Dr Sikander Sohani, senior manager training and advocacy at Aahung, an organisation working on HIV/Aids and related health issues, talks about various aspects of HIV/Aids in Pakistan
How does Pakistan fare in HIV/Aids prevalence from an international perspective?While the prevalence of HIV in the general population is low, the UNAID rates Pakistan on a higher risk of an HIV epidemic within the concentrated population. This is primarily because within certain groups of people, its prevalence is far higher compared to the general population.
Who are these specific groups of people stated as more vulnerable and why are they more likely to contract HIV?These groups include migrant workers, sex workers and drug addicts. They act as channels through which HIV virus can be transferred to the general population. Drug addicts are most likely to be infected by the virus, as they exchange needles. These drug addicts also attain services of sex workers, who then contract the virus. They extend far beyond women and also include men, children and transgender sex workers. Sex workers are highly prone to contracting the disease and once they do, because they provide service to the general population, they act as a bridge between the general population and drug users.
Pakistani blue collar workers, who migrate to the Gulf for better opportunities, also receive similar services from sex workers and often contract the virus. Once a Gulf government finds out about the virus, they immediately deport the victim, and when the victim goes back to the family, and due to the asymmetrical gender power relations, wives also tend to catch the disease.
Besides migrant workers, promiscuous truck drivers also increase the geographical mobility of the disease. Many drivers in particular attain sexual services of children and men, and transmit the virus to their spouses.
Have there been efforts by the government and NGOs to curtail the spread of HIV/Aids, and have they been effective?In the earlier period, the government has implemented plans such as National Aids and Tameer programme. They have also accepted drug users as a legitimate group of people, which makes it easier to channel resources towards reducing it in the high risk segments. In 2008, there were Aids outbreak in Larkana and Gujrat, and adequate steps were taken to minimise the spread of the virus.
Do you think rights-based approach towards HIV/Aids can help reduce the levels of spreading the disease?Empirically speaking, rights-based approach curtails spreading of HIV/Aids by reducing the root of the problem. It provides fundamental human rights to drug users and sex workers, as opposed to stigmatising them, and allows them to receive access to appropriate treatment. These groups do not receive the same empathy and compassion as people from the mainstream society and as a result, they are usually denied treatment. Furthermore, by acknowledging the HIV status to the vulnerable groups of people, it may help them to take more responsible decisions and obtain better healthcare. Due to low literacy rate, most of these workers would not otherwise have knowledge of their rights, obligations and the ability to effectively prevent others from contracting the disease. On a bigger picture, this will eventually lead to more structural decline in the likelihood of HIV/Aids contagion.
Does implementation of the rights-based approach receive acceptance in Pakistan?International human rights convention is the architectural basis for the rights-based approach. These values are not only institutionally accepted, but the values entailed in this framework are similar to values in our or any other society. These values transcend cultures and nationalities and have a strong humanitarian basis. As far as acceptance within the conservative audience is concerned, there are different segments within this group of people who can be measured on a continuum of the narrow minded and the intolerant. Those who are more reasonable, tolerant and empathetic are likely to acknowledge that humanitarian measures need to be taken to reduce the likelihood of contraction of HIV/Aids, and this group of people is mainly the majority. —Sachal Abbassi