Commercial Sex Worker in Pakistan
Commercial Sex Worker in Pakistan
-Mohammad Khairul Alam-
-Rainbow Nari O Shishu Kallyan Foundation-
-24/3 M. C. Roy Lane-
In 1987, Pakistan was reported first HIV/AIDS case in Lahore. During the late 1980s and 1990s, it became evident that an increasing number, mostly men, were becoming infected with HIV while living or traveling abroad.
In Pakistan, the intravenous drug users (IDU) are the most potential carriers of HIV/AIDS among the vulnerable groups in the country, high HIV infection levels among groups of IDUs could cross over into other populations, including male and female sex workers. In Larkana, 8% of injecting drug users were HIV-infected in 2005, as were at least 6% in Faisalabad, Lahore, Sargodha and Sialkot, where a majority of injecting drug users were either married or sexually active. In Karachi, 26% of injecting drug users participating in a 2005 study were found to be HIV-infected. The majority of infected drug users had one risk factor in common: they used non-sterile injecting equipment. Even the most basic elements of effective harm reduction are lacking. Only one half of the injecting drug users taking part in a study in Karachi and Rawalpindi, for example, knew that HIV could be transmitted through using unclean needles—and as many of them said they had used non-sterile injecting equipment in the previous month.
Rainbow Nari O Shishu Kallyan Foundation’s reveal extremely high levels of infections among adolescent girls, which are higher than those for boys. This is mainly because of the fact that at young age, boys have sex with girls of similar age, while girls have relations with older men, who are more likely to be infected. Sexual harassment of schoolgirls by older men sometime may be the cause of HIV infection. Poverty also drives many adolescent girls to accept relationships with ‘sugar daddies’ (older men who are prepared to give money, goods or favors in return for sex).
The presence of significant risk factors such as the very low use of condoms among vulnerable populations including female sex workers, men who have sex with men, as well as the low use of sterile syringes among injecting drug users. In addition increased number of migrant workers, unsafe practice in health service, unsafe sex practice etc. movement of population, less use of condom, polygamy, homosexuality, extra-marital relations, further increases the susceptibility.
Commercial female sex workers don’t use condom regularly. Fewer than one in five female sex workers—and one in 20 of their male counterparts—in Karachi and Rawalpindi said they had consistently used condoms during the previous month. In an earlier study in Karachi, one in four sex workers could not recognize a condom. In addition, a 2005 study has confirmed that HIV transmission is occurring within the sexual networks of male and eunuch (hijra) sex workers in Karachi. The study found 7% of the male sex workers and 2% of the hijras were HIV-infected. In another study in Karachi, 4% of male sex workers and 2% of hijras tested positive. Very high levels of other sexually transmitted infections indicate widespread sexual risk-taking. In the latter study, 23% of the male sex workers had syphilis and 36% had gonorrhoea, while among the hijras, 62% had syphilis and 29% gonorrhoea. Indeed, only 4% of male sex workers and less than 1% of the hijras said they used a condom the last time they had sex with a man. Also of note is the finding that one in four of the male sex workers said they also bought or sold sex to women. Such high-risk behaviour must be addressed in order to limit the further spread of HIV in and beyond those sexual networks.
There are several social components link to develop this harmful situation, these reasons due to increase HIV-AIDS in Pakistan, such as (i) lack of political will due to lack of advocacy among the political leaders and the bureaucracy, (ii) inadequate data due to limited surveillance (iii) lack of awareness in the rural areas (iv) no clear policy on care and support of affected individuals and the management of full blown cases and (v) no proper training for all medical/paramedical faculties and the non medical field workers. The majority of the program activities were concentrated in the urban areas.
Source: Rainbow Nari O Shishu Kallyan Foundation, UNAIDS, CARE, UNICEF