The rising prevalence of HIV and AIDS in Balochistan has laid bare deep-rooted issues such as social stigma, misinformation, and inadequate healthcare infrastructure. A key factor contributing to the spread of the virus is the lack of awareness about sexual health, leading to unintentional transmission within families. The consequences are devastating, with many individuals facing family rejection, social isolation, and a stigma that hampers prevention and treatment efforts. Despite the growing crisis, initiatives to combat HIV/AIDS are heavily reliant on donor funding, raising concerns about the sustainability of these efforts.
Misinformation surrounding the virus remains pervasive, particularly the belief that HIV only affects individuals deemed immoral or sinful. This misconception discourages many from seeking testing, as they fear both a positive diagnosis and breaches of privacy. The lack of awareness is so severe that many people living with HIV remain unaware of their condition, inadvertently spreading the virus within their families. This has led to greater isolation, rejection, and intensification of the social stigma.
One such case is Muhammad Sabzal*, a father of five from Awaran, one of Balochistan’s poorest districts. Sabzal contracted HIV, and due to the lack of awareness, both his young son and his wife also became infected. It was only after the family experienced severe illness that they sought medical help and were diagnosed with HIV at a hospital in Karachi. Now, they receive treatment through the Balochistan AIDS Control Programme at Jam Ghulam Qadir Hospital in Hub Chowki, which currently cares for over 90 HIV/AIDS patients.
Zain Ullah, case manager at the AIDS Control Programme in Jam Ghulam Qadir Hospital, reports rising HIV infection rates in areas like Hub and Lasbela, driven largely by sexual transmission and narcotics use. Drug addicts, often unaware of the risks of HIV, frequently share needles, further facilitating the spread of the virus. According to the Excise, Taxation and Narcotics Department, over 300,000 people in Balochistan, or approximately 1.7 per cent of the population, are addicted to drugs, exacerbating the HIV crisis.
While the AIDS Control Programme, in collaboration with the Health Department, works on prevention and rehabilitation efforts, Zain Ullah highlights a significant challenge: by the time many patients arrive at the Hub Chowki centre, their HIV has already progressed to AIDS, making treatment more difficult. The province of Balochistan, which spans 42 per cent of Pakistan’s land area, contributes about three per cent to the country’s HIV burden, with an estimated 47,831 people living with HIV, according to the Ministry of National Health Services. However, health officials believe the actual number is higher, as many people avoid hospitals due to fear and stigma, making it difficult to identify and treat new patients.
Staff nurse Mahjabeen, who works at Jam Ghulam Qadir Hospital, underscores the need for greater public awareness and efforts to destigmatize HIV/AIDS. “Once we succeed in raising awareness and identifying more infected people, we will be able to bring the epidemic under control,” she explains. However, persuading individuals to get tested remains a major hurdle. Even when symptoms of HIV or AIDS are present, many patients refuse screening, citing cultural shame as a primary reason.
Zaratoon Bibi*, a patient from Lasbela now receiving treatment at Jam Ghulam Qadir Hospital, recalls her initial shock upon being diagnosed with HIV. She feared not only the illness but the shame and rejection that would follow if her community discovered her diagnosis. “In our society, having HIV is considered a disgrace. I thought if people in my community found out, I would die of shame before HIV could kill me,” she says. Her experience echoes that of many in Balochistan, where the stigma surrounding HIV/AIDS leaves infected individuals struggling to cope emotionally and socially.
Adding to the complexity of the crisis is the lack of mental health support for people living with HIV. Many face emotional and psychological challenges in isolation, as family members—unaware of the nature of the disease—often shun them. Recognizing the need for mental health integration, health officials stress the importance of psychological counseling to help patients cope with feelings of anger, hopelessness, and death anxiety. They argue that addressing the emotional toll of HIV/AIDS is crucial to improving the overall well-being of infected individuals.
Another significant challenge in combating HIV/AIDS in Balochistan is the absence of a consistent policy. The Balochistan AIDS Control Programme (BACP) received a budget of Rs 188.4 million from July 2016 to June 2019, with a no-cost extension granted until June 2020. However, a 2019 review of the National HIV Programme revealed that the BACP had spent only 47.5 per cent of its budget, mostly on salaries, equipment, and awareness campaigns. The review also noted that the BACP had failed to meet its 2017-2021 strategy targets for prevention and treatment due to limited collaboration with NGOs and community-based organizations.
The current Balochistan AIDS Strategy, which runs from 2020 to 2025, has already been shortened due to underperformance. Health officials admit that the AIDS control programme is heavily reliant on global funds, and there is no clear strategy from the provincial government for sustaining efforts if foreign funding ceases. A long-term local strategy is needed to ensure the sustainability of HIV prevention and treatment programs, but such a plan has yet to materialize.
For individuals like Muheem Hassan*, who contracted HIV through unsafe sex, the fear of losing access to treatment looms large. After initially struggling to accept his diagnosis, Hassan now fears that without continued donor support, his treatment could be cut off. Many others across Balochistan share this concern, as the province’s limited treatment centres leave thousands without adequate care.
Zain Ullah stresses the need for a sustainable, locally-driven approach to combating HIV/AIDS, arguing that reliance on foreign aid is not a viable long-term solution. As he points out, “How long can we continue relying on foreign funding to fight what is clearly a local issue?”
Names have been changed to protect privacy.
Articulated by Rukhsar Baloch an independent freelance journalist.
