HIV/AIDS REPORT

Current National Situation

Pakistan has a narrow window of opportunity to act immediately and decisively to prevent a widespread HIV/AIDS epidemic. Although the estimated HIV/AIDS burden is still low- around 0.1 percent of the adult population- the threat due to the presence of risk factors is significant. Without vigorous and sustained action, Pakistan runs the risk of experiencing the overwhelming social and economic impact of a full-blown HIV/AIDS epidemic.

It is estimated that 70,000 to 80,000 persons, or 0.1 percent of the adult population in Pakistan, are infected with the HIV virus, according to UNAIDS. However, by the end of December 2003, only 1,951 HIV-positive and 246 AIDS cases had been reported to the government’s National AIDS Control Program. As in many countries, underreporting is due mainly to social stigma, underdeveloped surveillance, and voluntary counseling and testing systems, as well as lack of knowledge among the population and practitioners.

Although the prevalence of HIV infection in Pakistan is still low, the country is highly vulnerable to an escalating epidemic due to a number of significant risk factors. Heterosexual transmission accounts for about 63 percent of reported cases, exposure to infected blood or blood products for about 7 percent, male-to-male sex for about 5 percent, mother-to-child transmission for about 3 percent, and injecting drug users for about 1 percent. The mode of transmission for the remaining 21 percent of cases is not known. To date, the majority of infected cases are among males, with a male-to-female ratio of 7 to 1, a ratio, which is to be expected in the early stages of an HIV epidemic.
(Source: World Bank Report)

Risk & Vulnerability                   Back to Top

There are serious risk factors that put Pakistan in danger of facing a widespread epidemic if immediate and vigorous action is not taken:

• Injecting Drug Users (IDUs): The number of drug dependents in Pakistan is currently estimated to be about 500,000 of whom an estimated 60,000 inject drugs. An outbreak of HIV was discovered among injecting drug users in Larkana, Sindh, where, out of 170 people tested, more than 20 were found HIV positive. It serves as a confirmation of the threat that HIV poses to Pakistan.

• Commercial Sex Workers (CSW): Commercial sex is prevalent in major cities and on truck routes. Commercial sex workers (CSWs) and their clients report very low condom use and have insufficient access to information about HIV and sexually transmitted infections (STIs). Behavioural and mapping studies in three large cities found a CSW population of 100,000 with limited understanding of safe sexual practices.

• Inadequate Blood Transfusion Screening and High Level of Professional Donors: It is estimated that 40 percent of the 1.5 million annual blood transfusions in Pakistan are not screened for HIV. In 1998, the AIDS Surveillance Centre in Karachi conducted a study of professional blood donors- people who are typically very poor, often drug users, who give blood for money. The study found that 20 percent were infected with Hepatitis C, 10 percent with Hepatitis B, and 1 percent with HIV. About 20 percent of the blood transfused comes from professional donors.

• Migration and Refugees: Large numbers of workers leave their villages to seek work in larger cities. A significant number (around 4 million) are employed overseas. Away from their homes for extended periods of time, they become vulnerable to high-risk behaviours, such as having unprotected sex.

• Unsafe Medical Injection Practices: Pakistan has a high rate of medical injections: around 4.5 per capita per year. Studies indicate that 94 percent of injections are administered with used injection equipment. Use of un-sterilized needles at medical facilities is also widespread. According to WHO estimates, unsafe injections account for 62 percent of Hepatitis B, 84 percent of Hepatitis C, and 3 percent of new HIV cases.

• Low Levels of Literacy and Education: Efforts to increase awareness about HIV among the general population are hampered by low literacy levels and cultural influences. In 2001, the illiteracy rate of Pakistani women over 15 years old was 71 percent.

• Vulnerability Due to Social and Economic Disadvantages: Restrictions on women and girls’ mobility limits access to information and preventive and support services. Young people are vulnerable to influence by peers, unemployment frustrations, and the availability of drugs. In addition, some groups of young men are especially vulnerable due to the sexual services they provide, notably in the transport sector. Both men and women from impoverished households may be forced into the sex industry for income.

(Source: World Bank Report)