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Patterns and trends in Pakistan's heterogeneous HIV epidemic.

Reza T, Melesse DY, Shafer LA, Salim M, Altaf A, Sonia A, Jayaraman GC, Emmanuel F, Thompson LH, Blanchard JF - Sex Transm Infect (2013)

Bottom Line: Projection suggests the prevalence may reach as high as 65-75% among IDUs in Faisalabad by 2025.HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana.There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

View Article: PubMed Central - PubMed

Affiliation: Canada-Pakistan HIV/AIDS Surveillance Project, , Islamabad, Pakistan.

ABSTRACT

Background: Considerable HIV transmission occurs among injection drug users (IDUs) in Pakistan and recently the HIV prevalence has been increasing among male (MSW), hijra (transgender; HSW) and female (FSW) sex workers. We describe past and estimate future patterns of HIV emergence among these populations in several cities in Pakistan.

Methods: The density of these key populations per 1000 adult men was calculated using 2011 mapping data from Karachi, Lahore, Faisalabad, Larkana, Peshawar and Quetta, and surveillance data were used to assess bridging between these key populations. We used the UNAIDS Estimation and Projection Package model to estimate and project HIV epidemics among these key populations in Karachi, Lahore, Faisalabad and Larkana.

Results: The density and bridging of key populations varied across cities. Lahore had the largest FSW population (11.5/1000 adult men) and the smallest IDU population (1.7/1000 adult men). Quetta had the most sexual and drug injection bridging between sex workers and IDUs (6.7%, 7.0% and 3.8% of FSW, MSW and HSW, respectively, reported injecting drugs). Model evidence suggests that by 2015 HIV prevalence is likely to reach 17-22% among MSWs/HSWs in Karachi, 44-49% among IDUs in Lahore and 46-66% among IDUs in Karachi. Projection suggests the prevalence may reach as high as 65-75% among IDUs in Faisalabad by 2025. HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana.

Conclusions: There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

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Related in: MedlinePlus

Injection drug user (IDU), female sex workers (FSWs) and combined male sex workers (MSWs)/hijra (transgender) sex workers (HSWs) population per 1000 adult men in six cities in Pakistan in 2011.
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SEXTRANS2012050872F1: Injection drug user (IDU), female sex workers (FSWs) and combined male sex workers (MSWs)/hijra (transgender) sex workers (HSWs) population per 1000 adult men in six cities in Pakistan in 2011.

Mentions: The density of each population group per 1000 adult men varies considerably across cities (figure 1). The MSW/HSW population density is smallest in Peshawar and largest in Larkana (1.8 and 12.4 per 1000 adult men). The FSW population density is smallest in Peshawar and largest in Lahore (4.2 and 11.5 per 1000 adult men). Lahore has the smallest IDU population density and Faisalabad the largest (1.7 and 8.1 per 1000 adult men). Karachi is a very large city and has the largest population size of all groups, particularly FSWs (estimated 25 399 individuals) and IDUs (estimated 16 544 individuals) (figure 2).


Patterns and trends in Pakistan's heterogeneous HIV epidemic.

Reza T, Melesse DY, Shafer LA, Salim M, Altaf A, Sonia A, Jayaraman GC, Emmanuel F, Thompson LH, Blanchard JF - Sex Transm Infect (2013)

Injection drug user (IDU), female sex workers (FSWs) and combined male sex workers (MSWs)/hijra (transgender) sex workers (HSWs) population per 1000 adult men in six cities in Pakistan in 2011.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756441&req=5

SEXTRANS2012050872F1: Injection drug user (IDU), female sex workers (FSWs) and combined male sex workers (MSWs)/hijra (transgender) sex workers (HSWs) population per 1000 adult men in six cities in Pakistan in 2011.
Mentions: The density of each population group per 1000 adult men varies considerably across cities (figure 1). The MSW/HSW population density is smallest in Peshawar and largest in Larkana (1.8 and 12.4 per 1000 adult men). The FSW population density is smallest in Peshawar and largest in Lahore (4.2 and 11.5 per 1000 adult men). Lahore has the smallest IDU population density and Faisalabad the largest (1.7 and 8.1 per 1000 adult men). Karachi is a very large city and has the largest population size of all groups, particularly FSWs (estimated 25 399 individuals) and IDUs (estimated 16 544 individuals) (figure 2).

Bottom Line: Projection suggests the prevalence may reach as high as 65-75% among IDUs in Faisalabad by 2025.HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana.There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

View Article: PubMed Central - PubMed

Affiliation: Canada-Pakistan HIV/AIDS Surveillance Project, , Islamabad, Pakistan.

ABSTRACT

Background: Considerable HIV transmission occurs among injection drug users (IDUs) in Pakistan and recently the HIV prevalence has been increasing among male (MSW), hijra (transgender; HSW) and female (FSW) sex workers. We describe past and estimate future patterns of HIV emergence among these populations in several cities in Pakistan.

Methods: The density of these key populations per 1000 adult men was calculated using 2011 mapping data from Karachi, Lahore, Faisalabad, Larkana, Peshawar and Quetta, and surveillance data were used to assess bridging between these key populations. We used the UNAIDS Estimation and Projection Package model to estimate and project HIV epidemics among these key populations in Karachi, Lahore, Faisalabad and Larkana.

Results: The density and bridging of key populations varied across cities. Lahore had the largest FSW population (11.5/1000 adult men) and the smallest IDU population (1.7/1000 adult men). Quetta had the most sexual and drug injection bridging between sex workers and IDUs (6.7%, 7.0% and 3.8% of FSW, MSW and HSW, respectively, reported injecting drugs). Model evidence suggests that by 2015 HIV prevalence is likely to reach 17-22% among MSWs/HSWs in Karachi, 44-49% among IDUs in Lahore and 46-66% among IDUs in Karachi. Projection suggests the prevalence may reach as high as 65-75% among IDUs in Faisalabad by 2025. HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana.

Conclusions: There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

Show MeSH
Related in: MedlinePlus