Unsafe sex: Migrant workers put native communities at risk of HIV

Patients form People Living with AIDS organisation to increase awareness.

PESHAWAR:

When Manzoor Iqbal goes for prayers at his neighbourhood mosque, nobody wants to stand next to him. They do not want to eat with him either. “The behaviour of my family members and the villagers has changed even though it happened 15 years ago...”

Iqbal’s one decision while he was working in Dubai almost took his life. “Sex workers there would offer condoms before sexual intercourse, but I refused to use it,” said Iqbal, 43, a resident of Swabi.

He was earning more than Rs70,000 a month in Dubai, enabling him to indulge in prostitution. He was arrested by the Dubai police in 2001 close to midnight for testing positive for Human Immunodeficiency Virus (HIV). Authorities immediately deported him and barred him from ever returning, but he was never given the details of the disease at the time.

“The practice of unsafe sex in foreign countries particularly in the Arab states has increased HIV patients in Pakistan. Moreover, the immigrants are not told as to why they are being deported,” said AIDS Control Programme (ACP) Provincial Manager Dr Sher Muhammad Khan. “However, HIV is the prime reason behind it, though they prefer to write bad blood on their documents.”

Seven years later, Iqbal finally tested his blood in a laboratory in Islamabad and was told that he was infected with HIV and had lost the immunity battle.



While the disease cannot be cured, patients must continue treatment during their entire life to sustain immunity levels, said a psychologist at the Hayatabad family care centre, Dr Hilal Ahmad.

“If the immunity cells in the patient’s body fall under 350 cells in CD 4 test, we provide them treatment and prescribe them medicine. We first provide them counselling, however, on how to protect their family members from being infected,” Dr Ahmed said.

Iqbal had been in Dubai since 1992 where he drove heavy vehicles. Every time he would renew his visa, he would be required to submit a medical report along with a blood sample. He went through the process one last time in 2001.

After having a moral epiphany, Iqbal embarked on his quest to create awareness about HIV and assist in efforts to protect another generation from the disease.

He formed the People Living with AIDS (PLWA) association to give his efforts meaning. PLWA works in conjunction with the government and other non-profits to educate young men and women from Khyber-Pakhtunkhwa (K-P) and the tribal areas.

PLWA has nine HIV-infected members who are also registered with the provincial government. Most of their stories sound similar to Iqbal’s.

Away from their family, many migrant workers engage in unsafe sex, which increases the risk of spreading HIV at home. When people like Iqbal return, everyone around them is at risk, especially when the victim is unaware of his condition. The married men who carry HIV easily transfer HIV onto their wife and their offspring.

“The dilemma with residents of K-P is that 90% of men do not bring their wives for medical check up, even after the male has tested positive,” said the head of ACP in the province Dr Rajwal Khan.

Treating HIV patients

Two family care centres were established in Hayatabad and Kohat in 2011. There are 1,014 HIV patients registered, including 715 males, 248 females and 51 children in the Hayatabad centre, while 136 in Kohat. Out of this, 435 patients were immigrant workers who lived in foreign countries, including Saudi Arabia, Iran, the United Arab Emirates, South Africa and Japan.

“Most patients registered with us are illiterate and have no information about HIV,” said Dr Ahmad. Patients who test positive in all of K-P or the tribal areas are sent to the centre where we register them along with their history and start their treatment, he added.

Dr Rajwal said the issue has been discussed with governments over time to raise awareness about HIV prevention. “We have suggested involving community welfare attachés and labour unions for disease prevention,” he said.

Dr Sher Muhammad said they are planning to distribute informative brochures on all airports to inform immigrants against HIV.

Treating HIV can be very expensive and costs can run as high as Rs12,000 a month, he added. Only the two registered centres in Hayatabad and Kohat provide free treatment to all patients.

Published in The Express Tribune, March 17^th, 2013.