Living With It!

“On World AIDS day the glob­al com­mu­ni­ty acknowl­edges HIV/AIDS as a larg­er issue for all human­i­ty and not just for peo­ple who are liv­ing with it. This is a day that high­lights the impor­tance of life with­out hate, fear, stig­ma and dis­crim­i­na­tion”, says Ali a young man liv­ing with HIV in Lahore. “The glob­al com­mu­ni­ty also acknowl­edges that HIV is not only a health issue, but more impor­tant­ly a human rights one”, he empha­sizes.

Each year World AIDS day is observed on Decem­ber 1st; to com­mem­o­rate the more than 39 mil­lion lives claimed by HIV/AIDS across the world. It is also a day for peo­ple world­wide to unite in the fight against HIV and to show their sup­port for peo­ple liv­ing with HIV. The first World AIDS Days was com­mem­o­rat­ed on Decem­ber 1st, 1988. This day also high­lights that in the fight against HIV there is urgent work that still needs to be done. For past sev­er­al years the inter­na­tion­al efforts to high­light HIV/AIDS aware­ness were focused on achiev­ing the com­mon goal of, “Get­ting to Zero: Zero new HIV infec­tions. Zero deaths from AIDS-relat­ed ill­ness. Zero dis­crim­i­na­tion.” But the rapid­ly dete­ri­o­rat­ing fund­ing for HIV pro­grams, ide­o­log­i­cal restric­tions on research efforts, improp­er pre­ven­tion tech­niques and end­less stig­ma and dis­crim­i­na­tion proved to be major road­blocks in the achieve­ment of Get­ting to Zero. Now in 2015, the dis­cus­sion around HIV is focused on “Think Pos­i­tive: Rethink HIV”. World Aids Day this year is all about get­ting peo­ple to rethink out­dat­ed stereo­types, declas­si­fy myths and be pos­i­tive about HIV.

In Pak­istan, an esti­mat­ed 94,000 peo­ple are liv­ing with HIV. But this num­ber could be much high­er as a lot of peo­ple in the coun­try do not have access to screen­ing ser­vices and are prob­a­bly liv­ing in igno­rance of their HIV sta­tus. “In the fight against HIV/AIDS in Pak­istan the biggest chal­lenge is that we have no data avail­able for peo­ple liv­ing with HIV/AIDS. All we have are esti­mates that do not rep­re­sent the full pic­ture, says Rah­man an activist asso­ci­at­ed with an NGO work­ing on aware­ness and pre­ven­tion of HIV/AIDS. “For our inter­ven­tion plans to be more effec­tive and effi­cient we need more research”, he adds fur­ther.
Accord­ing to the UNAIDS web­site for Pak­istan adults aged 15 and above are at an increased risk of get­ting the virus. More­over, the mor­tal­i­ty rate from HIV/AIDS in Pak­istan saw an increase of 11 % between 2000 and 2013. Dur­ing the same time peri­od rate of new HIV/AIDS infec­tions each year for Pak­istan was 15 %. This seems extreme­ly prob­lem­at­ic when we look at the glob­al trends for new infec­tions and mor­tal­i­ty which were declin­ing. A report pub­lished by the UN in 2013 also high­light­ed that new cas­es of HIV were on rise in Pak­istan mak­ing it one of the only two coun­tries in the world where rate of new HIV infec­tions is uncon­trolled and on the rise. Most of the pre­ven­tion efforts and Pub­lic AIDS con­trol pro­grams in the coun­try are tar­get­ed at Inject­ing Drug Users and sex work­ers in the coun­try. Pub­lic pre­ven­tion pro­grams have yet to include the gen­er­al pop­u­la­tion who if not more; than are at the same lev­el of risk as the sex work­ers. The HIV/AIDS nation­al sur­veys and pub­lic pre­ven­tion pro­grams pre­vi­ous­ly did not include males who have sex with males and trans­gen­der peo­ple who are uni­ver­sal­ly acknowl­edged as two high risk pop­u­la­tions. This was changed only this year when after much advo­ca­cy and delib­er­a­tion by com­mu­ni­ty activists these two groups were includ­ed in Nation­al AIDS Strat­e­gy lll. Because with­out includ­ing the key affect­ed pop­u­la­tions into their pre­ven­tion efforts the nation­al and provin­cial AIDS con­trol pro­grams can­not halt the spread of HIV in Pak­istan.

The trans­mis­sion of the HIV virus is tied to spe­cif­ic high-risk behav­iors and has noth­ing to do with a person’s sex­u­al ori­en­ta­tion. It is not uncom­mon for peo­ple to blame gen­der non-con­form­ing peo­ple for increased preva­lence rates of HIV in soci­ety, but the real cul­prit is the state-spon­sored homo­pho­bia and big­otry which dri­ve them under­ground. The oppressed are always blamed for their prob­lems by the oppres­sors. Soci­etal norms, dom­i­nant cul­tur­al prac­tices and reli­gious beliefs are respon­si­ble for dri­ving sex­u­al minor­i­ty groups under­ground due to which they are mar­gin­al­ized from HIV/AIDS relat­ed pre­ven­tion efforts and have lim­it­ed or no access to such pro­grams. Because of this they are at a high­er risk of being infect­ed with HIV/AIDS. No log­i­cal per­son would will­ing­ly want to con­tract HIV and gen­der non-con­form­ing peo­ple are no dif­fer­ent. Numer­ous research stud­ies have proved that reduced stig­ma and dis­crim­i­na­tion always leads to a reduc­tion in the infec­tion rates.

Extra­or­di­nary advances in the field of med­i­cine have made it pos­si­ble for HIV-pos­i­tive peo­ple to live long and lead healthy lives. But in the absence of a cure each year tens of thou­sands of new infec­tions occur. A major­i­ty of the world’s pop­u­la­tion exposed to the HIV virus con­tin­ues to live in either igno­rance or shame about their HIV sta­tus. Only through lead­ing by exam­ple can we improve the lives of those liv­ing with HIV. We can get test­ed to learn our HIV sta­tus and show care and sup­port towards those who have already been test­ed pos­i­tive. Togeth­er, we can slow the spread of HIV and bet­ter care for those affect­ed by it. “End­ing AIDS epi­dem­ic as part of sus­tain­able devel­op­ment goal by 2030, can­not be achieved in Pak­istan with­out decrim­i­nal­iz­ing the key affect­ed com­mu­ni­ties in this coun­try”, says Qasim Iqbal an activist head­ing a nation­al lev­el orga­ni­za­tion involved in the fight against HIV/AIDS. As an HIV pos­i­tive indi­vid­ual him­self, Qasim went on to say, “On World AIDS Day, we need to remind our­selves and let the world know as well that we are not dying from HIV. We are liv­ing with it!”