There is an alarming surge in HIV/AIDS cases among injecting drug users (IDUs) in Pakistan, the Canadian International Development Agency (CIDA) says.
HIV/AIDS prevalence among IDUs in the country averages 36.7 percent, according to the report of the CIDA-funded HIV/AIDS Surveillance Project (HASP).
According to the findings of the project's survey, in some cities of the Punjab province, the number of HIV/AIDS infected IDUs was as high as 52.5 percent followed by 42.5 percent in Sindh province, Xinhua reported.
The results of the survey showed a steady increase in HIV/AIDS among IDUs in the aftermath of the cancellation of the one billion rupee World Bank-financed risk reduction project in Punjab's eight cities by the then provincial health secretary in April 2010.
Under the project, the IDUs used to be provided with new syringes in exchange of the old ones to minimise risk of transmitting the disease to others.
The termination of the contract by the Punjab government came after it demanded the service providing organisation disclose the identity of its beneficiaries in violation of the agreement's confidentiality clause.
This resulted in stoppage of services to over 14,000 individuals and families in Punjab and an additional 6,000 individuals in Sindh.
The provincial government had apparently planned to put in place an alternative service delivery system but this could not happen, forcing the IDUs to exchange used needles.
There are an estimated 125,000 IDUs in the country. Half of them are estimated to be married.
According to official statistics by Pakistan National AIDS Control Programme, there are over 80,000 people suffering from HIV/AIDS across Pakistan.
The Canadian report also said that Karachi holds the unenviable statistic of housing the largest number of female sex workers in Pakistan, which stands at 25,399 and is closely followed by Lahore that has a total of 23,766.
At the same time, 19,115 male sex workers, who provide services to male clients, live in Pakistan. They are spread over 3,706 spots in 14 cities of the country.
Experts associated with HIV/AIDS control in Pakistan are alarmed at the statistics, which indicate a growing number of male sex workers along with an increased prevalence of HIV/AIDS in female sexual workers.
According to the survey, there are some 89,178 female sex workers in 14 cities. Meanwhile, based on calculations, there are 7.2 female sex workers for every 1,000 men.
The survey also found that over 23,000 transvestite sex workers were offering services in 14 cities of the country. In addition to them, the mapped study also said that approximately 3,594 gurus, mentors of these sex workers, were operating in these cities.
There are some 1.9 transvestites for every 1,000 men. In Sukkur and Multan, the ratio is higher as for every 1,000 adult males in these two cities, as there are 6.9 and 3.4 transvestites, respectively. Larkana, Mirpurkhas and Quetta have about three such sex workers for every 1,000 men.
The surveyors calculated 1.6 male sex workers for every 1,000 men living in the mapped cities, while their numbers in Punjab’s cities were significantly lower. Only Faisalabad and Sargodha showed more than one male sex worker for every 1,000 men. Sindh and KPK (Khyber Pakhtunkhawa) also showed lower numbers with 1.9 and 1.7 such workers for every 1,000 men, respectively.
The study identified that some female workers operated their business from home, some from Kothikhanas, others from brothels or streets while some would use cell phones to contact their clients. A middleman mostly mediates between the sex worker and the client.
The survey showed that each middleman directly controlled an average of 5.2 female workers.
Two major types of transvestites are home-based and Dera-based. Although every transvestite is associated with a guru and a Dera, nearly 6,885 of them were found living in homes (often with families) and only visited Deras to socialise with community members or find work.
A much larger number of them -- 16,433 — were living in Deras. Their community is strongly linked in most cities and each guru knows several others. This is especially likely in Punjab’s cities. In Lahore, for example, one guru knew 20 others within the city and was in contact with 34 Deras.
The survey found that male sex workers were quite thinly distributed in all the cities. These spots, often referred to as “pick-up points’ or ‘cruising sites’, are specific locations where these sex workers solicit clients. Some 5.2 male sex workers were found operating at each point.
Recent improvements in communication technology, especially the availability of cell phones, have revolutionised the sex industry in Pakistan. Sex workers now interact with clients via cell phones, without having to stand on streets to find clients or involving network.