Breaking Taboos: Can Pakistan stop social ostracism of HIV patients?




It was the dawn of the 1990s and a disease was sending shockwaves around the world on the wings of highly publicised pictures of an emaciated Arthur Ashe or a Freddie Mercury. It was called AIDS – Acquired Immunodeficiency Syndrome. The list of celebrity victims gave AIDS almost as much shock value as the mode of transmission – through blood and blood products and therefore through unprotected sex. It is a different matter that years later, the rate of sexual transmission of HIV/AIDS has been established to be far less than other means like infected syringes and blood transfusion. Aside from being spotlighted to some extent every year on Dec 1, World AIDS Day, HIV/AIDS barely registers a blip on the radar in Pakistan. This newspaper yesterday carried a notice placed by the Sindh government’s health department about its Enhanced HIV/AIDS Control Programme which was fairly informative and mercifully devoid of the overt political self-aggrandisement that such communiqués are wont to display. The facts contained therein indicate that some progress is being made in the province where HIV/AIDS is concerned. Facilities for care and treatment are available in five major hospitals, four in Karachi and one in Larkana; nearly 25,000 jail inmates — a high-risk group — have been screened for the disease, out of whom 235 were found to be HIV positive; and steps to control mother-child transmission of the virus are bearing fruit. However, it is in the fine print that one finds cause for concern. For while the notice puts the total number of HIV/AIDS cases in the province at 9,107 — including 235 AIDS cases — it also says that the total is “approximated” to be 42,000 cases “as many go unreported”. One can only imagine what actual figures for the entire country could be. Such underreporting is not surprising: HIV/AIDS is not only a battle against a deadly virus but also against social stigma, because its transmission is entirely — and incorrectly — associated with sexual mores that are frowned upon in this conservative society. Such ignorance and lack of compassion can only be fought through a sustained awareness-raising campaign in the mass media. According to WHO’s guiding principles, HIV testing must be voluntary, and that can only take place in an environment where the disease does not evoke revulsion and lead to social ostracism of those infected.