Late diagnosis of human immunodeficiency virus infections in high-risk groups in Karachi, Pakistan

Zahra Hasan, Sharaf Shah, Rumina Hasan, Shoaib Rao, Manzoor Ahmed, Mars Stone, Michael Busch

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Human immunodeficiency virus (HIV) infection prevalence in Pakistan has been increasing in high-risk groups, including people who inject drugs (PWID) and transgender hijra sex workers (TG-HSWs) nationwide. Effective control of HIV requires early diagnosis of the infection. We investigated recency of HIV infections in newly-diagnosed cases in PWID and TG-HSWs. This was an observational study with convenience sampling. Overall, 210 HIV-positive subjects comprising an equal number of PWID and TG-HSWs were included. Antibody avidity was tested using the Maxim HIV-1 Limiting Antigen Avidity (LAg) EIA (Maxim Biomedical, Inc. Rockville, Maryland, USA). The mean age of study subjects was 29.5 years: PWID, 28.5 years and TG-HSWs, 30.4 years. Study subjects were married, 27%, or unmarried. Eighteen percent of individuals had recently-acquired HIV infections: 19% of PWID and 17% of TG-HSWs. Eighty-two percent of individuals had long-term HIV infections: 81% of PWID and 83% of TG-HSWs. This is the first study identification of recent HIV-1 infections in Pakistan. We show that most newly-diagnosed HIV patients in the high-risk groups studied had long-term infections. There is an urgent need for intervention in these groups to facilitate early diagnosis and treatment of HIV infection to reduce transmission in Pakistan.

Original languageEnglish
Pages (from-to)1400-1406
Number of pages7
JournalInternational Journal of STD and AIDS
Issue number14
Publication statusPublished - 1 Dec 2018


  • Indian subcontinent
  • diagnosis
  • high-risk behavior, HIV, AIDS
  • homosexual
  • sex workers


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