Rising HIV cases in Pakistan: Start of a pandemic?

Among all pandemics in recorded history, acquired immunodeficiency syndrome (AIDS) has caused the most devastation. It is caused by human immunodeficiency virus (HIV) that infects several immune system cell types expressing CD4 receptor on their surfaces [1]. According to WHO, there were a total of 38.4 million HIV-positive individuals by the end of 2021 and 0.7% of adults between the ages of 15 and 49 have HIV worldwide [2]. Potential risk factors for the spread of HIV, according to WHO, are male circumcision with unclean blades, reuse of needles, hazardous blood transfusion procedures, ear and nose piercing with unsafe needles, and sharing of needles [3].

The incidence of new HIV infections in the Asia-Pacific decreased by 31% from 2000 to 2014. Countries like Nepal and Thailand are included in this region, where cases have declined by 87% and 63% since 2001, respectively [4]. While the cases have decreased globally but in Pakistan, they have reportedly increased between 2010 and 2020. At present, there are around 200,000 cases in the country, with thousands being reported every year making it the second largest Asian country with people living with HIV, India being the first [5].

Most of Pakistan's community is still ignorant of this deadly virus's transmission sources. Only 13% of people in Pakistan who were polled could name three ways that the virus is spread, and 50% had heard of it according to a 2013 report by the UN Office on Drugs and Crime [6]. According to the National AIDS Control Program, 5202 cases of HIV have been confirmed in Pakistan over the course of the past six months alone [7]. Numerous studies have indicated that high-risk practices such as tainted blood transfusions, the reuse of injections and syringes, and the country's general lack of hygiene standards have contributed to the spread of the disease [3].

Due to a significant lack of knowledge about the illness, social stigmas, expensive and exclusive testing, and few available treatments, there are high transmission rates in the country. The fact that most households avoid talking about HIV makes the situation more serious. Many people would put off getting tested for it out of concern for judgment or censure. This indicates that the majority of the populace is blissfully ignorant of the disease's potential causes, modes of transmission, potential diagnostic techniques, and sources of care [7].

The attempt to put self-testing kits on the market could provide countless people with the means to quietly diagnose themselves and receive treatment. It is important to realize that this will not be sufficient to stop the spread of HIV/AIDS; measures focused on educating the public, eliminating the stigma associated with the condition, and changing people's perceptions are necessary. This mentality shift is crucial and ought to be supported on many fronts, including those of religion, medicine, and education. We require and must strive for a comprehensive, multi-layered policy.

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The conceptualization was done by HSR and ZA. The literature and drafting of the manuscript were conducted by HSR, ZA, MHO and HF. The editing and supervision were performed by MAS. All authors have read and agreed to the final version of the manuscript.

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