05/18/2006, 00.00
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HIV/AIDS threat underestimated in Pakistan

by Qaiser Felix
A local NGO warns that HIV/AIDS figures for intravenous drug users are higher than reported. Without decisive action the country could find itself facing a full-blown epidemic in just a few weeks.

Lahore (AsiaNews) – HIV could reach epidemic proportions in Pakistan within a few months, this according to Nai Zindagi (New Life), a local NGO. Main causes: underreporting of the infection, official indifference and "token" preventive measures. The net result is that "Pakistan no longer has a 'window of opportunity' to act in advance in order to prevent the transmission of HIV/AIDS among people injecting drugs".

With HIV prevalence among drug users as high as 9.5 per cent and 12 per cent respectively in Faisalabad and Sargodha (Punjab), "the price of 'inaction' would be immense."

"We can no longer deny that although we had to act 'yesterday', we must at least act now in order to minimize further damage," the report said.

According to its authors, decision makers must take stock of what works and what does not and, based on experience, improve services and interventions to reach at least 60 per cent of the people at risk.

Like most Asian countries, in Pakistan people intravenous drug users are highly stigmatised and their behaviour, criminalised. Access to generic health and social care is often denied or not available to HIV-positive people. This favours the spreading of the virus.

The report said that since approximately 50 per cent of intravenous drug users are married and sexually active, secondary transmissions due to unprotected sex with spouses or casual sex partners (mostly female sex workers) is inevitable.

About 10 per cent of those affected are young people between 18 and 24 years of age. If it has not already done so, early HIV infections due to needle sharing could lead to a large-scale epidemic, the report warned.

In a press briefing last week, Nai Zindagi Chief Executive Tariq Zafar said that blood tests of around 6,000 intravenous drug users were conducted in the four Punjabi cities, Faisalabad, Lahore, Sargodha and Sialkot, out of which 6.2 percent tested HIV positive. He cautioned that HIV prevalence in urban areas had increased from the status of 'low' to 'generalised'.

Similarly, Zafar rejected the notion that Pakistan's HIV/AIDS status was low-risk. Such a view, he believes, is based on limited data and cannot be generalised.

The report recommended that to minimise damage and contain the pandemic, decisions must be taken at a policy level that would immediately initiate or upgrade existing street-based comprehensive harm reduction programmes to prevent the spread of HIV among people injecting drugs and those closely associated.

It also urged law enforcement authorities to be more "pragmatic and less bureaucratic", keeping in mind the "urgency of the situation".

Preventive measures are needed involving the health care system in cooperation with civil society groups and networks that are affiliated with the affected communities.

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