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Friday, 2 August 2019

HIV in Pakistan: Who knows, who cares?

By Shehrzadae Moeed and Adil Sayeed

Photo credit: Torange.biz


In April 2019, a doctor in Larkana’s Ratodero sub-district was arrested for allegedly passing on Human Immunodeficiency Virus, or HIV, to his patients. In the aftermath, as the Government of Sindh moved into firefighting mode, more than 30,000 individuals were screened, of which 851 tested HIV positive. More than 64% of these were under the age of six. In Kot Imrana, Punjab, the number of people with HIV increased from 1.4% in June 2018 to 13.4% in January 2019. It has been reported that over 5000 quack doctors operate in the area and 869 people have been diagnosed with AIDS. A recent report by the UNAIDS puts Pakistan on a list of 11 countries with the highest global prevalence of HIV, at 13%.

Why has Pakistan experienced sharply increased rates of HIV? In this blog, we will look at the data to assess why HIV remains prevalent and use cross-country evidence to learn lessons on tackling what is a very manageable illness.

HIV and its causes
HIV is an infectious disease that is spread through the blood, such as through used syringes, or transmitted sexually. It can also be transmitted to children if the mother is pregnant. The infection damages the immune system, and its most advanced stage develops into AIDS (Acquired Immune Deficiency Syndrome), which is life-threatening. It is a serious illness with global efforts to tackle it. However, even though it is a lifelong condition, developments in medicine mean that, with proper and regular treatment, an infected person can live a full life.

Commonly, the causes of the growth of HIV prevalence in Pakistan, similar to many developing countries, are attributed to medical negligence, a broken healthcare system, unregistered blood banks, and unlicensed practitioners, including quacks. In addition to this, the common Pakistani “penchant for receiving injections and drips as quick fix in lieu of healthy nutritional lifestyles” contributes to the inclining HIV prevalence in Pakistan.

Further, migrant labour forces open to commercial sex, and increasing man-to-man sexual activity, also contribute to this. In any other country where same-gender sex isn’t a criminal offence, governments work hard to ensure the practice of safe sex. In Pakistan, however, taboos around sexual health make it difficult for sufferers to seek help or even find a support group. If no one can talk about sex, who’s ever going to talk about safe-sex?

What does the data tell us
While the proximate causes commonly discussed in the media may have to do with unsafe sex, reusing needles, blood transfusions, and similar unsafe practices arising from quackery, medical negligence or drug use, the data suggests that the underlying cause, however, is the lack of awareness of sexually transmitted illnesses (STIs).

In the Pakistan Demographic and Health Survey (PDHS) 2017-18, only 32% of women and 67% of men reported that they had heard of AIDS. In Sindh, this is even lower, with 26% of women and 49% of men reported being aware of AIDS. These figures are very low.

Furthermore, out of every 100 women, less than 4 are aware of the fact that there is a treatment for HIV and less than 3 know where to receive HIV treatment. Similarly, less than 33% of men are aware of the fact that there is a treatment for HIV, and less than a quarter have any knowledge of treatment centers. Comprehensive knowledge about HIV is abysmally low, with only 4% women and 10% men being familiar with the details of this illness.

A lack of awareness of this public health challenge is thus endemic – a flip side of the same coin, however, is the discrimination among those who are aware. In the same survey, more than 50% of the respondents said they would not buy fresh vegetables from a shopkeeper who has HIV. Similarly, 46% of women and 48% of men who are aware of AIDS said they would not want HIV positive children to go to a school with those unaffected by this illness.

Discrimination in a population acts as a disincentive for people to get tested and treated. It is the taboo associated with HIV and AIDS that also leads to less people being open about it, thereby reinforcing the lack of awareness.

Way forward
What is clear is that the Government of Pakistan’s National AIDS Control Programme (NACP), which was established in 1986-87 and has received significant donor financing, has been ineffective in tackling the social causes of HIV/AIDS prevalence. Perhaps there is a need to learn from other countries – after all, Pakistan is not the first country facing this issue.

In Brazil, for example, massive reduction in cases can be largely attributed to a massive awareness program (prevention) coupled with widespread distribution of free medication (treatment). Their ministry of health also utilized social media in a 2014 awareness campaign. This also assisted in reducing the population growth rate which currently stands at a relatively low 0.8% as compared to Pakistan’s 2% annual growth rate. The success of Brazil’s AIDS campaigns is evident today as 84% of the population with HIV is aware of their condition as compared to just 15% in Pakistan.

In sum, Pakistan needs to rethink its strategy to fight HIV and AIDS. HIV, if caught and treated, can yield a normal life for those infected with it. If not treated properly, however, HIV can quickly develop into AIDS, which is life-threatening and a miserable condition to be in for someone infected with it. The spreading of STI’s and the chances of HIV developing into its last stage of AIDS are particularly high because of the lack of awareness and stigma associated with them in Pakistan. The NACP needs to tackle these head on, perhaps by talking about these issues from an early age, including sexual education in school, as other countries, including Brazil, have done. As long as there is a lack of awareness regarding the issue, these epidemics will continue to prevail and the people will continue to suffer.


The authors were interns at the Collective in July 2019.

9 comments:

  1. I am here to testify, I can't stop thanking Dr Odumodu for this great thing he has done in my life. I am so grateful to him, I was suffering HIV diseases for 8years, when I contacted Dr Odumodu after reading the wonderful testimony that people has been sharing about him. I have being on medication and trying looking cure to my ailment. I went through the internet doctors and I contacted a Tradomedical/Traditional herbalist doctor named, Dr Odumodu for help. He gave me all his rules and regulations that if he cure me that I should write about him on internet site and that is what I am doing now. He assured me that he will cure me completely with his natural herbal medicine which he really did, and I am now completely cured from HIV diseases, what will I say rather than thanking him for saving my life. Why suffering in silence when there is remedy to your problems, Dr Odumodu also specialized in curing the following diseases!
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    ReplyDelete
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    ReplyDelete
    Replies
    1. i already gave up on ever getting cured of HSV2 because i have try many treatment none of them work out for me i have go to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr ohunyom, in the net from a lady called Angela i contacted him and he reassured me with him herbal medicine which i took according to the way he instructed, that how i was cured. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under two weeks i was totally fee from #Herpes. i want to say a very big thank you to DR ohunyom for what he has done in my life. feel free to leave him a message on email drohunyom@gmail.com and also WhatsApp him +2349060579973..
      He can still be able to help you with this herbs medicine:
      1...ALS CURE/DIABETES CURE/EPILESY/HPV CURE/LUPUS/HEPATITIS/CANCER/GOUT 

      Delete
  6. Hello everyone! I don't just know the reason why some people is finding it difficult to believe that there is a cure for herpes, I have been suffering from herpes since six years with my wife but today I am happy that I have been cured from it with the herbal medicine made by Dr Ohunyom the great healer, I was browsing the internet searching for help when I came across a testimony shared by someone on how Dr Ohunyom cure Him from Herpes Virus. I quickly contacted him to get the cure and today me and my wife are now totally free from the virus, I am so much happy today that we have someone like this great healer out there,please sir keep your good work cause there are many out there who is in need of your healing medicine. Contact him now on his email: drohunyom@gmail.com or you can text him on WhatsApp : +2349060579973 and he also has the herbal cure for the Following DISEASES, eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV,Infections,ulcer ETC 

    ReplyDelete