title: The spread of HIV in Pakistan: bridging of the epidemic between populations.
abstract: In the last two decades, 'concentrated epidemics' of human immunodeficiency virus (HIV) have established in several high risk groups in Pakistan, including Injecting Drug Users (IDUs) and among men who have sex with men (MSM). To explore the transmission patterns of HIV infection in these major high-risk groups of Pakistan, 76 HIV samples were analyzed from MSM, their female spouses and children, along with 26 samples from a previously studied cohort of IDUs. Phylogenetic analysis of HIV gag gene sequences obtained from these samples indicated a substantial degree of intermixing between the IDU and MSM populations, suggesting a bridging of HIV infection from IDUs, via MSM, to the MSM spouses and children. HIV epidemic in Pakistan is now spreading to the female spouses and offspring of bisexual MSM. HIV control and awareness programs must be refocused to include IDUs, MSM, as well as bisexual MSM, and their spouses and children.
authors.affiliation: Department of Microbiology, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Muhammad R
authors.initials: MR
authors.lastname: Khanani
authors.forename: Mehreen
authors.initials: M
authors.lastname: Somani
authors.forename: Sadiq S
authors.initials: SS
authors.lastname: Rehmani
authors.forename: Nazle M C
authors.initials: NM
authors.lastname: Veras
authors.forename: Marco
authors.initials: M
authors.lastname: Salemi
authors.forename: Syed H
authors.initials: SH
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D055030:Drug Users / Q000706:statistics & numerical data; D058872:Epidemics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1 / Q000145:classification / Q000235:genetics; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010802:Phylogeny; D012306:Risk; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D004279:DNA, Viral