21 October 2004	Thursday	06 Ramazan 1425

KARACHI, Oct 20: According to the most recent HIV estimates, provided by the National AIDS Control Programme - Pakistan, a total number of 1,972 HIV and 231 AIDS cases had been reported to the government.

Projections based on these numbers provide estimates of approximately 70,000 to 80,000 persons infected with the human immuno-deficiency virus in Pakistan. Although these numbers are significantly low in comparison to other countries in the region, a general upward trend is noticed both for HIV and the number of AIDS cases reported from every province.

The relatively low numbers of reported and estimated cases can be attributed to a host of factors including lack of an appropriate surveillance system for case detection, lack of large scale epidemiological studies, general lack of awareness about the disease and the social stigmatization attached to the disease itself.

Pakistan is identified as a country in a low-level stage of the HIV epidemic, which means HIV prevalence assumed to be less than five per cent in all known populations presumed to practice higher risk behaviours.

However, there is an array of factors which put the country at a substantial risk of witnessing a full blown HIV epidemic. Some of these include low levels of literacy and generalized lack of awareness about the disease besides problem of rapid urbanization, structural changes and a large number of migrant workers. Well organized and established sex industries operating in all economic centres of the country, which include both male and female sex workers who report very low condom use and have insufficient access to information about HIV and sexually transmitted infections (STIs) is another major factor contributing towards HIV epidemic.

Inadequate blood transfusion screening facilities is also a factor which is reported all across the nation.

The total fertility and low contraceptive rate in Pakistan (often used as indicators of the potential spread of HIV infection) reflect the unwillingness of local population to respond to reproductive health messages.

Inadequate data and information regarding HIV/AIDS to track the course of the epidemic as well as to suggest directions to the policy makers is also one of the major handicaps. This leads to an imperative need for an urgent response to HIV/AIDS to address the challenge of gaining early information about HIV epidemic in order to prevent its spread.

Under the given situation, experts suggest that the National AIDS Control Programme must build HIV surveillance systems that should perform activities in a standardized manner; the corner stone of such systems being the consistency methods, populations and tools in order to provide reliable information, which with passage of time could enable the country to monitor trends.

In low-level epidemics, the risk of HIV infection is likely to be concentrated among those with higher risk behaviours like the sex trade workers, injecting drug users, and migrant workers etc.

As the HIV will spread more rapidly among those with the highest levels of behavioural risk, focusing a significant portion of prevention efforts in the low prevalence phases of an epidemic will have the greatest impact on slowing the spread of HIV. -APP