LAHORE: Huge gap between the number of identified and actual HIV positive patients continue to pose serious challenge when the country is observing yet another World AIDs Day tomorrow (December 1). WAD is being observed globally on December 1 since 1988 for raising awareness about the pandemic, preventive measures and proper treatment of HIV positive patients. Public sector and private healthcare institutions, non-governmental organisations and individuals around the globe observe the day with variety of functions for education on AIDS prevention and control. WAD theme this year is “Getting to Zero”, zero new infections, discrimination and AIDS related deaths.

Like the previous years, public sector and private institutions will perform the ritual of holding seminars, walks and symposiums to mark the day but without any sincere efforts to bridge the gap between identified and actual HIV positive patients. So far about 7,000 people have been tested HIV/AIDS positive. The United Nations, however, estimated that the HIV/AIDS patients in Pakistan are from 87,000 to 120,000. As such majority of the patients are yet to be identified that poses threat of transmission of virus to healthy individuals through matrimonial and extra marital relations, unscreened blood transfusion and reuse of syringes. HIV/AIDS epidemic is taking hold in Pakistan, mostly among drug addicts, male/transgender sex workers and repatriated migrants.

Though the number of confirmed HIV patients are not that high, really alarming situation is that majority of these are unidentified either due to lack of awareness about the condition or social stigma attached to the disease. The overall prevalence of HIV infection in adults aged 15 to 49 is 0.1 per cent. Officials say that the majority of cases go unreported due to social taboos about sex and victims’ fears of discrimination. “There is a huge gap between the number of reported and actual HIV patients. So far around 7000 people have been tested positive for HIV. At present over 4500 registered patients including 164 children are getting free medicines, testing facilities from AIDS centres at teaching hospitals in nine cities of Punjab. The government is focusing on identifying people living with HIV. Over 300 people living with HIV were identified last year.

This year 400 more will be identified,” said Dr Salman Shahid, Additional Secretary Health (Technical) who is also heading AIDS Control Program in the province. Pakistan enjoyed a low prevalence phase of epidemic. Different studies and the national HIV surveillance have confirmed an escalating epidemic among drug users and more recently among male and transgender sex workers. Although overall HIV prevalence is low, HIV is well established among IDUs and epidemic is also spreading among transgender (6 per cent) in a few cities. HIV among female sex workers has remained negligible. Given the protective effect of circumcision, a generalized sexually transmitted epidemic is unlikely but evidence of significant linkages between sex work and injecting drug use point to the potential for the spread of the epidemic far beyond these groups.

Currently, the national average prevalence of HIV among drug users is nearly 20 percent. Several cities also show concentrated epidemic among male/transgender sex workers as well. Major factor in the overall HIV transmission scenario is the rampant use of therapeutic injections, often with non-sterile injection equipment. There are an estimated 800 million therapeutic injections given annually in Pakistan or approximately 4.5 per capita, the highest in the World. A small but significant proportion of these are reused.