Rawalpindi There has been an 11 per cent increase in mortality rates from Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) in Pakistan, whereas, worldwide, deaths from HIV/AIDS declined at a rate of 1.5 per cent between 2000 and 2013. AIDS has killed about 6,000 people in Pakistan so far. Pakistan is among the countries in the Asia-Pacific which houses a majority of people infected with HIV. It is defined as concentrated epidemic that the prevalence in traditional risk groups exceeds 5 per cent. However, HIV prevalence among general adult population is still below 0.1 per cent. Currently, the national average prevalence of HIV among Intravenous Drug Users (IDUs) is nearly 37.8 per cent. Prevalence among Hijra sex workers (transgender) is recorded as 5.2 per cent, among male sex workers 3.1 per cent and female sex workers is 0.6 per cent. Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ on Sunday in connection with World AIDS Day being observed tomorrow (December 1) around the globe with an objective of raising awareness of the HIV/AIDS epidemic. The day provides an opportunity to express solidarity and support for those living with HIV/AIDS, and to ensure that pandemic is kept on the national and international agenda. Red Ribbon is global symbol of solidarity with people living with HIV & AIDS. In 2015, World AIDS Days has the theme of “Getting to Zero: Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths”. Studies reveal that AIDS is caused by Human Immunodeficiency Virus (HIV) that infects cells of the human immune system, destroying or impairing their function. AIDS is also called “Slim Disease”. The symptoms of HIV vary depending on the stage of the infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. In the early stages of infection, the person has no symptoms. However, as the infection progresses, the immune system becomes weaker, and the individual can develop other signs and symptoms such as swollen lymph nodes, weight loss, fever, diarrhoea and the more susceptible to so-called opportunistic infections like TB, neurological disorders and unusual cancers. Diagnosis of HIV/AIDS is made on the symptoms, signs and blood tests. If someone has had a recent possible HIV exposure, retesting should be done after 6 weeks to confirm test results. HIV testing should be voluntary. Testing for HIV and other sexually transmitted infections is strongly advised for all people exposed to any of the risk factors so that they can learn of their own infection status and access necessary prevention and treatment services without delay. Dr. Ashraf said that according to UN estimates there are 97,000 to 125,000 HIV positive persons in Pakistan whereas an estimated 50,000 cases are from the Punjab province. From 2005 to 2014, the country averaged a 16 per cent annual increase in rates of new HIV/AIDS infections, ultimately rising from less than 1 case per 100,000 to 6.7 per 100,000. He believes that the number of infected persons might be running in millions in Pakistan if proper screening is carried out. Stigma and discrimination against people living with HIV and populations at higher risk of infection are major causes behind low reporting of cases, he said. HIV continues to be a major global public health issue having claimed more than 34 million lives so far. As many as 36.9 million people were living with HIV in 2014. Total number of new HIV infections was two million and 1.2 million deaths in 2014. Sustainable Development Goal target is of ending the epidemic by 2030, said Professor Ashraf. He added that there are serious risk factors such as having unprotected sex, low literacy rate especially among women, significant power imbalances in men and women, negative peer pressure, economic frustration in Pakistan, widespread poverty, lack of any system to check the HIV positive reported persons, indiscriminate transfusion of unscreened blood, use of unsterilized medical instruments, re-use of used syringes and needles, sharing contaminated needles and syringes, quackery, community dental clinics, street barbers, commercial sex, sex of men with men, labour migration, rising number of drug addicts, low condom use rates etc that put Pakistan in danger of facing a rapid spread of HIV if immediate and vigorous action is not taken. He believes that young people in Pakistan are more vulnerable to HIV in urban areas. HIV prevention programmes are failing to reach young people at risk. In Pakistan many women get the disease from their husbands who had stayed abroad before coming to get married. Then these women after becoming pregnant transfer the HIV infection to their babies, which is criminal. There is a need of legislation to ensure that men contracting marriage are HIV free. The mode of HIV transmission in Pakistan is largely heterosexual, said Professor Ashraf. He explained the most advanced stage of HIV infection is AIDS and it can take 10-15 years for an HIV-infected person to develop AIDS. AIDS is the end-stage of HIV infection – usually person dies in six months. There is no specific treatment of AIDS; however, antiretroviral drugs (ART) can slow down the progress and people with HIV can enjoy healthy and productive lives, he said. Since there is no vaccine or no definite cure of AIDS, prevention of HIV infection is the only answer. Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Unless prevention services are scaled up, efforts to slow and halt the impact of the pandemic will ultimately fail, said Professor Ashraf. He said prevention is everybody’s responsibility. AIDS is not solely a medical problem. Government should use all ways of communications for creating awareness on HIV/AIDS throughout the country. Every health care provider should spare at least five minutes daily to make at least one person aware of the HIV/AIDS related issues. Screening for jail inmates and the staff at risk must also be conducted, suggested Dr. Ashraf.
