Revitalizing the HIV Response in Pakistan

Pakistan has made strides over the last decade in its Acquired Immunodeficiency Syndrome (AIDS) response, with active surveillance, considerable research, both governmental and non?governmental prevention and care activities, and treatment since 2005 to 2006. However, the Human Immunodeficiency Virus (HIV) prevalence among People Who Inject Drugs (PWID) has not declined, coverage of current prevention and treatment programs remains limited and the gains made to date are threatened by internal and external factors. This report attempts to review and synthesize available data on HIV in Pakistan and to use these data to suggest strategic priorities for the next phase of the HIV response in an effort to improve the allocative efficiency of resources and effective and efficient implementation of the response. This report presents an integrated model for HIV services delivery that depicts a continuum of care from prevention outreach to treatment with a focus on evidence based interventions and strong linkages. It describes three potential models for Volunteer Counseling and Testing (VCT) services for most at risk populations that increase outreach and engagement with PWID, hijra communities, and Male Sex Workers (MSWs), and their clients. It also places heavy emphasis on evidence based approaches to prevention including expanding treatment for High Risk Groups (HRGs) and improving the linkages for HIV positive and HIV negative PWID for drug treatment services, such as Methadone Maintenance Therapy (MMT), and outlines the steps for an evidenced based, effective and efficient policy response at a time of shrinking resources for HIV in overall low prevalence settings. This report is organized as follows: chapter one gives introduction; chapter two presents epidemiology methods; chapter three gives country context; chapter four presents status of HIV epidemic; chapter five gives summary of key findings; chapter six deals with systems response to HIV and AIDS in Pakistan; chapter seven gives key policy recommendations; and chapter eight gives conclusion.

