Programme for Research and Capacity Building in Sexual and Reproductive Health and HIV in Developing Countries

Programme researchers, in collaboration with National AIDS Control Programme (NACP) and the Sindh Institute of Urology and Transplantation, have recently conducted a survey on levels of STIs and HIV in Pakistan. The survey, commissioned by the NACP and funded by the UK Department for International Development (DFID), found that while HIV is currently found principally among injecting drug users, there is a strong possibility that it could spread to other groups and become a much greater threat to public health.

The research identifies five key interventions to stem the transmission of HIV/STIs in Pakistan:

1. needle and syringe exchange programmes for injecting drug users
2. comprehensive sexual health care for male and transgender sex workers
3. sexual and reproductive health care for female sex workers
4. targeted behaviour change communication for most-at-risk groups
5. addressing stigma and discrimination, and promoting and protecting the human rights of those at greatest risk.

Key Points

• Pakistan has multiple risk factors for an escalating HIV epidemic.
• These include high levels of other STIs among people who inject drugs and those who sell sex.
• These groups are interlinked and connected with the general population, thus an epidemic could affect multiple populations.
• Moreover, these groups have limited or no access to STI prevention and treatment.
• A more cohesive approach to STI control is urgently needed, with more STI services specifically for sex workers and expanded needle and syringe exchange programmes for injecting drug users.
• Discrimination and violence committed by the police and others is contributing to HIV risk in these most-at-risk populations.
• Addressing these human rights violations is crucial to improving public health.

Further information

This research is presented in more detail in an April 2009 supplement of Sexually Transmitted Infections (volume 85, Suppl.2).

We have also produced two policy briefs and a research brief:

Policy Briefings

1. Confronting the HIV challenge in Pakistan: Urgent need for health services in most-at-risk communities
2. Confronting the HIV challenge in Pakistan: How human rights abuses are fuelling HIV risk

Research Briefing

1. HIV in Pakistan: Preventing a future epidemic in most-at-risk groups