Pakistan is in a state of denial about the extent of its HIV/AIDS problem, and political leaders need to understand the reality or it will be very difficult to contain the epidemic, a UN AIDS official said.
The Pakistani government has reported about 3,500 cases of people with HIV, of whom 367 have developed AIDS.
But the true number of HIV cases could be as many as 210,000, said Aldo Landi, the country coordinator of the UNAIDS agency in Pakistan.
"There is still a state of denial for many reasons, but it's not only in Pakistan," Landi told the agency on Friday.
"Unfortunately in many countries, it's a major problem. It's the reason we are not successful in containing HIV.
Political will is the first thing. If there is no real strong political will, it is very difficult to contain the epidemic," Landi said.
Pakistan has a major heroin problem and studies have found that about a third of injecting drug users in Pakistan's biggest city, Karachi, are HIV positive, he said.
The virus is also being spread through sex, he said: "The sexual part is also very important".
"We know that 30 per cent are positive," he said, referring to Karachi's drug users.
"They are young, jobless, 40 per cent are married," which means they infect their wives through sex, he said.
"Your political leaders have to understand what is going on," he said.
No one knows the true extent of the spread of HIV as surveillance for the virus is only beginning in Pakistan but the figure is not the issue, he said.
"The problem is not the number, the problem you have already in the country is that there is an epidemic," he said.
Nazir Masih, an HIV-positive Pakistani, told the news conference attitudes are slowly changing in the conservative, predominantly Muslim country.
"People did not go to doctors for fear of stigma but now things are changing," said Masih, who runs a charity helping people with HIV.