• Investigative results shared with the Ministry of National Health Services.
• The incidence of HIV among Pwid dropped drastically to 27 %.
• There is an urgent need to increase access to condoms, promoting the use of it.

Islamabad: Human Immune Fund Virus (HIV) has spread rapidly among specific populations including female sex workers (FSWs), men who have sex with men (MSM) and transgender (TGs) due to unprotected sex and limited access to Preventive measures.

A report presented by Integrated Biological and Behavioral Surveillance (IBBS )’s sixth round showed development and worrying trends in HIV outbreaks in Pakistan, The news reported.

The first results of the study were shared with the Ministry of National Health Services, Regulations and Coordination on Tuesday. The study was conducted by the Health Services Academy (HSA) in collaboration with the Progressive Development Initiative (PDI), the UK, HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance (HIVHUB), Iran, Iran, almost ten years after the last round.

The results show a mixed image showing the effectiveness of injury reduction programs for people injecting drugs (PWID) and the increasing incidence of HIV in sexual networks, which acts as a link between important groups and the general public.

While MSM reports HIV prevalence of 7%, up from 5.6% in the latest study, prevalence among TGs has risen to 10%, up from 7.2% in 2016. The prevalence among FSWs has also risen from 2.2 % in 2016 to 3.8 % currently. The incidence of HIV among Pwid, on the other hand, has drastically decreased from 38.4 % in 2016 to 27 %, thanks to injury reduction initiatives and a step towards non-incisable drug use, such as ice or methamphetamine.

The HIV Prevest Percentage of 4.7 % among inmates-a population assessed for the first time in IBBS-is among the most alarming results. In the Prison and Probation Service, overcrowding, unavailability of condoms and untreated drug use all to the spread of HIV among this signed demographic.

One of the largest studies to date to measure HIV prevalence in Pakistan, IBB’s round 6 investigated and tested 28,377 people, including 6,500 PWID, 7,606 MSM, 6,670 FSWs, 7,601 TGs and 5,000 inmates.

The study was conducted across 31 districts, which ensured broad geographical representation, including Karachi, Lahore, Islamabad, Peshawar, Quetta, Faisalabad, Multan, Sukkur, Hyderabad, Jacobabad, Larkana, Rawalpindi, Gujranwala and Gujrat.

The results highlight significant barriers to condom use among TGs, MSMs and FSWs. While over 50 % of TGs and MSM reported on the use of a condom, there are still shortcomings in consistent use, especially during high -risk meetings. Among FSWs, condom use at about 40 %remains, hindered by limited availability of female condoms, client rejection and stigma associated with carrying or requesting condoms.

These holes emphasize the urgent need for targeted interventions to increase access to condoms and promote their consistent use. Damage reduction efforts for Pwid have shown success, with increased accessibility of needle exchange programs in both public and private sectors, contributing to the decline in the HIV prevalence within this group. However, challenges such as uncertain injection practices, stigma and substance abuse continue to pose risks.

The involvement of prisoners as a vulnerable population of IBBS has for the first time shed light on the vulnerability of prisoners.

The results emphasize the urgent need for extensive HIV prevention, testing and treatment services within the Prison and Probation Service.

The comparative analysis with 2016 data reflects a mixed result. While the falling prevalence among Pwid means progress, the rising rates reveal among TGs, MSM and FSWs serious gaps in prevention strategies. These canyons are further aggravated by stigmatization, discrimination and limited outreach efforts that prevent access to care and protection measures for these populations.

The report also highlights educational differences among key populations. A significant part of TGs, MSM and FSWs lack secondary education, limiting their awareness of HIV prevention and protective measures. Among Pwid, the level of education is even lower, with many are completely illiterate. The study also assessed prisoners and revealed that while some had completed elementary school or secondary education, many widespread knowledge of HIV prevention lacked.

The IBBS study also evaluated other vulnerable population groups, such as truck drivers, migrant workers and street children whose high mobility, low condom use and limited reach make them particularly vulnerable to HIV. These groups require focused interventions to address their specific risk factors.

The study also highlights a critical overview: the lack of focus on HIV transmission through weak infection prevention and control measures in health environments.

Previous outbreaks, such as the devastating Rato Dero outbreak in 2019, emphasize the role that uncertain medical practice plays in the spread of the virus. Future HIV prevention strategies must incorporate robust infection control protocols to mitigate these risks.