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EPIDEMICS
Pakistan's shunned HIV victims fight pariah status
by Staff Writers
Karachi (AFP) Dec 1, 2011


Shunned by their families and society, Rubina and Iqbal are a Pakistani couple who have struggled for years to win their lives back and spread a message of respect for fellow victims of HIV/AIDS.

Rubina Naz, 33, one of 12 children born to a labourer, was diagnosed with HIV four years ago, a year after her drug-addicted husband passed away.

"I didn't know what it was until I was tested positive. I was afflicted with this horrible disease by my first husband, who was an AIDS victim," said Rubina.

They married when she was 16 years old and had two daughters and two sons together, but Rubina was unaware of her husband's illness until she read his medical tests after his death and friends advised her to take her own.

Finding out she was HIV positive ruined her life.

"My in-laws threw me out and took my kids. Even most of my own family treated me like a sinner and stayed away when I was desperate to be helped. Those days were horrible," she said.

Pakistan, the second-largest country in South Asia, stands a few steps behind India and Nepal in terms of the extent of the HIV epidemic.

The National AIDS Control Programme says Pakistan is a "low prevalence, high risk" country, with low rates of the virus across the general population but a high concentration among risk groups such as injecting drug users.

UN figures from 2009 show that there are an estimated 97,400 cases of HIV/AIDS in Pakistan.

Rubina's meals were always served separately to the rest of her family, who were fearful of contracting the disease, but with her mother's support she says she has overcome prejudice.

She now works as a kitchen assistant at charity Pakistan Society, dedicated to helping HIV positive people, which is where she met her new husband Mohammad Iqbal, 35, who is HIV positive and recovering from drug addiction.

Iqbal was a tailor in his teens when he was introduced to heroin by friends. He contracted the virus 10 years ago by sharing needles to inject the drug.

"My addiction shocked my parents, who both died early, then my brothers threw me out of home and I was forced to live on the streets," he said.

A charity gave him the tests that led to his diagnosis. But it was another three years before he decided to get well.

"Continuous hatred towards me wore me out. I decided to live a meaningful life or end it. I opted to live and agreed to get rehabilitated," he said.

Rubina and Iqbal found each other in the kitchen, which serves food to patients and visitors at the charity's medical centre.

The charity also goes into communities to help drug addicts across the southern city of Karachi and the wider Sindh province, where it spreads the message that HIV victims can live a normal life and should not be cast out.

"Now I don't hesitate to see myself in the mirror. I am regaining my lost respect in the world," Iqbal said.

Rubina's in-laws have agreed to allow her children to see her regularly and Iqbal's brothers have permitted him to rejoin the family.

Anti-retroviral drugs that treat the illness are provided free of charge at state-run hospitals, clinics and health centres across Pakistan, meaning that those diagnosed have the chance of a relatively normal life.

So long as Rubina and Iqbal continue to take their daily medication and maintain a healthy lifestyle, Pakistan Society head Saleem Azam said their prognosis is good and their life expectancy should not be affected.

Azam said that women are the least documented victims.

The 2009 survey revealed that 15 percent of wives of injecting drug users in just one district, Larkana, where Pakistan's political dynasty the Bhuttos have their ancestral seat, are HIV sufferers.

But Azam said the actual incidence may be much higher as many cases go undetected and there could be many women "who die of the disease without even knowing what happened to them."

"In our male dominant society women have fewer choices to save themselves from their HIV positive husbands. The majority have not heard of the disease and if they do they cannot stop their husbands from afflicting them."

Rubina and Iqbal have taught their families to respect HIV-positive people but say they will continue their quest to educate the rest.

"It is not over yet as the rest of society is still there to be educated," said Rubina.

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HIV drives families into 'irreversible poverty': UN
Bangkok (AFP) Dec 1, 2011 - Tens of thousands of HIV-affected households in Asia are facing "irreversible poverty" because of the cost of living with the disease, with women and children hardest hit, a UN report said Thursday.

Catastrophic healthcare costs and the loss of employment opportunities due to widespread discrimination mean that many HIV-positive households across the region are in "rapid socio-economic decline," the report said.

"Without intervention, many (HIV-affected families) will slip into irreversible poverty," the UN Development Programme's deputy regional director Nicolas Rosellini said in a statement released Thursday.

He called on regional governments to do more to mitigate the socio-economic impact of the disease, which drives many families into debt traps, locking their children into a lifetime of poverty.

The extra costs faced by HIV-affected households make it harder for parents to pay for their children's education, with school dropout rates far higher for such families across the region, the report found.

The disease also "disproportionately affects women and girls" who are biologically more vulnerable to infection, have more limited access to treatment and usually take on the bulk of responsibility for caring for affected individuals, it found.

In countries like India, Indonesia and Vietnam, HIV-affected families spend up to three times more on healthcare costs than the average, according to the report, which examined some 17,000 households across Asia.

Cambodia is the only country in Asia where households' health expenditure as a percentage of their overall consumption is not substantially higher for HIV-affected families due to the widespread government provision of antiretroviral treatment, the report said.

The UN estimates some 34 million people worldwide lived with HIV last year, while improved treatment has meant that the number of AIDS-linked deaths has steadily dropped from a peak of 2.2 million in 2005 to 1.8 million last year.

About half of those eligible for treatment are now receiving it, something that saved the lives of 700,000 people in 2010, the UN has said.

"Yet the challenge is far from over," Samlee Plianbangchang, regional director of the World Health Organisation, wrote in an opinion piece in the Bangkok Post Thursday.

"The impact on women and children is devastating. An estimated 1.3 million women aged 15 and above currently live with HIV" in Asia, he wrote, adding that the number of children living with HIV had risen 46 percent from 2001 to 2009.

The main drivers of the spread of HIV are unsafe sex and drug injection, with five countries -- Myanmar, India, Indonesia, Nepal and Thailand -- accounting for the majority of the disease burden in the region, he said.



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