Even though Pakistan is among the minority of countries where more and more people are being infected with HIV, only half of Pakistanis understand the risk.
Many people are unaware that HIV (Human Immunodeficiency Virus) is a virus while AIDS (Acquired Immune Deficiency Syndrome) is the disease that the virus causes. More and more people in Pakistan are living with HIV/AIDS. Globally, new infections are going down due to widespread prevention campaigns but in Pakistan they are going up. In Pakistan during the last two years, there was an almost 11% increase in persons with HIV/AIDS. This overall figure of HIV cases is not only increasing but also has become the highest rate of increase within the world, according to the US Central Intelligence Agency World Fact book.
Unlike in places like Uganda, where education and awareness campaigns, condom distribution and testing through programs such as Together We can, Treatment Action and Love Life succeeded in reversing the spread of HIV and AIDS, the majority of Pakistani citizens don’t have even basic knowledge about the disease.
In Pakistan, the majority of people living with HIV are men. Out of every ten people with HIV, there are seven men for every three women. 20 to 24 year olds are the most at risk for HIV/AIDS in Pakistan.
Figure 1: Two Pakistani men infected for every one woman with HIV
A spike in HIV rates among specific marginalized segments of society over the last seven years play a pivotal role in spread of HIV. HIV transmission rates have grown among Injection Drug Users (IDUs), Transgenders, Hijras or Male and Female Sex Workers. These groups have unsafe sex practices, risky sexual and drug injection behaviors which lead to spread the disease. Additionally, social stigma makes it difficult to provide them with preventative services. NACP reports that Prostitution together with unsafe sex practices are at peak levels. The number of reported deaths due to HIV/AIDS is also on rise. Many cases and deaths go unreported due to lack of societal acceptance so rates are probably higher.
Table 2: HIV Trends of Pakistan segments – 2005 to 2011
Knowledge, Attitude and Behaviors against HIV/AIDS within Pakistani Community
Studies indicate that ignorance drives the spread of HIV/AIDS. Majority of Pakistanis do not understand the causes of HIV or how to protect themselves and therefore are unknowingly exposing themselves to the virus. (Source: Pakistan Demographic and Health Survey 2012-13 )
Lack of knowledge and access to correct health information, social restrictions related to sex issues, risky behaviors, economic exploitation, regional and national conflicts and a lack of access to adequate reproductive health services are the major contributing factors for the spread of HIV/AIDS. These factors have hobbled campaigns for both awareness and preventive services.
According to this survey where almost 14,000 individuals were surveyed from all provinces excluding AJK, knowledge of HIV is not yet universal.
Lack of Knowledge of HIV prevention: There is a similar lack of knowledge on how to prevent HIV infection.
- Only one in five women versus one in three men knows that the risk of getting HIV can be reduced by using condoms and practicing safe sex.
- Only one in 10 women and two in 10 men know that HIV is automatically transferred from an affected mother to her newborn and that it can be prevented by taking drugs during pregnancy.
Knowledge about HIV Testing
- Men are more likely than women to know of a place where they can go to get an HIV test (3:1 out of 10 ratio)
- Knowledge of where to get an HIV test increases with education and wealth for both women and men. It is highest in ICT and lowest in Gilgit Baltistan for women and men.
Pakistani women and men are not accepting of people living with HIV/AIDS. Fewer than half of women and men report that they would buy fresh vegetables from a shopkeeper living with HIV. However 90% of women and men would be willing to care for a family member with AIDS in their home.
Basic Facts About HIV/AIDS
From a public health angle, review of health spending shows that America spends the highest on its health (17.4% of its GDP) while Pakistan allocates only 2.61% of its GDP, for the year 2014 to healthcare. 180 countries of world spend more than Pakistan, clearly indicating that public healthcare is not a priority despite the menace of HIV.
Efforts to combat AIDS at national and provincial scale
Since its launch in 1993, National AIDS Control Program (NACP), along with other national and international donors and agencies have worked to reduce the spread of HIV/AIDS in Pakistan, especially during the last decade. It started working with UNAIDS in 1999. Since 2005, government in partnership with NACP, UNAIDS and many others, took a lot of initiatives for controlling the spread of HIV/AIDS.
Some of these initiatives included: yearly surveys carried out with infected persons, regular monitoring of activities, providing free of cost treatment and support services to drug users, awareness to drug users/ sex workers/ transgenders/ truck drivers on how to prevent the disease, free testing and treatment centres for HIV positive patients etc.
Many rounds of projects of GFATM (Global Fund for AIDs, TB and Malaria) were and are still being carried out to improve the situation of disease spread. More than 100 million rupees were spent in each round. Besides the increased provision of health facilities for HIV/AIDS patients, a shift in attitudes and behaviors towards the disease is mandatory to claim a decrease in numbers.