The threat of HIV epidemic

Disturbing news has emerged regarding the prevalence of HIV in Pakistan. According to a UN report released on Monday, "new data suggests that the country could be on the verge of a serious HIV epidemic." Unfortunately, our health authorities have long been in a state of denial about the problem.
True, they have been placing periodic public awareness advertisements in the media, but these efforts have been of an inconsistent nature, not part of a well thought-out, comprehensive plan to stop the spread of the deadly disease that, we now learn, threatens to strike the country in epidemic proportions.
In fact, the report discloses that "a major epidemic has already been detected among injecting drug users in Karachi," and that "one in five sex workers cannot recognise a condom, and three quarters did not know that condoms prevented AIDS." Identifying the problem areas specific to Pakistan's context, the report says that a combination of risky behaviour and limited knowledge among drug addicts and sex workers favours the rapid spread of HIV.
Though the report does not mention it, but it is a well-known fact that most hospitals, including some of the expensive private sector hospitals, do not deem it necessary to carry out screening tests before blood transfusions. Patients needing blood transfusions, thus, are constantly exposed to the dangers of catching HIV and hepatitis viruses.
So far as the consequences of risky behaviour are concerned it is imperative that the awareness campaigns be carried out on a continual basis. Of course, religio-cultural taboos governing this society make it difficult to offer the needed information more openly. Even the word condom cannot be mentioned in the public awareness campaigns.
No wonder, many of the sex workers interviewed for the UN survey report had never heard before that condoms prevented AIDS. The report praises Thailand for the success it has achieved in bringing down, by 2003, the estimated national adult HIV prevalence to its lowest level ever, about 1.5 percent. This despite the fact that only 51 percent of the Thai sex workers reported using condoms. But then the two societies are completely different; what worked there cannot even be discussed in Pakistan.
Our peculiar situation places a major responsibility on the shoulders of the population planning department to inform more and more people about the use of condoms. Since the sex trade here is more discrete than in places like Bombay, where the incidence of HIV infection has already assumed epidemic proportions, it may not be easy for the government to reach out to the sex workers to provide the needed information.
Still, the level of awareness deficit that the UN report mentions is unacceptable. The government must take a fresh look at the issue and formulate a new strategy to increase awareness about preventive measures. The same should apply to drug addicts injecting drugs with used syringes. It must also take urgent notice of lack of blood screening facilities in hospitals, and ensure that no transfusions take place without tests for HIV virus. Hopefully, the government will treat the UN report as a strong warning, and take urgent action to avert an impending HIV epidemic.