Writing about Acquired Immune Deficiency Syndrome (AIDS) reminds me of the kind of physical environment there used to be behind my school: the footpaths there were, and probably still are, home to heroin addicts. In the hidden crevices offered by electricity poles, they would share needles – one form of transmission of the Human Immunodeficiency Virus (HIV) that causes AIDS. On World AIDS day, it is essential that we talk about what the situation in Pakistan is. In April this year, it was reported that there are approximately 133, 299 HIV positive people in the country, while the total number of registered people in December 2016 was 18, 440.
Injected drug users (IDUs) and sex workers are at the highest risk of contracting this disease. The former transfer it to their spouse, and may potentially carry it on to their unborn child. Unsafe blood transfusion, reliance on quacks for dental treatment and other medical issues are other causes of this disease. However, beyond these bare facts lies a larger issue – that of the stigma faced by victims of AIDS and the kind of narrative built around them.
Once diagnosed, they are shunned by their family members. In Pakistan, HIV is largely associated with death and people commonly think it transmitted through sex or drug use. It is considered the responsibility of the victim or a moral fault if someone gets infected. Stigma leads to the victim concealing their disease, and they are thus prevented from getting proper treatment, even though medical care at the initial stage can prolong someone’s life by 20 to 25 years.
People are quick to distance themselves from those who test HIV positive and fall prey to AIDS. Injected drug users who are HIV positive can transmit their disease to their female spouse. These women are maligned and their children are taken away from them. This shows the kind of misperceptions that people have about the transmission of this disease. The virus is never transmitted by sharing the same water or space, not through saliva, sweat, tears, nor by insects or pets, and not by sharing toilets, food or drinks.
In Pakistan, the khwaja sira community suffers because of the way this disease is brushed under the carpet. More than 90 percent of the sex workers from this community do not use protection. Or rather, it should be said that they cannot use protection because they live on the fringes of a society where their work earns them money only sufficient for their daily needs. Even young boys who are employed as labour fall prey to this disease because sexual abuse and child labour are rarely ever talked about.
A little research on the prevalence of this disease in Pakistan shows the kind of narratives built around it. Articles written on HIV and AIDS highlight them as a disease of the poor and sex workers, subtly laying blame on them for not speaking out or seeking help. They rarely speak about the other multiple ways of transmission, for instance how quacks are also to be blamed. They highlight the “plight” of victims, but don’t raise awareness about how and where they can get help. For this, more community-based programmes are required where every person gets educated about the virus and the syndrome, rather than “development” agencies such as USAID or the UN imposing their discourse about it. We all need to play our part in creating awareness and solutions so that we can end the stigma and prevalence of AIDS.