January 5, 2011
Near Karachi, two men who work at an HIV/AIDS organization recently discussed how disease-related misinformation and stigma hamper HIV prevention.
"Not only did I share needles, [I] also visited brothels," says "Ahmad," the pseudonym of a peer-educator diagnosed HIV-positive two years ago, just three months into his marriage. "I had no clue how risky my entire behavior was." "My worst fear is that if I disclose my status, my wife will leave me," he said. "I can't bear the thought of that."
Ahmad and his wife had agreed they did not want children, so they were already having protected sex. He continues to use that as an excuse and tries to work late most nights. Though he has not told her of his infection, Ahmad has taught her all he knows about the disease.
"Imran," Ahmad's co-worker, was diagnosed with HIV eight months ago and has yet to tell his wife of five years. "When I take people with AIDS to the hospital, doctors will wear two and sometimes three pairs of gloves [and] stay as far away from them as possible," Imran said. "If doctors are so uncomfortable around us, what can you expect from those less knowledgeable?"
A 2008 report by UNAIDS and the UN Office on Drugs and Crime found a "hidden epidemic" of HIV in the wives of injection drug users (IDUs). Prevalence among these women ranged from 5 percent to 15 percent, depending on the area surveyed. Over 70 percent of the wives reported no condom use at last sex with their husbands.
Eventually, most HIV-positive IDUs do reveal their serostatus to their spouses, said Dr. Saleem Azam, who has worked with IDUs for 25 years. "But it takes time and counseling for them to brace themselves for the disclosure, given the strong societal pressures they encounter."