title: Drug-related HIV epidemic in Pakistan: a review of current situation and response and the way forward beyond 2015.
abstract: Pakistan is among four countries in Asia where the estimated number of new HIV infections has been increasing year by year ever since 1990. The Asian Epidemic Modelling (AEM), conducted in 2015, reconfirmed that the use of contaminated injection equipment among people who inject drugs (PWID) remains the main mode of HIV transmission in the country. The estimated number of PWID ranges from 104,804 to 420,000 PWID. HIV prevalence in this population is above 40 % in several cities, including Faisalabad (52.5 %), D.G. Khan (49.6 %), Gujrat (46.2 %), Karachi (42.2 %) and Sargodha (40.6 %), respectively. Harm reduction service delivery is being implemented through a public-private partnership led by the National and Provincial AIDS Control Programmes and Nai Zindagi with funding support from the Global Fund. Current programmatic coverage of the needle and syringe programme, HIV testing and counselling and antiretroviral treatment among PWID remain insufficient to control ongoing transmission of HIV in the country. While opioid substitution therapy (OST) is yet to be introduced, significant progress and coordination among various ministries have taken place recently to register buprenorphine in the dosage required for treatment of opioid dependence, and possible introduction of OST will greatly facilitate adherence to antiretroviral treatment among PWID living with HIV.
authors.affiliation: United Nations Office of Drugs and Crime (UNODC), Plot 5-11, Diplomatic Enclave-II, G-4, Islamabad, 44000, Pakistan. anne.bergenstrom@unodc.org.
authors.forename: Anne
authors.initials: A
authors.lastname: Bergenstrom
authors.affiliation: National AIDS Control Programme, National Institute of Health, Chak Shahzad, Park Road, Islamabad, 44000, Pakistan. achakzaibk@gmail.com.
authors.forename: Baseer
authors.initials: B
authors.lastname: Achakzai
authors.affiliation: National AIDS Control Programme, National Institute of Health, Chak Shahzad, Park Road, Islamabad, 44000, Pakistan. sofiafurqan@hotmail.com.
authors.forename: Sofia
authors.initials: S
authors.lastname: Furqan
authors.affiliation: United Nations Office of Drugs and Crime (UNODC), Plot 5-11, Diplomatic Enclave-II, G-4, Islamabad, 44000, Pakistan. manzoor.ul.haq@unodc.org.
authors.forename: Manzoor
authors.initials: M
authors.lastname: ul Haq
authors.affiliation: UNAIDS Country Office for Pakistan & Afghanistan, Level-5, Serena Business Complex, Khyaban-e-Suhrwardy, Islamabad, Pakistan. KhanR@unaids.org.
authors.forename: Rajwal
authors.initials: R
authors.lastname: Khan
authors.affiliation: UNAIDS Country Office for Pakistan & Afghanistan, Level-5, Serena Business Complex, Khyaban-e-Suhrwardy, Islamabad, Pakistan. sabam@unaids.org.
authors.forename: Marc
authors.initials: M
authors.lastname: Saba
mesh_terms: D015897:Comorbidity; D003376:Counseling / Q000706:statistics & numerical data; D058872:Epidemics / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D040261:Harm Reduction; D006801:Humans; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data; D010154:Pakistan / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*