Alarming HIV rise found among TGs, MSM and FSWs

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ISLAMABAD: Unsafe sex and limited access to preventive measures have led to alarming increases in HIV prevalence among key populations, including transgender people (TG), men who have sex with men (MSM). (MSM) and female sex workers (FSW).

These findings come from the sixth round of Integrated Biological and Behavioral Surveillance (IBBS), which presents both progress and alarming trends in the HIV epidemic in Pakistan.

The preliminary results of the study, almost a decade after the last round, were carried out by the Health Services Academy (HSA) in collaboration with the Progressive Development Initiative (PDI), UK, and the HIV/STI Surveillance Research Center and the WHO Collaborating Center for HIV. Surveillance (HIVHUB), Iran was shared with the Ministry of National Health Services, Regulations and Coordination on Tuesday.

The findings present a mixed picture, highlighting the success of harm reduction services for people who inject drugs (PWID) while exposing the increasing prevalence of HIV in sexual networks. who act as a bridge between critical populations and the general population.

HIV prevalence among TGs has reached 10%, up from 7.2% in 2016, while MSM reported a prevalence of 7% compared to 5.6% in the previous survey. Similarly, prevalence among FSWs has increased from 2.2% in 2016 to 3.8% today. In contrast, HIV prevalence among PWID has significantly decreased from 38.4% to 27% in 2016, due to harm reduction programs and the use of non-injectable drugs, including methamphetamine or ice. There is a transition to

One of the most alarming findings is the HIV prevalence rate of 4.7 percent among prisoners, a population surveyed for the first time at IBBS. Overcrowding, lack of access to condoms, and rampant drug use in prison facilities contribute to the spread of HIV among this neglected population.

IBBS Round 6 surveyed and tested 28,377 people, including 6,500 PWID, 7,606 MSM, 6,670 FSWs, 7,601 TGs, and 5,000 inmates, making it the most comprehensive survey of HIV prevalence in Pakistan so far. Makes one of the largest surveys.

The study was conducted in 31 districts including Karachi, Lahore, Islamabad, Peshawar, Quetta, Faisalabad, Multan, Sukkur, Hyderabad, Jacobabad, Larkana, Rawalpindi, Gujranwala, and Gujarat ensuring wide geographical representation.

Findings highlight significant barriers to condom use among TGs, MSM, and FSWs. While more than 50% of TGs and MSM reported condom use, disparities persisted in consistent use, particularly during high-risk encounters. Among FSWs, condom use remains at around 40%, hampered by limited availability of female condoms, client refusal, and stigma associated with carrying or requesting condoms.

These gaps underscore the urgent need for targeted interventions to increase access to condoms and promote their consistent use. Harm reduction efforts for PWID have demonstrated success, with the increased availability of needle exchange programs in both the public and private sectors leading to a reduction in HIV prevalence within this group. However, challenges such as unsafe injection methods, stigma, and substance abuse pose risks.

The inclusion of prisoners as a vulnerable population in the IBBS for the first time has highlighted the vulnerabilities of the incarcerated.

Findings underscore the urgent need for comprehensive HIV prevention, testing, and treatment services within correctional institutions.

A comparative analysis with 2016 data reflects mixed results. While declining prevalence among PWID indicates progress, increased rates among TGs, MSM, and FSWs indicate serious gaps in prevention strategies. These gaps are exacerbated by stigma, discrimination, and limited outreach efforts, which impede access to care and preventive measures for these populations.

The report also highlights educational disparities among key populations. A significant proportion of TGs, MSM, and FSWs lack secondary education, limiting their awareness of HIV prevention and preventive measures. Among PWID, education levels are even lower, with many being completely illiterate. The survey also looked at prisoners, revealing that while some had completed primary or secondary education, many lacked comprehensive knowledge about HIV prevention.

The IBBS study also examined other vulnerable populations, such as truck drivers, migrant workers, and street children, whose high mobility, low condom use, and limited access make them particularly vulnerable to HIV. Makes a victim. These groups require attention to address their specific risk factors.

The study also highlights an important oversight: the lack of attention to HIV transmission through weak infection prevention and control measures in health care settings.

Previous outbreaks, such as the devastating Rato Daru outbreak of 2019, highlight the role of unsafe medical practices in spreading the virus. Future HIV prevention strategies should include robust infection control protocols to reduce these risks.