HIV/AIDS in Pakistan: Confusion & denial
HIV/AIDS is a viral illness that is transmitted through unprotected and promiscuous sexual intercourse, through unsafe injection and surgical practices and from affected mother to newborns.
Pakistan has registered a little more than 53 thousand cases from the start of our hiv epidemic, since 1987.
This is in stark contrast to the population of the country and the immensely high prevalence of other diseases like hepatitis B and C which share similar modes of spread.
Pakistan is presently undergoing a concentrated HIV AIDS epidemic which means that the high risk groups have an HIV prevalence of the order of 5 per cent, while the prevalence in general population is less than 1 percent.
The high risk groups primarily include intravenous drug users, commercial sex workers (male, female, transgender and children).
Bridge groups are the groups of people who are in direct contact with both high risk groups and general population.
They include clientele of sex workers, spouses of IV drug users, migrant men and truck drivers. The social connections of these groups have been studied in detail.
However the role of Pakistans poorly regulated mixed health system has the potential to act as an incubator for the spread of HIV AIDS.
The 2019 incident in Rato Dero Sindh province is a clear evidence of this. Many children were found to be HIV positive in the absence of their parents being positive; owing to poor injection practices of local medical practitioners
Unfortunately in Pakistan more than one million people are practicing medicine out of which only 200 thousand are registered medical and dental practitioners.
The infection safety practices of many public and private sector medical and dental health care facilities are not up to the mark and often cause blood borne infections. Contact tracing mechanisms are also inequitable.
The FELTP programme in NIH is a well equipped body with a well trained workforce, however it lacks the capacity to tackle infections on a national scale. The ethics involved in sexually transmitted diseases carry further complexity in this regard.
Partner notification is almost nonexistent and the stigma affiliated with sexual and reproductive health problems forces people to move towards unqualified alternative medicine practitioners and quacks.
A health systems approach is the need of the hour where a well coordinated effort can be put in place with the National AIDS control program leads the way for its provincial counterparts. Simultaneous efforts are needed for all tiers of the health system.
—The writer is Assistant Professor, Islamabad Medical and Dental College.
