nations, Neil Buhne said that Pakistan, as the IBBS shows, is at a crucial stage where HIV is growing but the capacity to reverse it also exists. He said Pakistan can build on the result of the survey and the experience of the regional countries with high prevalence to scale-up the response.

Country Director UNAIDS Pakistan Dr Mamadou Sakho, said that according to the last UNAIDS report in 2016, in the Asia Pacific region, India, China and Pakistan are among the 10 countries which account for more than 95 per cent of all new HIV infections. The Philippines, Indonesia, Thailand and Malaysia are amongst the others.

HIV in Pakistan looks like a concentrated epidemic among key populations including injecting drug users, TG, men who have sex with men and sex workers.

National Program Manager Dr Baseer Khan Achakzai said the HIV epidemic in Pakistan continues to grow among key populations with an estimated 133,529 people living with HIV in the country.

Although HIV prevalence in the general population remains less than 1 per cent, but an increase in prevalence has been noted in all key populations with a risk of spread to the general population through sexual networks.  NACP has been successfully implementing the Global Fund grants GF-ATM SSF grant (2013-16 worth 9.8 million USD) ii) GF-ATM NFM grant (2016-17 worth 9.02 million USD) and has secured funding of 17.5 million USD for 2018-20 to implement the high-impact intervention scenario in line with the SDGs and national strategy targets to curb and control the AIDS epidemic by 2030.


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