20 November 2004	Saturday	07 Shawwal 1425

KARACHI, Nov 19: Pakistan is viewed as a 'low-prevalence but high-risk' country when it comes to the Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).

Despite the fact that all official documents describe the country as such, not enough attention is being paid to the simmering problem, which may boil over sooner than expected.

Data collated by Dawn, however, suggests that the country should no longer be described as having 'low-prevalence' of the fatal ailment. Rather, it should be viewed as a country with a concentrated epidemic of HIV/ AIDS.

According to internationally-accepted standards, any country having a prevalence of five per cent or more, in any of the vulnerable groups, should be categorized as one with a 'concentrated epidemic' of HIV/AIDS.

Pakistan, unfortunately, qualifies for the status in view of the high prevalence of HIV/AIDS among the abusers of in jectable drugs here, which far exceeds this cutoff point.

So far, more than 5,000 injectable drug users (5,150 to be exact) have been tested for HIV/AIDS, manager of the Sindh AIDS Control Programme told Dawn on Friday. Dr Srichand Ochani added that of the tested drug users 315 were found to be positive, which meant that the prevalence was 6.1 per cent in the group.

In Karachi, the situation was far worse, acknowledged Dr Ochani. "In the city, a total of 3,154 users of injectable drugs have been tested. The number of people testing positive stands at 264, which means that the prevalence is 8.3 per cent," he remarked.

Dr Ochani was, however, adamant that Pakistan should not be described as a country having a concentrated epidemic of HIV/AIDS. "We should be cautious and we should not jump to conclusions."

He was of the opinion that no conclusion should be drawn unless tests were carried out in all the districts of the country. "This exercise has been carried out only in the major cities of Sindh, namely Karachi, Hyderabad, Larkana and Sukkur."

Dr Ochani pointed out that tests remained to be carried out, in sufficiently large numbers, in all the districts of Punjab, NWFP and Balochistan. However, a well-placed source said no matter which angle the problem was viewed from, Pakistan was no longer fit to be described as a 'low-prevalence country'. "Take the example of Karachi, which is estimated to have between 25,000 and 35,000 users of injectable drugs.

"Let's say Karachi has 30,000 drug users of which 3,000 have been tested. This means that more than 10 per cent of the group population has already been tested. Isn't that a sufficiently large sample size?"

According to him, drug users generally migrate to places where they are likely to get uninterrupted supplies of narcotics. "That is why the drug addicts generally get concentrated in a few major cities where narcotics are traded in large quantities.

"It follows then that the drug addicts are not likely to be in great numbers in the rural areas of the province. This means that we can safely reach conclusions on the basis of the tests that have been carried out in four major cities of Sindh," the source said.