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Ann Med Surg (Lond)
Ann Med Surg (Lond)
MS9
Annals of Medicine and Surgery
2049-0801
Lippincott Williams & Wilkins Hagerstown, MD

AMSU-D-24-01127
10.1097/MS9.0000000000002400
00009
3
Editorials
Concerns regarding the alarming surge in HIV/AIDS cases in Pakistan
Qazi Tariq Siraj PhD atariq.anjum40@gmail.com

Ying Zhang PhD bcoco90305@126.com

Xiao Yuanyuan PhD a*1471115621@qq.com

Ali Tooba MBBS dtoobaali455@gmail.com

Haque Md Ariful MBBS, MD, MPH cgh*arifulhaque58@gmail.com

Shahzad Kamran BSN ehshehzadkamran22@gmail.com

Khan Taimur BSN fhKhantaimour442@gmail.com

Shah Aftab Ali BSN fhtaimourkhan878@gmail.com

a Department of Public Health, Kunming Medical University
b Nursing School of Kunming Medical University
c Department of Orthopedic Surgery, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
d Dow University of Health Sciences, Mission Road, Karachi
e Ayub Teaching Hospital, Abbottabad
f Ayub Medical Complex, Khyber Pakhtunkhwa, Pakistan
g Department of Public Health, Atish Dipankar University of Science and Technology
h Voice of Doctors Research School, Dhaka, Bangladesh
* Corresponding authors. Address: Atish Dipankar University of Science and Technology, Dhaka 650500, Bangladesh. Tel.: +88 018 947 737 47. E-mail: arifulhaque58@gmail.com (Md Ariful Haque), and Tel.: +86 180 884 781 83. E-mail: 1471115621@qq.com (Y. Xiao).
9 2024
23 7 2024
86 9 49634965
4 6 2024
14 7 2024
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

OPEN-ACCESSTRUE
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pmcAround 15 million people die each year worldwide from infectious diseases caused by a variety of microorganisms. The most common causes of death are acute respiratory infections (ARCIs) and HIV1. Over the past four decades, the global impact of the HIV has become increasingly significant. Researchers have delved into the pathology of HIV, investigating aspects such as its causation, development, morphological transformations, and biochemical implications aimed at mitigating the immunosuppressive effects it induces. HIV, belonging to the Lentivirus genus, comprises HIV-1 and HIV-22,3. While both types share fundamental structures, including three structural genes (gag, pol, and env), they differ in the organization of their genetic material. Both HIV-1 and HIV-2 infect immune system cells, leading to changes in immune responses that extend to regional lymph nodes and the bloodstream4,5.

In 1987, Pakistan witnessed its first recorded case of HIV, stemming from an unsafe blood transfusion. In the subsequent two decades, Pakistan has documented a comparatively modest count of domestically contracted HIV cases in contrast to its neighboring nations6. The primary occurrence of HIV among injection drug users surfaced in 2004 in isolated areas of Larkana, situated in the Sindh province, signifying Pakistan’s initial HIV outbreak7. Notably, within the Asia-Pacific region, Pakistan ranks second-highest in terms of AIDS prevalence8. However, a careful analysis of recent data from the HIV/AIDS data Hub for Asia Pacific’s 2021 fact sheet reveals that Pakistan is grappling with an estimated 210 000 individuals living with HIV. Among them, 41 000 are women, and 170 000 are men, all aged 15 years and older4.

Additionally, the statistics shows that HIV affects 4600 children under the age of 15 in the country. These figures underscore the significance of targeted interventions and public health initiatives to address the diverse demographics affected by HIV in Pakistan. It has become evident that there is a dramatic escalation in the incidence of HIV/AIDS in Pakistan. According to the National Health Survey as of August 2018, Pakistan had 0.15 million HIV patients, out of which 48% were from Punjab, 38.7% from Sindh, 10% from Khyber Pakhtunkhwa, and 3.3% from Baluchistan9.

The National AIDS Control Program Pakistan reports a staggering 21 344 registered HIV/AIDS patients in Sindh, with 10 592 cases in Karachi alone. Two thousand four hundred seventy are children, highlighting the critical need for awareness-raising and assistance10. This surge necessitates urgent attention from the scientific and public health communities as well as policymakers. Several factors may contribute to this alarming trend, including but not limited to inadequate awareness and education, limited access to preventive measures, such as condoms, the stigma associated with testing, and challenges in healthcare infrastructure. To illustrate, an examination of condom prices in Pakistan reveals that they can pose a significant financial burden for many individuals, especially when compared to the average income in the Pakistani household. For instance, the average cost of condoms in Pakistan varies from 100 to 1500 rupees, whereas the average monthly household income stands at Rs 10 00011. This striking comparison underscores the financial obstacles that limit access to these preventative interventions. Although meeting the needs of diverse populations in healthcare is an issue that affects all nations, low- and middle-income nations confront particular difficulties.

Further research is necessary on how often empirical treatment is used in low- and middle-income countries. This is influenced by factors such as a high patient load a shortage of medical professionals, diagnostic tools, and medications12. To develop targeted interventions that address the root causes, we must thoroughly examine these factors.

