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Responding to HIV service needs of injecting drug users in Pakistan

Document type: mthesis
Download file(s): 193920 (614 KB)
Abstract: Drug abuse is increasingly becoming a major social and public health problem in Pakistan, specially injecting drug use. Poverty and geographical location of Pakistan also makes the country most vulnerable. However, it is often overshadowed by other issues the country is facing. Until the mid-1990s popular mode of taking drugs was inhalation. Due to the heroin supply disruptions and many other reasons drug users began to shift from inhalation and other routes to injecting, also synthetic drugs along with pharmaceutical combinations easily available over the counter. The issue of injecting drug use has direct links with poverty, social system, government policies and deprivations. More and more young people are falling, or converted to injecting drug use. Stigma and confinements faced by IDUs make the situation even more difficult for them and for any effective response. Pakistan has moved from low-level to a concentrated level HIV epidemic, primarily because of the high prevalence among injection drug users (IDUs). After the first reported outbreak of HIV among this group in 2003, it continues to increase reached to other cities. 31% prevalence of HIV is reported in Karachi during 2007. Evidence informs about modest interaction between some high risk groups including IDUs. For example IDUs reportedly paid to have sex with female, male or hijra sex worker. This kind of interaction can potentially transmit HIV infection from high risk groups to low risk groups such as the general population. It is highly possible that an IDU can pass on the infection to an FSW, MSW who can possible have sex with a married man and this way the transmission dynamics take place. While there are harm reduction programmes in the country providing needle/syringe exchange and other services. However, main challenges in reducing risk of HIV transmission among IDUs and preventing further spread are to achieve the desired behaviour change along with increase coverage. At the moment coverage is no more than 15-20%. There are still no drug substitution programmes in the country and no ARVs for HIV positive IDUs. Concentrated HIV epidemic among IDUs show shift of trend of the epidemic in Pakistan. Policies should be made focused on appropriate coverage of harm reduction programs, increasing health awareness and making services available and accessible for the people in need such as IDUs. Drug substitution programs and ARV services for IDUs need special attention from government, NGOs and donors. Policies should be made to address challenges that programs can face in Pakistani context.
Authors: Hussain, T.
Country: Pakistan
Category: Research
Department: Development Policy & Practice
Institute: KIT (Royal Tropical Institute)
Keywords: HIV and AIDS , disease prevention and control
Language: eng
Organization: KIT - Royal Tropical Institute
PAGE: vii, 50
Year: 2008
Region: South Asia
Right: © 2008 Hussain
Subject: Health and Nutrition
Title: Responding to HIV service needs of injecting drug users in Pakistan
Training: Master of Public Health / International Course in Health Development (ICHD)