HIV/AIDS set to spread warns UNAIDS

Pakistan could see the rapid spread of HIV/AIDS among the general population due to a combination of high-risk behaviour and limited knowledge, warns the latest report from the UN joint programme on HIV/AIDS (UNAIDS). The UNAIDS policy position report entitled, 'Intensifying HIV Prevention', and released on Monday, has called for urgent prevention programmes to limit HIV transmission within, and beyond, high-risk groups such as intravenous drug users and sex workers. According to the National AIDS Control Programme (NACP), some 2,943 HIV/AIDS cases have been reported since the programme started in 1986, of which 321 were full-blown AIDS cases. The programme also records a 7:1 male to female ratio. However, estimates of HIV/AIDS cases in the country, according to UNAIDS, go as high as 70,000 to 80,000. The UNAIDS report noted, a major epidemic has already been detected among injecting drug users in the southern port city of Karachi, where 23 percent of users were found to be HIV positive in 2004. "That epidemic is unlikely to be confined to Karachi for long since many of these injectors move from city to city and also a very high proportion of them, some 48 percent, use non-sterile injecting equipment," said the report. However, high-risk behaviour is the eastern city of Lahore is even greater where an estimated 82 percent of injectors use non-sterile syringes. An HIV epidemic among injecting drug users was reported in June 2003 in the city of Larkana, in Pakistan's southern Sindh province, where almost 10 percent of drug users tested HIV positive. Besides high-risk behaviour, knowledge about HIV/AIDS among the two high-risk groups of drug injectors and sex workers is extremely low. More than one-quarter of drug injectors in Karachi had never heard of AIDS and as many did not know that using non-sterile injecting equipment could result in infecting them with HIV, the UNAIDS report recorded. At the same time, a survey of sex workers in the country's main trading city of Karachi showed that only 2 percent of female sex workers used condoms. One in five sex workers could not recognise a condom or did not know that condoms could prevent HIV/AIDS, the report maintained. In addition to the lack of knowledge and low use of condoms, there was a high degree of sexual interaction between intravenous drug users and sex workers. Quoting the country's Ministry of Health, the UNAIDS report said that over 20 percent of female sex workers in the two biggest cities of Karachi and Lahore had sold sex to injecting drug users. Condom use was very low during those encounters resulting in a high prevalence of sexually transmitted infections. Looking at the extent of high-risk practices, such as sex work and intravenous drug use, the UNAIDS policy paper for 2005 has asked for urgent focused interventions to avert the threat of an HIV/AIDS epidemic becoming established among the general population.