Additionally, there is a pressing need for increased research and surveillance to understand the dynamics of HIV/AIDS transmission in different regions of Pakistan. This understanding is crucial for tailoring effective prevention and intervention strategies. Therefore, it is proposed that medical professionals play a pivotal role in fostering awareness and initiating dialog on this issue, such as through community education. Implement thorough community programs for accurate HIV/AIDS information, transmission details, and preventive measures. School integration: Include HIV/AIDS education in school curricula for younger demographics, promoting empathy and understanding. Media campaigns: Launch targeted campaigns on TV, radio, and social media to dispel myths, reduce stigma, and encourage testing. Healthcare training: Conduct programs to enhance healthcare professionals’ HIV/AIDS knowledge for accurate information, testing, and counseling. Community engagement events: Organize workshops, seminars, and town halls for open discussions, correcting misconceptions, and fostering support. Celeb advocacy: Leverage public figures for HIV/AIDS awareness, reducing stigma, and reaching diverse audiences. Support groups: Establish safe spaces for individuals and families affected by HIV/AIDS to share experiences and address challenges. Testing centers: Ensure accessible and confidential testing centers to encourage regular testing and early diagnosis. NGO collaborations: Partner with NGOs specializing in HIV/AIDS for expertise and community outreach. Policy advocacy: Advocate for policies supporting comprehensive sex education, healthcare access, and anti-discrimination to foster HIV/AIDS awareness.

Additionally, it is imperative to highlight the effectiveness of implementing HIV/AIDS education programs based on successful outcomes observed in other countries. Multiple research reports have documented the positive impact of introducing comprehensive HIV/AIDS education initiatives. For instance, the implementation of school-based HIV/AIDS education programs in South Africa significantly reduced the number of new HIV infections among adolescents13. Similarly, another study in Kenya found that targeted media campaigns led to increased HIV testing rates and improved knowledge about HIV transmission and prevention methods14. These examples underscore the high probability that adopting similar options will be effective in Pakistan and contribute to mitigating the spread of HIV/AIDS.”

As the HIV/AIDS pandemic continues to worsen in Pakistan, it’s essential to stay up-to-date with the latest HIV research and vaccine developments. In the latest news, Moderna and IMIV announced the start of clinical trials for Africa’s first mRNA HIV vaccine15. A dedicated special issue or a series of articles could provide a platform for researchers, clinicians, and policymakers to share insights, data, and innovative solutions to curb the escalating HIV/AIDS crisis in our nation. Cost-sharing programs may result from cooperative efforts, including those of governmental bodies, charitable institutions, and pharmaceutical corporations16. A commitment to advancing public health discourse aligns with the significance of this matter. The possibility of contributing to a collaborative effort comprehensively addresses this public health challenge.

Ethical approval

Ethics approval was not required for this review.

Consent

Informed consent was not required for this editorial.

Source of funding

Authors have not received any funds.

Author contribution

All authors have equally contributed to the manuscript and have approved the final manuscript to be published.

Conflicts of interest disclosure

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Research registration unique identifying number (UIN)

None.

Guarantor

Tariq Siraj Qazi.

Data availability statement

Not applicable.

Provenance and peer review

Not commissioned, externally peer-reviewed.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
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References

1 Abusalah MAH Chopra H Sharma A . Nanovaccines: a game changing approach in the fight against infectious diseases. Biomedicine & Pharmacotherapy 2023;167 :115597.37783148
2 Aizaz M Abbas FA Abbas A . Alarming rise in HIV cases in Pakistan: challenges and future recommendations at hand. Health Sci Rep 2023;6 :e1450.37520460
3 Tolstoy I Kropinski AM Brister JR . Bacteriophage taxonomy: an evolving discipline. Bacteriophage Therapy: From Lab to Clinical Practice 2018:57–71.
4 Fanales-Belasio E Raimondo M Suligoi B . HIV virology and pathogenetic mechanisms of infection: a brief overview. Annali dellIstituto Superiore Di Sanità 2010;46 :5–14.
5 Asia-Pacific migration report 2020 : assessing implementation of the global compact for migration 2020. https://repository.unescap.org/handle/20.500.12870/380
6 Moir S Chun T-W Fauci AS . Pathogenic mechanisms of HIV disease. Annu Rev Pathol: Mech Dis 2011;6 :223–248.
7 Rai MA Warraich HJ Ali SH . HIV/AIDS in Pakistan: the battle begins. Retrovirology 2007;4 :22. 10.1186/1742-4690-4-22 17376244
8 Singh Manisha . An overview of HIV on world AIDS day: a short commentary. Int Healthcare Res J 2021;5 :SC1–SC2.
9 Hemelaar J Elangovan R Yun J . Global and regional epidemiology of HIV-1 recombinants in 1990–2015: a systematic review and global survey. Lancet HIV 2020;7 :e772–e781.33128904
10 Shah SA Altaf A Mujeeb SA . An outbreak of HIV infection among injection drug users in a small town in Pakistan: potential for national implications. Int J STD & AIDS 2004;15 :209 209.
11 Rehman A Shaikh BT Ronis KA . Health care seeking patterns and out of pocket payments for children under five years of age living in Katchi Abadis (slums), in Islamabad, Pakistan. Int J Equity Health 2014;13 :1–6.24383432
12 Ali T Habib A Nazir Z . Healthcare challenges in LMICs: addressing antibiotic resistance threats, a call for comprehensive global solutions: an editorial. Int J Surg 2024;110 :3085–3087.38748502
13 Gallant M Maticka-Tyndale E . School-based HIV prevention programmes for African youth. Soc Sci Med 2004;58 :1337–1351.14759680
14 Ross JD Scott GR . The association between HIV media campaigns and number of patients coming forward for HIV antibody testing. Sexually Transmitted Infect 1993;69 :193–195.
15 Chopra H Choudhary OP . mRNA vaccines as an armor to combat the infectious diseases. Travel Med Infect Dis 2023;52 :102550.36754340
16 Nazir Z Habib A Ali T . Milestone in infant health: unveiling the RSV vaccine’s shielding effect for newborns. Int J Surg 2024;110 :1836–1838.38100625
