Unsterilized needles, quacks spread HIV/AIDS more than unsafe intercourse

Pakistan has been facing a silent but a creeping epidemic of the human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS. Contrary to the common perception that this potentially fatal disease is spread by ‘immorality’, and by extension, homosexual relationships or accepting transgender identities, the disease is spread more by improper use of unsterilized needles and unscreened blood.

This was stated by Sindh Communicable Disease Control (CDC) HIV / AIDS Center Additional Director Dr Ershad Kazmi.

Speaking to SAMAA TV in connection with international HIV/AIDS day, he said that if someone as a client goes to a sex worker – whether cisgender or transgender – and returns infected, they likely acquired the disease due to unsafe intercourse.

But, Dr Kazmi said that this is not the main cause of the spread of the disease in Pakistan.

Generally, quacks, infected blood, and people who have multiple sexual partners are more prone to the disease.

Dr Kazmi said that in Sindh, some 19,466 people are registered as infected with HIV / AIDS.

“The health department screened more than a million people, of which just 3,515 people tested positive in 2022,” he said, adding that the positivity ratio was at 0.35%.

He added that according to World Health Organization (WHO), there are more than 300,000 HIV-affected people across Pakistan. Of this, some 90,000 people are positive in Sindh, but only 19,466 were registered with the provincial health department.

One major issue they face in detecting and then treating or managing the disease is that the stigma and taboo associated with it prevent people from subjecting themselves to screenings or disclosing a known infection to others.

Most people think that they acquired the disease due to illicit relations, Dr Kazmi explained. He added that this causes people to hide the disease even from their physicians.

“Most of the people are not even aware of the disease they are carrying in their blood,” he added.

He said that it is our responsibility to find these people through increased blood screening and take them towards treatment.

“The provincial health department has a keen interest in increasing screening capabilities, especially for children,” he further announced.

Kazmi said that previously, the Sindh government had established 16 treatment centers across the province. Now, another screening center has been established through a public-private partnership, which takes the total number of treatment centers in the province to 17.

Dr Irshad Kazmi further said that they conducted around 0.5 million antenatal tests and found that the positivity ratio was quite low.

Talking about the issue in the Ratodero area of Sindh, where a massive outbreak was reported a few years ago, he said that it remains the most affected area when compared to other parts of Sindh province.

“In Ratodero, people were affected due to the use of used syringes,” he explained.

However, he said that the situation in Larkana is better, as we have targeted 50,000 people for screening.

Blaming quacks, who provide medical treatment in rural areas, for the spread of diseases, Dr Kazmi urged the government to conduct raids against these unqualified people.

“I repeat, people must take care when using syringes,” he concluded.

Why does AIDS spread

Dr Kazmi said that a major reason for the spread of AIDS was the unsafe practice of sharing needles.

There are various reasons for the sharing or reuse of needles.

One of these is that drug addicts share unsterilized needles, while another reason is quacks reusing needles to effect treatment to people they are not qualified to treat.

There are other causes for the spread of the disease as well, including transfusion of unscreened blood.

Another reason for the spread of the disease is unsafe sexual practices and having sexual relations with multiple partners – as is usually a practice followed by sex workers.

“We have initiated an awareness campaign and started a project in upper Sindh,” he announced in a nod to the issue that emerged in Ratodero and Larkana a few years ago.

For this purpose, Kazmi said that they were educating teachers, headmasters, religious scholars, opinion makers in villages, barbers, and general practitioners to make them aware of how the disease spreads and the precautions that can be taken to not only protect the people but also eliminate the menace.

Another key aspect of the awareness drive was to tell people that getting infected with HIV was not the end of the world and that it was possible to seek treatment.

Further, he said that the awareness focuses on reducing the stigma surrounding infection with HIV/AIDS.