Pakistan's "Window of Opportunity" to Prevent HIV

Pakistan has a "window of opportunity" to prevent the rapid spread of HIV among vulnerable groups, the World Bank said as a bank-sponsored conference on HIV/AIDS in South Asia gets underway in Sri Lanka.

UNAIDS estimates show 0.1 percent of the adult population in Pakistan, or about 85,000 people, are HIV-infected. However, as of September 2004, just 300 AIDS cases and 2,300 HIV infections were officially reported to the National AIDS Control Program. As in many countries, HIV stigma, limited surveillance and testing programs, and a general lack of knowledge about the disease contribute to under-reporting.

The World Bank warned that the combination of high levels of risky behavior and limited knowledge about HIV among high-risk groups could lead to an outbreak. Evidence from a baseline survey of high-risk groups in Lahore and Karachi conducted March-July 2004 showed a concentrated epidemic among injection drug users (IDUs) and men who have sex with men (MSM) in Karachi.

According to the survey, 23 percent of 402 IDUs and 4 percent of 409 MSM sampled were HIV-positive. Alarmingly high rates of syphilis were found among hijras, or eunuchs, in Karachi (60 percent) and Lahore (33 percent). The survey also found very low condom use among these groups, especially MSM, and low use of sterile injecting equipment among IDUs.

Preliminary surveillance results from selected cities in Punjab conducted in 2005 found HIV prevalence among IDUs ranged from 2.5 percent to 11 percent.

Pakistan could see a rapid spread of the epidemic if immediate and vigorous action is not taken, the bank said.

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