The spread of HIV/AIDS in Balochistan is being fueled by deep-rooted stigma, a lack of awareness, and a shortage of treatment centers, according to a recent report by psychologist Imrana Imdad in The News International.
The report highlights how misinformation, cultural taboos surrounding sexual health, and insufficient healthcare infrastructure are contributing to the rising number of HIV/AIDS cases in the region, with patients facing social isolation, mental health challenges, and difficulties in accessing proper care.
Stigma and Awareness Gaps
Imrana Imdad, who counsels HIV/AIDS patients, highlights that limited awareness and societal stigma are significant obstacles to addressing the virus’s spread in the region.
She emphasizes the need for greater awareness of sexual health and HIV transmission. In Balochistan, misunderstandings about the disease have led to the virus being unknowingly spread within families, compounding stigma, isolation, and rejection.
The disease is widely misunderstood, with many believing that HIV only affects those perceived as engaging in “sinful” behavior. This misconception discourages people from seeking screening and treatment. As a result, many are unaware of their status, contributing to the spread of the virus and reinforcing stigma.
One case is that of Muhammad Sabzal (a pseudonym), from Awaran, one of Balochistan’s poorest districts. Unaware of his HIV status, Sabzal transmitted the virus to his wife and young son. The family sought medical help only after experiencing severe illness and was subsequently diagnosed at a Karachi hospital. They are now receiving treatment at Jam Ghulam Qadir Hospital in Hub Chowki through the Balochistan AIDS Control Programme (BACP), which supports more than 90 HIV/AIDS patients.
Zain Ullah, a case manager at BACP, notes rising infection rates in districts like Hub and Lasbela, close to Karachi, largely due to sexual transmission and drug use. “Many drug addicts, unaware of the risks of HIV, share needles, further spreading the virus,” he says. The Excise, Taxation, and Narcotics Department estimates that over 300,000 people in Balochistan, or about 1.7% of the population, are addicted to narcotics.
While the AIDS Control Programme works with the Health Department to provide treatment and raise awareness, significant challenges persist. “By the time most patients arrive at the Hub Chowki center, their HIV infection has already progressed to AIDS, making treatment less effective,” Zain Ullah adds.
The Ministry of National Health Services, Regulations, and Coordination estimates that around 3% of Pakistan’s total HIV burden is in Balochistan, with approximately 47,831 people living with the virus. However, the actual numbers could be higher due to societal stigma and reluctance to seek testing, according to health officials.
Mahjabeen, a nurse at Jam Ghulam Qadir Hospital, highlights the need to reduce stigma and encourage screening. “Once we raise awareness and identify more infected people, we can bring the epidemic under control,” she says.
“The real challenge is convincing people to get screened. Even when people come here for regular check-ups and we spot symptoms of HIV or AIDS, many refuse screening. Cultural shame is a primary reason for this reluctance.”
Mental Health Impacts
The psychological toll of HIV/AIDS is also significant. Imdad’s report shares the experience of Zaratoon Bibi (a pseudonym), who felt overwhelmed by social stigma after her diagnosis.
“When I first found out I had contracted HIV through sexual transmission, I was shocked and thought I was going to die,” she says. “Overcoming the shame was the hardest part. In our society, having HIV is seen as a disgrace.”
Imdad emphasizes that mental health support is crucial for those living with HIV/AIDS. The emotional trauma of being diagnosed, often accompanied by feelings of anger, anxiety, and hopelessness, can be profound.
“Introducing psychologists and counselors is essential for addressing the emotional toll on those living with HIV,” she says. Health officials stress that providing psychological support can help patients cope with the self-stigmatization associated with the diagnosis.
Policy Challenges and Funding Gaps
Efforts to combat HIV/AIDS in Balochistan face financial and policy-related challenges. The BACP’s most recent budget of Rs 188.4 million, covering July 2016 to June 2019, was extended until June 2020.
However, a 2019 review of the National HIV Programme found that the BACP used only 47.5% of its budget, primarily on salaries, equipment, and awareness campaigns.
The review revealed shortcomings in meeting prevention and treatment targets, partly due to limited collaboration with NGOs and community-based organizations.
The current Balochistan AIDS Strategy, which spans from 2020 to 2025, was reduced by a year because of underperformance. Health officials highlight the program’s reliance on global funding and the absence of a clear localstrategy for sustaining efforts if foreign funds cease.
“We need a proper local strategy and mechanisms for sustainability,” a health official says. “Allocating sufficient resources and developing a long-term strategy—at least a 10-year plan—is necessary to create a roadmap for prevention.”
Limited Access to Treatment
Access to HIV/AIDS treatment in Balochistan is limited, with centers available in only five districts: Quetta, Naseerabad, Hub Chowki, Loralai, and Turbat. This shortage of facilities leaves thousands without adequate care.
“The most alarming aspect of HIV and AIDS in Balochistan is the limited number of centers,” says Zain Ullah. “Even where we have facilities, mental health counseling is missing. Many patients suffer from severe mental health issues due to a lack of awareness.”
The limited availability of resources and fear of losing access to treatment add to the challenges faced by patients. Muheem Hassan (a pseudonym), infected through unsafe sex, shares his concern: “At first, I was terrified to continue treatment because I didn’t want to face the reality that I had AIDS. Now, my biggest fear is losing access to free treatment and medication.”
Health officials argue that without a sustainable local strategy, efforts to support HIV/AIDS patients in Balochistan will remain inadequate. The heavy reliance on foreign funding, combined with limited access to both treatment and mental health services, underscores the urgent need for a coordinated approach to address the crisis.