Global Fund for Aids, TB and Malaria (GFATM)

Background
Pakistan remains a country having a concentrated HIV epidemic with prevalence levels consistently reported to be greater than 5% among injecting drug users (IDUs). The HIV epidemic in Pakistan is primarily driven by injecting drug use which exhibits the highest average prevalence of 20.8%, followed by 6.1% among hijra sex workers (HSWs,) and 0.9% among male sex workers (MSWs). Although HIV infection rate among female sex workers (FSWs) remains low at 0.97%. Factors such as sexual networking among FSWs and IDUs pose added risk, thereby increasing the risk of spill-over into networks of commercial sex workers and their clients. The geographic trend of the epidemic is expanding from provincial capitals and major cities to smaller cities and towns. The national adult HIV prevalence among the general population remains under 0.1%. This Program is aimed at supporting the national response through filling the prevalent gap of 31% in covering IDUs, filling the prevalent gaps in covering people living with HIV/AIDS (PLHIV) for treatment, care and support, and playing a key role in strengthening public-private partnerships to effectively respond to the epidemic. The Program will also increase access to treatment, care and support for PLHIV and their families as well as enhance program management capacities of the implementing entities.

The package of IDU services or Continuum of Prevention and Care (CoPC) includes needle and syringe exchange to minimize HIV transmission risks. Early HIV detection and referral among IDUs and associated populations will be accomplished through CoPC community-based sites encompassing Voluntary Confidential Counseling and Testing services. Under Objectives 1 & 2. CoPC and CHBC packages are designed to complement each other with strong cross referral supported through community based human resource and logistic support for the IDUs, PLHIV and associated populations and support from PC-1s.

Goal

• To reduce morbidity and mortality due to HIV and AIDS

Objectives

• To scale up comprehensive HIV prevention and harm reduction services to IDUs, spouses and partners of IDUs in selected districts of Sindh and Punjab Provinces.
• To improve access to HIV care and support to HIV affected persons, including PLHIV through the provision of CHBC services and improved referral mechanisms to ART sites, and provision of ART to PLHIV across Pakistan

• All people living with HIV/AIDS in Pakistan are beneficiaries under Objective 2 (care, support and treatment for PLHIV) of the grant
• IDUs, PLHIV and associated populations, and all people living in Sindh and Punjab (accounting for approximately 81% of total national population) are beneficiaries of Objective 1 of this grant.
• Members of Public and private sectors all over the country