KARACHI, June 26: A dangerous situation is prevalent in the province regarding HIV/Aids infections and there is an urgent need for multi-sector collaboration to combat the menace.
These views were expressed by speakers at a workshop organised by the Sindh Aids Control Programme at the PMA House on Monday to disseminate results of behaviour and biological surveillance conducted among female sex workers (FSWs), male sex workers (MSW), eunuch sex workers (ESW) and injection drug users (IDUs) in Karachi, Hyderabad, and Sukkur.
According to the report, the IDUs were at a high risk of HIV/Aids, while MSWs as well as ESWs were consistently turning HIV positive. In the case of FSWs, it was said that the HIV positive female workers had been reported for the first time in Sindh.
These high risk groups (HRGs)- IDUs, MSWs, ESWs and FSWs- were interlinked and were a serious threat to the general population, concluded the report on integrated behavioural and biological surveillance (IBBS), which was conducted from Sept 2005 to Dec 2005, at different hot spots in the three cities where HRGs congregate.
At Karachi, 198 MSWs, 188 ESWs and 389 FSWs were interviewed and examined by the members of the surveillance teams, out of which 8 (4 per cent), 3 (1.5 per cent) and 3 (0.7 per cent) respectively were found HIV positive. According to an earlier survey, 26 per cent of the IDUs in the sample were found infected.
In the case of Sukkur, 19.6 per cent of the IDUs, 1.7 per cent of the ESWs and 0.2 per cent of the FSWs were found HIV positive. At Hyderabad, 25.8 per cent of the IDUs and one per cent of the ESWs included in the surveillance sample were found HIV infected. No MSW and FSWs at Hyderabad and no MSW at Sukkur was found infected, under the survey.
According to the surveillance results, more than 50 per cent IDUs in Hyderabad and Sukkur were above 30 years of age.
As many as 34.4 per cent of the IDUs in Hyderabad have been injecting drugs for over 10 years, while in Sukkur, 62.3 per cent of the sampled IDUs have been injecting drugs for the last five years.
At Sukkur, 78 per cent of the IDUs in question took 2-3 injections a day, while in Hyderabad, the figure came as 62.8 per cent. When questioned, did they not used a new syringe for last injection, 77.6 per cent out of 402 respondents said in affirmative at Sukkur, while another 44.1 per cent at Hyderabad.
As many as 53.7 per cent of IDUs at Sukkur were found sexually active with their wives or other women, while at Hyderabad this ratio is 23.7 per cent. Of the total surveyed IDUs at Sukkur and Hyderabad, 79.9 per cent and 20.1 per cent respectively shared syringes.
Discussing the age of commercial sex workers, the report mentioned that majority of them aged between 25-30 in the case of females, 20-25 in the case of MSWs, while ESWs between 25-30 years.
With reference to the demographics of FSWs, the report said that of the 390 included in the sample for Karachi 38.3 per cent were married and earned around Rs12,000 a month. Of the 390 FSWs at Hyderabad, 91.8 per cent were married, while 75 per cent of the 368 at Sukkur were married.
Coming on the high risk behaviours of FSWs in question, the report, which has been prepared by a consortium of health care units, NGOs and foreign consultants, said that 24.5 per cent of them got 20 paid clients per month, 48.8 per cent of them used condoms in the last sexual act, while 63.9 per cent knew that condoms protected against HIV.
Only 48 per cent of MSWs and 46 per cent of ESWs at Karachi knew that condoms provide protection against HIV. Only 22.5 per cent of the MSWs and 18 per cent of ESWs used condoms in the last sexual act, the survey revealed.
Wrapping up the findings of the reports, which is claimed to be first of its kind in the province, Dr Salma Kausar Ali, manager, Enhanced HIV/Aids Control Programme, Sindh, said that her institution was collaborating with all the stakeholders and was looking forward for a joint working to control HIV/Aids in Sindh.
She said that both the print and electronic media could contribute a lot in minimizing stigma and discrimination particularly of people living with HIV or Aids, with emphasis on the females. Please make HIV/AIDS a corporate priority and commit time and space to this issue and also provide current news coverage-globally and locally, she urged the media.
Dr Asma Bokhari, Manager of National Aids Control Programme, said that Pakistan, which had been long classified as a country in a "low level" stage of the HIV epidemic, was now heading to "concentrated level" in at least one group of high risk individuals, ie IDUs.
Now a concentrated epidemic among the IDUs is being reported from various cities including Karachi, Hyderbad, Larkana, Sukkur, Quetta, Faisalabad, Sargodha and Sialkot, she added.
Dr Bokhari said that the latest surveillance exercise by Sindh would surely help understand the role of various high risk groups in the transmission dynamics of HIV. She reminded that though sex trade was illegal in the country, sex workers were flourishing, which was a source of concern.
Sindh Health Secretary Dr Naushad A. Shaikh said that the details of the surveillance results were extremely shocking and called every one to admit the reality and act accordingly.
The situation is at a dangerous point and all quarters, including media, community, policy makers, politicians and religious leaders are needed to be more serious in their given role, he added.
He said that the changes in the patterns pertaining to HIV/Aids in the region were also alarming and required integrated efforts and holistic approaches. In addition to the IDUs and sex workers we should also have a track of Pakistani workers who are deported after their detection as HIV/Aids infected from the Gulf countries, without any intimation to the health authorities in Pakistan, he remarked and warned that the HIV/Aids problem could collapse the health and economy systems of the province and the country as well.
Dr Arshad Altaf, the provincial surveillance support officer, said that the survey, contacts and interviews with the high risk group peoples involved social issues and it was not an easy job. We had to stop IBBS data collection activities temporarily in three cities of Karachi, Hyderabad and Sukkur on the intervention of the stakeholders.
Dr Qaiser Sajjad, secretary general of PMA also spoke.
