title: HIV risk in Karachi and Lahore, Pakistan: an emerging epidemic in injecting and commercial sex networks.
abstract: The objective of this study was to measure HIV prevalence and risk behaviour in injecting drug users (IDUs), male sex workers (MSWs), Hijras (transgenders), female sex workers (FSWs) and male truckers in Karachi and Lahore, Pakistan. The design was a linked-anonymous cross-sectional study of individuals identified at key venues or through peer referral. Approximately 400 respondents in each group (200 for Hijras) responded to a standardized questionnaire and were tested for HIV antibodies at each site. In Karachi, 23% of IDUs and 4% of MSWs were HIV positive, and HIV-positive individuals were identified in all risk groups in at least one city. Two-thirds of all IDUs used a shared needle in the previous week, and unprotected commercial sex activity with men and women was high. The HIV epidemic has entered IDU and male and female commercial sex networks in Karachi and Lahore. Targeted intervention services must be scaled up and risk group surveillance intensified.
authors.affiliation: National AIDS Control Programme, Ministry of Health, Government of Pakistan, Pakistan.
authors.forename: Asma
authors.initials: A
authors.lastname: Bokhari
authors.forename: Naseer M
authors.initials: NM
authors.lastname: Nizamani
authors.forename: Denis J
authors.initials: DJ
authors.lastname: Jackson
authors.forename: Naghma E
authors.initials: NE
authors.lastname: Rehan
authors.forename: Motiur
authors.initials: M
authors.lastname: Rahman
authors.forename: Rana
authors.initials: R
authors.lastname: Muzaffar
authors.forename: Samina
authors.initials: S
authors.lastname: Mansoor
authors.forename: Hasan
authors.initials: H
authors.lastname: Raza
authors.forename: Kanwal
authors.initials: K
authors.lastname: Qayum
authors.forename: Philippe
authors.initials: P
authors.lastname: Girault
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pisani
authors.forename: Inayat
authors.initials: I
authors.lastname: Thaver
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000635:transmission; D015528:HIV Seroprevalence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D016485:Needle Sharing; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D011477:Sex Work / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014186:Transportation; D047568:Unsafe Sex / Q000706:statistics & numerical data*