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Missing the target in Pakistan

Nai Zindagi, in collaboration with the International Treatment Preparedness Coalition (ITPC) and Mainline, conducted research on the key barriers of access to HIV services and treatment for HIV+ people who inject drugs. The study is part of the Missing the Target (MTT) report series, a community monitoring initiative, which enables civil society advocates to monitor and advocate for HIV/AIDS services in their respective countries.

From November 2016, six hundred respondents in two cohorts were enrolled in the study. Cohort 1 focused on HIV+ people who use drugs and who accessed the voluntary treatment unit run by Nai Zindagi. Cohort 2 consisted of people who had been initiated on ARVs at least six months prior to the research. 


The report reveals a number of barriers, especially in the second cohort. Respondents mentioned various barriers such as:

  • Major travel distances to the limited number of clinics that can register new HIV+ clients and provide ARV treatment;
  • stigma and discrimination towards HIV+ people within their family, the general community and amongst health workers. Consequently, respondents feel ashamed to disclose their HIV status, which in turn has an effect on treatment access;
  • limited knowledge around HIV – for example about the importance of routine viral load testing;
  • lack of OST and detoxification services in Pakistan. For people with a drug dependency and a chaotic life on the streets, these services could provide the stability that is needed to adhere to ARV treatment.

This current study provides evidence of the status of HIV treatment and care in Pakistan and makes valuable recommendations to improve treatment access. This is particularly relevant as the Islamic Republic of Pakistan has been promoting treatment for all since 2018. A follow-up study among the respondents who are not linked into harm reduction services in any way would be a much-needed next step. Read the full report here



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