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Pak woman battles to prevent AIDS explosion

Instead of giving into stigma, Shukria Gul has taken on the fight against ignorance, not least among its medical community.
PTI | By Agence France-Presse, Islamabad
PUBLISHED ON NOV 30, 2004 08:15 PM IST

Shukria Gul, a Pakistani woman infected with HIV by her late husband, campaigns fervently in this Islamic republic for funds and awareness to prevent it going down the path of rampant HIV/AIDS infection.

Like most of Asia, Pakistan is at a "make or break stage" -- in the words of Nafis Sadiq, the United Nations' special envoy for HIV/AIDS in the Asia Pacific -- in controlling the spread of the virus.

Prevalence so far is low, but worst case scenarios are closer than ever to being realised as the factors making it ripe for an epidemic start playing out: a large migrant population, four million workers travelling overseas annually for work, and half a million heroin users, of whom many share needles and use prostitutes.

"The fact that we are still low prevalence, let me tell you very honestly, is mostly due to good luck," said Asma Bokhari, the head of Pakistan's National Aids Control Program, ahead of the first Asia Pacific Women and Girls Conference on HIV/AIDS.

Four million of seven million HIV-positive Asians are in India. Officially, only about 2,300 of Pakistan's 150 million people are HIV-positive, but the World Health Organisation estimates the actual figure at closer to 80,000.

In South Asia, married women like Gul are among the most vulnerable to HIV/AIDS infection in South Asia.

Young women on the subcontinent account for 62 per cent of infections in the 15-24 year old age group. In India, 90 percent of HIV-positive women are married and monogamous.

Gul discovered she was HIV-positive in 1995 as her husband fell into a coma, suffering chronic AIDS-related pneumonia. By the time his test results came back positive, he was already unconscious and within days he was dead. Gul thinks he contracted it while working in Africa for five years.

The face of the HIV/AIDS epidemic today is "typically that of the impoverished, undernourished woman from the third world," according to the United Nations agency UNAIDS.

"There is now evidence that the largest proportion of new infections in India is amongst women whose only 'high-risk behaviour' is being married," concluded a UNAIDS study carried in "The Gender Dimensions of HIV/AIDS Challenges for South Asia."

Instead of giving into the stigma, Gul has taken on the fight against ignorance in Pakistan, not least among its medical community and bureaucrats.

"The doctors here are afraid of HIV," she told AFP. "They isolated my husband when his test came back positive."

When Gul's own test proved positive, the doctor told her brother that the family could become infected if they ate with her.

"He also told my brother that it would be good if my two children were taken from me." Her children, who are not infected, are still with her.

A key focus of Gul's campaign are the poor testing facilities in Pakistan.

Gul presented two test results for one woman, a Pakistani nurse who was required by the Saudi government to undergo an HIV test when she applied to work there.

The first test at a government laboratory on July 29 this year came up negative. A second test at a private pathology clinic on July 30 came up positive. The third test confirmed she had HIV.

"The facilities in some provinces here are outrageously poor," Gul told AFP.

According to Bokhari, nine private clinics in Karachi performing blood transfusions were shut down because they were not following guidelines.

A "small percentage" of patients had become infected after transfusions at the clinics.

"There is no government involvement and nothing from donor agencies," Gul lamented.

The UN's Sadiq told the conference five billion dollars a year needs to be poured into the region to avert five million new infections and 100,000 deaths annually by 2010.

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