AIDS survey highlights at-risk groups in Pakistan
28 November 2008
Naveed
is
a feminised male prostitute. That means he dresses and behaves as a woman for
his male clients. In the poorer slums of Rawalpindi where he works, violence
and abuse from neighbours, clients, sex partners and the authorities are routine.
Naveed is philosophical about his relationship with the police. "They threaten to tell our families about our activities," he says, "so we try to pacify them by offering them sex."
Naveed represents a sub-culture that can be found in all Pakistan's cities - one in which drug use and unprotected commercial sex are rife.
DFID recently funded a national survey of HIV and other sexually transmitted infections in Pakistan. The survey, conducted across 12 cities, found that the greatest risk of HIV/AIDS spreading in Pakistan comes from its growing incidence among the kind of marginalised group to which Naveed belongs.
Surveying the most at-risk populations
One part of the nationwide survey covered 2,000 sex workers and injecting drug users from cities in Punjab and North-West Frontier. While it found the HIV rate to be low, the levels of other sexually transmitted infections were high, especially in certain groups, with almost half of all transgender sex workers, for example, infected with syphilis.
The survey also found that levels of knowledge about HIV and sexual health in general were extremely low. Perhaps as a consequence, the use of condoms during sex was also low. Injecting drug users knew more about HIV/AIDS but still resorted to sharing or re-using needles because of the lack of available new ones.
These findings suggest that any future HIV epidemic will be concentrated in groups with the highest levels of sexually transmitted infections. But these groups are also among the most marginalised and vulnerable to human rights abuses.
Human rights and AIDS prevention
The DFID survey suggests that Pakistan needs to act decisively to prevent the spread of HIV/AIDS. Prevalence has increased rapidly in the past few years in some high risk groups, such as injecting drug users. Others, such as male and transgender sex workers, are highly vulnerable to the epidemic.
Helping male and transgender sex workers won’t win wide approval in a traditional society like Pakistan’s. But the survey's researchers concluded that future AIDS-prevention projects must not only address medical concerns. They must target the underlying issue of human rights.
Marginalised groups need to be given better protection and security to let them access the medical care and education they require. Protecting the human rights of people like Naveen isn't just a moral issue. It could play a vital role in preventing the spread of HIV/AIDS to the wider community.
Facts and stats
- The 'National Survey of Sexually Transmitted Infections and HIV in Pakistan' was conducted over 18 months, 2006-2007. It was coordinated by researchers from the London School of Hygiene and Tropical Medicine in collaboration with Pakistan's National AIDS Control Programme.
- The survey was entirely funded by DFID and cost £1.4 million.
- DFID is giving ongoing support to the Pakistan government’s National HIV and AIDS Strategic Plan. This aims to reverse the rising prevalence of HIV in high risk groups. DFID is providing £3 million to support the Pakistan National AIDS Control Programme for the period July 2008 to December 2009.
- The results from the research will be published in a special issue of the journal
Sexually Transmitted Infections, forthcoming in April 2009.
