Pakistan has made strides over the lastdecade in its Acquired Immunodeficiency Syndrome (AIDS)response, with active surveillance, considerable research,both governmental and non?governmental prevention and careactivities, and treatment since 2005 to 2006. However, theHuman Immunodeficiency Virus (HIV) prevalence among PeopleWho Inject Drugs (PWID) has not declined, coverage ofcurrent prevention and treatment programs remains limitedand the gains made to date are threatened by internal andexternal factors. This report attempts to review andsynthesize available data on HIV in Pakistan and to usethese data to suggest strategic priorities for the nextphase of the HIV response in an effort to improve theallocative efficiency of resources and effective andefficient implementation of the response. This reportpresents an integrated model for HIV services delivery thatdepicts a continuum of care from prevention outreach totreatment with a focus on evidence based interventions andstrong linkages. It describes three potential models forVolunteer Counseling and Testing (VCT) services for most atrisk populations that increase outreach and engagement withPWID, hijra communities, and Male Sex Workers (MSWs), andtheir clients. It also places heavy emphasis on evidencebased approaches to prevention including expanding treatmentfor High Risk Groups (HRGs) and improving the linkages forHIV positive and HIV negative PWID for drug treatmentservices, such as Methadone Maintenance Therapy (MMT), andoutlines the steps for an evidenced based, effective andefficient policy response at a time of shrinking resourcesfor HIV in overall low prevalence settings. This report isorganized as follows: chapter one gives introduction;chapter two presents epidemiology methods; chapter threegives country context; chapter four presents status of HIVepidemic; chapter five gives summary of key findings;chapter six deals with systems response to HIV and AIDS inPakistan; chapter seven gives key policy recommendations;and chapter eight gives conclusion.
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