Alarming rise of HIV in Pakistan: 1,079 new cases every month

ISLAMABAD: As many as 1,079 new HIV cases are being reported monthly in Pakistan, with 9,713 people testing positive for HIV in the first nine months of 2024, officials in the Ministry of National Health Services revealed on Friday.

They warned that the total number of HIV cases for the entire year could exceed 12,950, assuming the current monthly average persists. This marks a significant increase compared to the 12,731 total cases reported throughout 2023, indicating a worsening HIV epidemic in Pakistan that demands immediate public health intervention.

According to official data, men constituted 69.4% of the new cases, women 20.5%, transgender persons 4.1% and children 6%.

Punjab recorded the highest number of new infections, with 5,691 cases detected between January and September 2024, averaging 632 new cases each month. Sindh followed with 2,383 new cases, averaging 265 monthly, while Khyber Pakhtunkhwa (KP) reported 926 cases, translating to an average of 103 cases per month. Balochistan recorded 329 new cases, while Islamabad and Azad Jammu and Kashmir (AJK) reported 378 and 10 cases respectively.

Comparatively, the figures for 2023 were even higher, with 12,731 new infections reported nationwide, but the consistent rise in monthly averages for 2024 reflects the worsening nature of the epidemic.

Alarmingly, experts have noted a significant spillover of HIV infections from high-risk populations—such as men having sex with men (MSM), transgender persons, injectable drug users (IDUs) and female sex workers—to the general population.

This is attributed to factors such as poor Infection Prevention and Control (IPC) at healthcare facilities, unsafe sexual practices, low awareness, stigma and risky behaviors like chemsex, a practice involving the use of drugs such as methamphetamine during sexual encounters.

Chemsex, in particular, has emerged as a growing concern among MSM, transgender individuals, and sex workers, contributing to the rapid spread of the virus.

“Despite collective efforts, the HIV epidemic is increasing in Pakistan. This demands innovative and sustainable interventions,” said Trouble Chikoko, the UNAIDS Country Director for Pakistan, during a recent meeting with the Ministry of Religious Affairs.

Chikoko emphasized the pivotal role that religious scholars and institutions could play in raising awareness about HIV prevention and reducing stigma. “Collaboration with UN agencies and partners is essential to address this crisis comprehensively,” he added.

Commenting on the HIV situation in Pakistan, the Common Management Unit (CMU) for HIV, TB, and Malaria has highlighted its ongoing efforts to curb the epidemic, claiming that 94 Anti-Retroviral Therapy (ART) centers have been established across the country to provide testing and treatment services.

Additionally, awareness campaigns have been launched through mass and social media, including multilingual radio messages and city-branding initiatives to destigmatize HIV testing and treatment.

Advocacy efforts involving key government officials and stakeholders have also been undertaken to mark events like World AIDS Day, CMU officials added.

However, these measures have faced challenges. “Stigma remains a major barrier to HIV testing and treatment. Most new infections are still concentrated in MSM, transgender persons and female sex workers. These groups are often hesitant to seek help due to societal discrimination,” a senior official at the CMU explained.

Officials and experts believe that the use of methamphetamine and other drugs during chemsex not only lowers inhibitions but also significantly increases the likelihood of unprotected sex, further fueling the epidemic.

“Chemsex is a hidden yet rapidly spreading phenomenon among key populations in Pakistan. Without targeted harm-reduction interventions, this practice will continue to drive new infections,” the official warned.

In addition to chemsex, other factors contributing to the rising HIV cases include insufficient access to preventive measures, such as condoms and clean needles, as well as limited public awareness about safe practices.

The CMU has reported that it is expanding its harm-reduction programs, particularly targeting IDUs, by providing clean needles and syringes. However, the scale of these programs remains inadequate given the increasing number of new infections.

The provincial breakdown of cases underscores the need for localized responses. Punjab, with the highest number of new infections, has been urged to intensify its prevention and awareness campaigns, particularly in urban centers where high-risk behaviors are more prevalent.

Similarly, Sindh’s efforts to reduce new infections have shown some progress compared to the previous year, but the numbers remain concerning, especially in Karachi and Hyderabad.

Islamabad’s significant drop in new cases, from 611 in 2023 to 378 in 2024, has been attributed to targeted campaigns and improved ART coverage. However, experts caution against complacency, warning that the capital’s success needs to be replicated nationwide to reverse the overall trend.

UNAIDS and CMU officials stress the need for greater community engagement to address stigma and misinformation surrounding HIV. “Community involvement is vital for raising awareness and encouraging testing and treatment,” said Chikoko. With over 1,000 new cases reported monthly, Pakistan is nearing a generalised HIV epidemic. Public health experts urge the government to increase resources for prevention and treatment while addressing barriers to care.