Rising HIV seroconversion rates & associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017

Abstract

Background and Objectives: In 2004 Pakistan escalated from ‘low-prevalence’ to ‘concentrated’ phase of HIV epidemic. Despite global decline in HIV incidence since 1997, rate of HIV infections in Pakistan is persistently rising since 1990. Available literature focusses on key populations or localized outbreaks limited by short study duration and regional applicability of results. We studied HIV seroconversion trends over a period of 8 years in a geographically diverse population and evaluated associated risk factors.
 Methods: A desk review of HIV surveillance data from 2010 to 2017 was carried out at Armed Forces Institute of Pathology. A case was defined as any adult employed in organization ‘X’, initially screened for HIV but later seroconverted on ELISA and western blot. Case-control study was conducted on cases diagnosed in 2017. Age and sex matched controls were identified from same population sub-group. Structured telephonic interviews were conducted and statistical analysis done at 5% margin of error.
 Results: The annual HIV diagnosis rate remained relatively stable till 2015 (< 40 /100,000/yr) after which it rose sharply to 60/100,000/yr in 2016. Upward trend continued in 2017 to reach 125/100,000/yr (>200% increase from baseline). Acquisition of HIV was significantly associated with commercial sex activities (OR=9; 95%CI: 1.25-395).
 Conclusion: HIV seroconversion rates among employees of organization X have increased significantly in the past two years. Unlike HIV outbreaks previously reported from Pakistan, sexual route seems to be the predominant mode of transmission. Focus is mandated on prevention of sexual transmission of HIV at national level as well for all vulnerable populations.
 doi: https://doi.org/10.12669/pjms.36.6.1735
 How to cite this:Mansoor E, Azam N, Niazi SK, Sheikh N, Baig MA, Azim MT, et al. Rising HIV seroconversion rates & associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.1735
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Frequency of Human Immune Deficiency Virus (HIV) Infections at Tertiary Care Hospital of Karachi from 2017-2019

“…Sindh showed the highest prevalence in the current study with a predominance in the Malir district. The distribution of places among HIV cases directly corresponds to the national data 8 . The recent outbreak of HIV in Sargodha and Larkana represents a very distressing situation 10 .…”

“…Furthermore, in 2019, the largest outbreak of HIV in Larkana was reported with the involvement of children being recorded for the first time 8 . It is a common observation that medical and social networks are reluctant to talk about HIV/AIDS in a contented environment, which adversely affects planning strategies to combat HIV/AIDS in Pakistan 12 .…”

“…Pakistan is a densely populated country with a low literacy rate. Lack of awareness regarding family planning, lack of contraceptive uses, increase in homosexuality, unchecked transfusion of blood and other body fluids, intravenous drug addiction and needle prick injury are the leading risk factors in spreading HIV/AIDS 8 . Moreover, inefficient sterilization practices during medical and surgical procedures as well as poor healthcare waste management systems are also important contributing factors to the spread of HIV infection 9 .…”