Decades of Stigma: HIV/AIDS Still Battles Misconceptions in Pakistan

Shazia Mehboob

Islamabad: Social and cultural stigma is cited as a major barrier to accessing prevention and treatment for those suffering from the HIV/AIDS epidemic in Pakistan.

Stigma, fear of ostracization, discrimination, and lack of awareness of causes lead to differential treatment of HIV/AIDS sufferers, which is now well recognised and acknowledged after almost two decades of awareness work.

The impact of HIV/AIDS is devastating on an individual’s family, social, and economic lives, according to an official working on the National Aids Control Programme who chose to remain anonymous.

The fear of society is more lethal than HIV/AIDS itself due to the stigma attached to this disease, said Dr Fazal Rabbi, infectious diseases specialist at Premium Diagnostics Islamabad. “We doctors even avoid mentioning our names when sending our sample for HIV screening,” the infectious diseases expert informed.

We doctors even avoid mentioning our names when sending our sample for HIV screening: Dr Fazal Rabbi

Dr Rabbi further said that the assumption that HIV/AIDS can only pass through sexual relationships is wrong because it can pass from mother to child during pregnancy, breastfeeding, illicit injectable drug use, sharing needles, contact with infected blood, or contact with contaminated blood.

Dental treatment from quakes sitting on roadsides or in compromised health facilities poses some additional risk factors, Dr Rabbi maintained.

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. It is the early dedication of the virus to the human body. If HIV is not treated at an early stage, it can lead to HIV/AIDS (acquired immunodeficiency syndrome). The stage when the HIV virus starts affecting an immune system is called HIV/AIDS, according to experts on infectious diseases.

There is currently no effective cure. However, people who get an early diagnosis and effective treatment can live long, healthy lives and protect their partners. The HIV/AIDS treatment reduces the amount of HIV in the human body and helps it stay healthy.

Once people get HIV/AIDS positive, they have it for life. But with proper medical care, it can be controlled.Dr Rabi

The expert on infectious diseases informed The PenPK.com that the HIV virus takes at least five to six years to get to the stage of HIV/AIDS. At this stage, the virus starts affecting the immune system. Dr Nasim Akhtar, who specialises in infectious diseases, said HIV/AIDS patients recurrently suffer different types of infections, depending on the severity of the disease.

There are no [as such] clear-cut symptoms of this disease, which could help in diagnosing the disease, but patients with recurrent headaches, brain infection, frequent fever, and pus in the brain should have HIV screening to keep themselves and others safe from HIV, Dr Akhtar informed.

Although HIV/AIDS affects the whole human body, it is more lethal to the lungs and brain, according to Dr Rabbi.

Currently, a vertical approach is being used for HIV/AIDS treatment led by the federal government; however, there is a strong need to make HIV screening a compulsion. There is no age limit; every age group that has external exposure can get this disease, said Dr Nasim.

An expert on infectious diseases not authorised to speak to the media said the HIV virus exists in every age group, and a missing culture of HIV screening can have long-term implications. There is a need to extend the screening programme to the remote areas of Pakistan at a broader level.

Drug addicts are the major source of HIV/AIDS spread in Pakistan, said an official at the National HIV/AIDS Control Programme, claiming anonymity.

Drug addicts are the major source of HIV/AIDS spread in Pakistan: NACP

According to the data available on the National Aids Control Programme website, Pakistan has an estimated 0.21 million reported people with HIV/AIDS, while there are an estimated 53,718 people living with HIV or who know their status in 51 art centres as of June 2022. Meanwhile, as many as 32,972 people with HIV/AIDS are under treatment in Pakistan.

In the 1990s, little was known about HIV/AIDS in Pakistan. In 2003, only 3,000 to 4,000 patients were reported. This is probably because of the inadequate registration of HIV/AIDS, said a senior doctor at PIMS, claiming anonymity. In 2019, an estimated 26,000 cases were reported in Pakistan, an estimated 14 percent of the total cases in the country, he said.

A large majority of HIV/AIDS patients who visit hospitals have the disease at its fourth stage, which means at a critical stage when they have no other option but to survive on medicines, said Dr. Nasim.

Most of the patients visit the hospital with a severe lung infection, pus in the brain, or TB, explained Dr Nasim. Of the 60 to 80 percent, people are drug addicts, and the remaining include foreign returnees and sex workers. HIV/AIDS patients who visit the hospital for treatment suffer from actual illness. Denial of the disease by youth and lack of awareness are some matters of concern, according to Dr Nasim.

Screening tests for HIV/AIDS are free of charge at all district headquarters hospitals in Punjab:Dr Irfan Rasheed

Punjab Hepatitis and Infection Control Programme District Focal Person, Dr Irfan Rasheed, said that screening tests for HIV/AIDS are free of charge at all district headquarters hospitals in Punjab.

Dr Irfan Rasheed stated that we always try to maintain patients’ privacy in accordance with the policy of the government for HIV patients. Doctors treating patients with HIV/AIDS usually face no discrimination and would not be at risk if they followed standard infection control measures. Their physical and mental health would be safe and sound.

One of the representatives of UNAIDS Pakistan refused to comment or answer queries, claiming she was not officially allowed to do so.

Source: Global AIDS Monitoring 2020 Report a woman running a salon in Islamabad, while sharing her experiences with the prevention of AIDS, explained that she has always been very particular about hygiene and preventive measures, especially when attending salons, but now even renowned salons are not following the SOPs. Due to her fear of being judged, she cannot stop her beauticians from using tweezers and other equipment that is being used by the public.

Pakistan has an estimated 0.21 million reported people with HIV/AIDS:NACP

She also mentioned that the same tweezers are usually used on private areas as well as the faces of clients in many salons, which, along with HIV/AIDS, cause other diseases as well.

One of the producers at a TV channel, while claiming anonymity, said that she has been stopped by higher management from designing a programme on AIDS because people would be uncomfortable and would end up making other assumptions while watching the show.

However, Kinza, a lady associated with a private diagnostic lab, said screening for HIV/AIDS is an expensive procedure. Usually, two methods are used by labs in Pakistan.

One is PCR (polymerase chain reaction), and the other is the ELISA (enzyme-linked immunoassay) method. There is no norm for lab technicians to go for regular screening for HIV/AIDS. Even if we are in the process of screening, we do not go for our own screening at regular intervals.

The cost of PCR quantitative in Chughtai Lab is Rs 11,300. It is abundantly clear that a number of factors—stigma, unawareness, fear, carelessness, judgemental discrimination, and the cost of screening and treatment—combine to prevent an effective programme of awareness, screening, and treatment that would help to make a major dent in the growth of HIV/AIDS in Pakistan. This calls for a complete overview of the situation.