On the backburner: Lack of funds hampering HIV control efforts

Published: December 1, 2014
Experts say easy availability of illicit drugs, poor medical waste disposal are major reasons behind HIV spread.

Experts say easy availability of illicit drugs, poor medical waste disposal are major reasons behind HIV spread.


Two years have gone by, but Riasat Ali cannot forget the time his family put him in isolation after he tested positive for HIV.

“The love turned into bitterness and they stopped talking to me. I became a ‘bad’ person because they thought I got infected through sexual contact,” said 56-year-old Ali. Hailing from Mandi Bahauddin, he works as a counselor at Nai Zindagi, an organisation working for the rehabilitation of drug addicts and HIV patients.

He says he started using intravenous drugs while in ninth grade and grew addicted to them. “We used to exchange syringes. I was unaware of the risks or the disease,” he said.

Later, he went to Saudi Arabia to make a living. “My health started deteriorating after I returned from Saudi Arabia. The bleeding made me weak and I was unable to walk,” he said.

Ali then had a few medical tests done and was told he was HIV positive.

“My family’s attitude was more painful for me than the burden of the disease.”

Ali came to Islamabad for the treatment. Later, his family was counseled and they accepted him back into the family. But he said it was never the same.

“HIV is still a taboo subject in Pakistan. Most people associate the disease with negative behaviour,” said Dr Baseer Khan Achakzai, National AIDS Control Programme (NACP) manager at the National Health Services, Regulations and Coordination (NHSRC) Ministry.

Talking to The Express Tribune in connection with World AIDS Day, observed on December 1, he said there was a dire need to create public awareness of the disease, for which he said the NACP lacked resources.

According to the health ministry’s Global AIDS Response Progress Report 2014, the epidemic continues to expand, concentrated among key populations and driven by intravenous drug use.

HIV prevalence among people who inject drugs is 27.2 per cent across urban centres.

After drug users, prevalence was highest among transgender sex workers (HSW) at 5.2 per cent, and 1.6 per cent among male sex workers.

Pakistan had an estimated 83,468 people living with HIV by the end of 2013, with 7,568 PLHIV registered at 18 HIV centres. Out of these, 3,211 HIV-positive adults  and 70 children were on anti-retroviral therapy.

At the same time, experts have said that due to underreporting, the actual number of cases would likely be significantly higher.

Pakistan Institute of Medical Sciences (Pims) Centre for Treatment and Prevention of AIDS head Dr Rizwan Qazi says that 1,700 HIV patients are currently registered with Pims, out of which over 600 are drug users.

Qazi says easy availability of all kinds of illicit drugs at low prices and poor medical waste disposal practices are the major reasons behind the spread of the disease among drug users.

“It has become challenging to treat IDUs as they escape during the treatment and
go back to shooting up drugs,” he said. They also become
a source of spread of the disease.

Dr Qazi said it has been revealed that all drug users that tested positive for HIV were also suffering from hepatitis C, which is another cause for concern.

Rutgers WPF Harm Reduction Programme (HARP) Supervisor Aftab Awan said 45 per cent of the 2,700 intravenous drug users they checked had tested positive for HIV.

The project provides HIV prevention and harm reduction services to drug users, their spouses and partners, in Jhelum, Gujrat, Kasur, Pakpatan and Lodhran districts.

He said there was a need to educate people in Pakistan that this disease was not just transmitted through sexual activity, but also through infected blood and used syringes.

“Families that isolate patients kill them psychologically. This disease does not spread through shaking hands, sitting next to, or eating food with the patients,” he said.

WHO Representative in Pakistan Dr Michel Thieren says the country faces continued risk of HIV transmission as a result of poverty, low literacy, gender discrimination, ignorance about the modes of transmission and stigmas that scare off people with risky lifestyles from seeking HIV testing or care.

Published in The Express Tribune, December 2nd, 2014.


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