Bibliographic Details

Main Authors:	Beyrer, Chris, Singh, Sonal, Ambrosio, Marco, Semini, Iris
Format:	Report biblioteca
Language:	English en_US
Published:	World Bank, Washington, DC 2012-11
Subjects:	ADDICTION, ADULT LITERACY, ADULT PREVALENCE, AIDS PROGRAMS, ANAL SEX, ANTENATAL VISITS, ANTIBODIES, ARMED CONFLICT, AT RISK GROUPS, BASIC HEALTH, BEHAVIOR CHANGE, BLOOD DONORS, BLOOD PRODUCTS, BLOOD SUPPLY, BLOOD TRANSFUSIONS, BOTH SEXES, CIRCUMCISION, CIVIL CONFLICT, CIVIL RIGHTS, CLINICS, COHORT STUDIES, COMMERCIAL SEX, COMMERCIAL SEX WORK, COMMERCIAL SEX WORKERS, COMMUNITY PARTICIPATION, CONDOM, CONDOM AVAILABILITY, CONDOM USE, CONDOMS, COST EFFECTIVENESS, CRIME, DEMOGRAPHIC TRANSITION, DEVELOPING COUNTRIES, DISASTERS, DISEASE, DISEASE OUTBREAKS, DOCTOR, DOCTORS, DRUG ABUSE, DRUG DEPENDENCE, DRUG OF CHOICE, DRUG TRAFFICKING, DRUG TREATMENT, DRUG USE, DRUGS, EFFECTIVE PREVENTION, EMERGENCIES, EPIDEMIC, EPIDEMICS, EPIDEMIOLOGIC TRENDS, EPIDEMIOLOGY, FAMILIES, FEMALE, FEMALE SEX WORKERS, FEMALES, FERTILITY, FERTILITY RATE, FEWER PEOPLE, GENDER, GENDER GAP, GENDER GAP IN LITERACY, GENDER IDENTITY, GENDER INEQUITIES, GENDER ROLES, GLOBAL HIV/AIDS, HARM REDUCTION, HEALTH CARE PROFESSIONALS, HEALTH INDICATORS, HEALTH PROFESSIONALS, HEALTH SECTOR, HEALTH SERVICES, HEALTH SYSTEM, HEPATITIS, HEPATITIS B, HEPATITIS B SURFACE ANTIGEN, HEPATITIS C, HEROIN USE, HIGH RISK GROUPS, HIV, HIV INFECTION, HIV INFECTION RATES, HIV INFECTIONS, HIV POSITIVE, HIV PREVENTION, HIV PREVENTION INTERVENTIONS, HIV TESTING, HIV TRANSMISSION, HIV/AIDS, HOSPITAL, HOSPITALIZATION, HOSPITALS, HUMAN DEVELOPMENT, HUMAN RIGHTS, HUMANITARIAN CRISES, INFECTION RATES, INFECTIOUS DISEASE, INJECTING DRUG USE, INJECTION DRUG, INJECTION DRUG USE, INTERCOURSE, INTERVENTION, LARGE CITIES, LAWS, LEVELS OF CONDOM USE, LEVELS OF EDUCATION, LIFE EXPECTANCY, LIVE BIRTHS, LOW PREVALENCE, MALE CIRCUMCISION, MALE SEX, MALE SEX WORKERS, MATERNAL MORTALITY, MATERNAL MORTALITY RATE, MEDICAL SCIENCES, METHADONE, MIGRANT, MIGRANT WORKERS, MIGRANTS, MIGRATION, MINISTRY OF HEALTH, MINORITY, MORTALITY, NATIONAL AIDS, NATIONAL AIDS CONTROL, NATIONAL POLICY, NATIONAL SURVEILLANCE, NATURAL DISASTERS, NEEDLE SHARING, NEW INFECTIONS, NUMBER OF ADULTS, NUMBER OF CHILDREN, NUMBER OF WOMEN, NURSES, PATIENTS, PHARMACEUTICALS, PHARMACISTS, POLICY RESPONSE, POLITICAL INSTABILITY, POPULATION REFERENCE BUREAU, POPULATION SIZE, POPULOUS COUNTRY, PRACTITIONERS, PREGNANT WOMEN, PREVALENCE, PREVALENCE RATE, PREVALENCE RATES, PREVENTION EDUCATION, PREVENTION INTERVENTIONS, PRIMARY HEALTH CARE, PRIMARY HEALTH CARE SYSTEM, PRISONS, PROGRESS, PUBLIC HEALTH, PUBLIC HOSPITALS, PUBLIC LIFE, RANDOMIZED CONTROLLED TRIALS, RATE OF CONDOM USE, RATES OF INFECTION, REFUGEES, REMITTANCES, REPRODUCTIVE LIFE, REPRODUCTIVE RIGHTS, RESOURCE ALLOCATIONS, RESPECT, RISK BEHAVIOR, RISK BEHAVIORS, RISK EXPOSURE, RISK FACTORS, RISK GROUPS, RISK POPULATIONS, RISK REDUCTION, RURAL AREAS, RURAL POPULATIONS, SCREENING, SERVICE DELIVERY, SERVICE PROVIDERS, SERVICE UTILIZATION, SEX, SEX BEHAVIOR, SEX WITH MEN, SEX WORK, SEX WORKER, SEX WORKERS, SEXUAL ACTIVITY, SEXUAL ENCOUNTERS, SEXUAL NETWORKS, SEXUAL PARTNERS, SEXUALLY TRANSMITTED INFECTION, SKILLED ATTENDANT, SOCIAL SUPPORT, SPECIALIST, STD, STIS, STRATEGIC PRIORITIES, STREET OUTREACH, SURVEILLANCE DATA, SURVEILLANCE PROJECT, SYPHILIS, SYRINGES, TB, THERAPY, TREATMENT, TREATMENT SERVICES, TUBERCULOSIS, UNAIDS, UNFPA, UNITED NATIONS POPULATION FUND, URBAN AREAS, URBAN CENTERS, URBANIZATION, VAGINAL INTERCOURSE, VIOLENCE, VIRAL LOAD, VIRUS, VOLUNTARY COUNSELING, VULNERABILITY, WOMAN,
Online Access:	http://documents.worldbank.org/curated/en/989991468145474026/Revitalizing-the-HIV-response-in-Pakistan-a-systematic-review-and-policy-recommendations-synthesis-report https://hdl.handle.net/10986/27222
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