he HIV infection is spreading at an alarming pace in Pakistan, leaving not just health policymakers in Pakistan concerned but also experts and officials at the World Health Organisation (WHO) headquarters in Geneva. The development comes in after health authorities in Islamabad reported last month that over 50 people were testing positive for HIV in the capital on a monthly basis and around 519 new HIV cases had been registered at the HIV treatment centre at the Pakistan Institute of Medical Sciences, Islamabad, in the current year alone.

The ground situation is far more grim. Over 10,000 new HIV cases had been reported in the country by December 15, as per official data.

Seeing an imminent HIV explosion in Pakistan, the Global Fund which provides funds to fight HIV, TB and malaria has allocated over $65 million for the next three years to prevent new infections and treat those who have tested positive.

A worrying aspect of HIV spread in Pakistan is the revelation that a majority of the 519 new HIV infected persons reported in the capital were men in the 18 to 25 age bracket.

According to the National Health Services, Regulations and Coordination (NHS, R&C) officials in Islamabad, of the 519 new HIV patients, 40 to 45 percent people are men aged 18-25 years, who describe themselves as homosexuals or men having sex with transgenders and involved in unsafe sexual practices.

“As per PIMS record, 38 new people tested positive for HIV in January, 61 in February, 40 in March, 34 in April, 45 in May. In July, 53 new HIV patients were registered with PIMS treatment centre, 61 tested positive for HIV in August, 64 in September and 49 new people have tested positive for HIV in October 2022”, an official of the NHS, R&C said.

In view of the growing burden of HIV cases in the capital, the official said that they have established another treatment centre for HIV patients at the Polyclinic Hospital, Islamabad, which has been functional for the last few weeks but has yet to be inaugurated formally.

“Every day two to three people are testing positive for HIV at our diagnostic lab. Most of those testing positive for the last couple of years are young, educated men. Most of them know about risks involved with their sexual behaviour and get themselves tested for HIV,” says Dr Naila Bashir, in charge of the HIV treatment centre at PIMS Islamabad, which has been declared a special clinic. Over 4,500 people living with HIV are currently registered with the PIMS. According to Dr Bashir their number is growing.

Public health experts say the rise in the number of HIV positive cases among young, educated men was first observed during the Covid-19 peak. For the last couple of years, they say, most of the people being tested for HIV at PIMS have been young men. They come from both affluent classes and labourers.

Over 10,000 people have tested positive for HIV in Pakistan during the last 11 months, raising serious doubts about HIV prevention and control efforts. Officials say this indicates an increase in spread of HIV from key population groups to the general public.

Officials say around 1,000 new HIV cases are being reported every month. This, they say, indicates that HIV is now spreading to the general population and is no longer limited to those injecting drugs and sex workers.

Pakistan has received hundreds of millions of dollars from the Global Fund and other international donor agencies during the last 11 years to contain and prevent the spread of HIV. According to UNAIDS, this suggests an increase in HIV transmission to bridging populations (spouses, partners and clients) of key populations.

NHS officials say the Punjab has the most new HIV infections with 6,106 people, followed by Sindh with 2,097 people and Khyber Pakhtunkhwa with 815. 316 new HIV cases have been reported from Balochistan and 496 from Islamabad.

More than 42,000 Pakistanis were deported from various countries, many on health grounds this year. They were infected with HIV or viral hepatitis or both. However, the deportation certificates do not mention their health status or why they were sent back.

“In the absence of screening at ports of entry, these people are potential carriers of the diseases,” says Mirza Nasiruddin Mashhood, the federal special secretary for health. He says many migrant workers and deportees have been found carrying the HIV infection and spreading it in the country by passing it on to their spouses.

Health Services Academy Vice Chancellor Prof Shahzad Ali Khan says that Pakistan must develop a strategy to test and isolate all deportees to avoid the spread of infection to family and others in the community. He also insists on effective utilisation of funds from the Global Fund with strict monitoring.

The writer is an investigative reporter, currently covering health, science, environment and water supply issues for The News International