Pakistan deals with challenges of HIV/AIDS

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LAHORE, Pakistan — Kashif, a 25-year-old pipe fitter working in Dubai, was looking forward to meeting his wife and two young children.

Then Dubai officials found out he was HIV-positive and deported him.

Back in Pakistan, Kashif said, “I just can't brace myself to tell my wife that I have the AIDS virus”.

“I came back loaded with problems”, he said. Another big one is that he can’t find a job. “I still have the skills, but it’s not easy. People don't want to accept me (because they say) extramarital sex does not happen in our society”.

A high number of migrant workers, social taboos, and an aversion toward safe-sex practices have combined to make Pakistan susceptible to the spread of HIV/AIDS that has occurred in the country.

The cycle is simple: Pakistanis leave the country to find work; the migrant workers have unprotected sex and contract HIV; they are then deported and return to Pakistan where they unwittingly pass the virus on to their partners.

“By and large, when the illiterate migrant is sent back because of having contracted HIV/AIDS, he has no idea that’s what it is. He then becomes a carrier, comes home and unknowingly spreads it within his family”, Dr. Ali Razaque, project director of the Punjab AIDS Control Programme (PACP) told Central Asia Online.

The result: The National AIDS control Programme (NACP) estimates that about 97,400 HIV/AIDS patients are living in Pakistan. That number is .06 percent of Pakistan’s population, a high percentage for a Muslim country.

The lack of communication that Kashif described only exacerbates the problem.

“Communication would be one of the major elements to create awareness as well as facilitate behavioural change”, said Saadia Naeem, behaviour change communication campaign coordinator at the PACP.

But the stigma associated with HIV and other sexually transmitted diseases has been a barrier for the delivery of PACP’s services.

All countries in South Asia have a range of factors that increase vulnerability to HIV/AIDS, especially for women. According to a UNAIDS report released August 18, more than 1.5 million women living with HIV in Asia have been infected by their husbands or boyfriends. Another 50 million are at risk of infection.

“My husband was also suffering from the same disease and passed away”, leaving her to support the large family, said Rubina. At 35, Rubina is a mother of four who was diagnosed as HIV positive last year.

“In Pakistan, many of the HIV/AIDS cases go unreported or even undiagnosed because of high cost of screening tests, social taboos and fear of discrimination, once confirmed”, said Riffat Maqsood, Senior Vice Chairperson Women Workers Help Line (WWHL).

“WWHL has launched a nationwide campaign on HIV/AIDS awareness based on a rights-based approach to create an understanding in the community on gender equality, women’s personal health issues, safe sex and enable them to create such environments where stigma and discrimination of HIV/AIDS positive people is no longer a submissive solution”, she said.

“Stigma and discrimination is specifically associated with children and women of Pakistan”, said Dr. Nadeem Zaka, Provincial Program Officer, World Health Organization (WHO). “These women have often been infected by their (migrant worker) husbands who have often been deported by certain countries without being told about their HIV positive status”.

Despite the stigma associated with the disease, health care options are available.

“The continuum of care and support to people living with HIV/AIDS, including free provision of anti-retroviral medicines, diagnostic tests, counseling services, etc., are being provided through PACP at HIV treatment centres”, Razaque said. Such centres exist at Mayo Hospital, Services Hospital and Shaukat Khanum Hospital, all in Lahore, and at District Headquarter Hospital in Sargodha.

Recently, a new HIV treatment centre has been established at Jinnah Hospital, Lahore, where free indoor medical facilities are being provided, he said.

PACP also established two Prevention of Parent to Child Transmission (PPTCT) of HIV/AIDS centres in Lahore to prevent the transmission from infected mother to child.