Inter Press Service - April 16, 2001
Nadeem Iqbal
ISLAMABAD, Apr 16, (IPS) - Sexual activity between men is increasingly spreading HIV in Pakistan with the national AIDS control programme unable to clearly convey the safe sex message, say health activists.
A survey by the National Aids Programme and the United Nations Programme on HIV/AIDS (UNAIDS) found that men make up more than 87 percent of HIV positive people in the South Asian nation.
Though the study shows that homosexual activity accounts for only two percent of cases, it adds that this is common in large areas of the country.
According to Masroor Gillani, a researcher with the Society for the Protection of the Rights of Child, both government and society have been slow in admitting widespread male homosexuality and child sexual abuse.
This has been encouraged by rigid Islamic social segregation enforced in the early 1980s by the then military rulers of the country, who imposed curbs on free mixing of unmarried men and women in public areas.
Boy are victims of an estimated 55 percent reported cases of child sexual abuse, says Gillani.
Another UNAIDS study of truck drivers in the country, who are considered a 'high-risk group', found less than three percent using condoms.
Some 93 percent of those quizzed for the survey knew that unprotected sex was the reason for HIV transmission, but believed that it was the sex workers and not themselves, who were at risk.
However, many truck drivers are known to engage in homosexual activity with young boys who travel with them as helpers, say health activists. Despite official denials, newspapers often report that male inmates of prisons too engage in such behaviour.
According to independent surveys, 85 percent of sexually active prisoners reported not using condoms. Many of these prisoners are also addicted to injectable drugs, sharing syringes and needles.
Male homosexuality in Pakistan is mainly associated with the Islamic nation's most conservative region -- the North West Frontier Province (NWFP) bordering Afghanistan, where rich, elderly men are known to keep young boys for sexual pleasure.
A study in the year 1997 by the National Coalition for Child Rights found that 23 percent of NWFP people consider paedophilia a matter of pride, 14 percent see it as a symbol of social status and another 11 percent do not consider it wrong.
Though strictly forbidden by Islam, male homosexuality is socially tolerated in parts of the country.
Male sex workers in the country are mainly transvestites who are at greater risk than women sex workers, say health activists. The former do not work out of brothels, but use small roadside hotels and massage centres.
However, the government's AIDS prevention and control programme is unable to carry out an appropriate mass awareness campaign because of social and religious taboos.
Advertising industry professional Rizwana Asad, long associated with AIDS awareness campaigns, says that initially authorities were reluctant to even use the electronic and print media for this.
It was only in the year 1993 that the government allowed the use of electronic media to spread the HIV/AIDS message.
"But still the advertisers are not allowed to use words like sex and condoms in the ads so they are only left with propagating fidelity to one's wife as a deterrence against HIV," she told IPS.
There are an estimated four million television sets in the country. More men than women watch television or listen to radio.
According to the national AIDS control programme, there are some 1,500 HIV positive people in the country. A total of 198 AIDS cases have been reported since the first was detected in the year 1987.
Health activists, however, say these figures do not reflect the actual situation. They cite estimates by the World Health Organisation (WHO) that for every reported case, there are actually between 100 to 5,000 HIV positive people.
Vulnerability to HIV has been increased by the high rate of prevalence of other sexually transmitted diseases (STDs), high levels of homosexual activity and inadequate screening of blood used for transfusion, they add.
Birjees Mazher, director of the national AIDS programme says it is concentrating on information/education, prevention, surveillance and safe blood supply.
The government has earmarked an annual sum of 80 million rupees (1.4 million U.S. dollars) for AIDS prevention, including screening of 150,000 blood bags. (END/IPS/ap-he/ni/mu/01)
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