Factors protecting Pakistani women against HIV infection

Introduction Biologically and socially, women are more vulnerable to HIV transmission. However in Pakistan, >90% of registered HIV/AIDS patients are men and transmission from HIV infected men to their spouses is less commonly... [ view full abstract ]

Introduction
Biologically and socially, women are more vulnerable to HIV transmission. However in Pakistan, >90% of registered HIV/AIDS patients are men and transmission from HIV infected men to their spouses is less commonly reported than elsewhere in the world. The purpose of our study was to identify factors that might be protecting women against transmission of HIV infection in Pakistan.

Methodology
We conducted focus group discussions and in-depth interviews with the spouses of injection drug users (IDUs), NGOs, and outreach workers working with the IDU population in the Sindh province. Data were collected using semi-structured questionnaires. All qualitative data were transcribed and analyzed through the process of coding, categorizing and identifying themes.

Results
Data suggested that: (1) only a very tiny proportion of IDUs in the country are females; (2) street female IDUs are rare in Pakistan as in contrast to male IDUs as most female IDUs are not abandoned by their families, due to social and cultural reasons; (3) male IDUs are not welcomed by their wives, yet it is difficult for IDUs to buy or sell sex because of their poor financial and unhygienic conditions; (4) most IDUs in the country are circumcised; (5) despite financial difficulties, most of the spouses of IDUs practice monogamy and only a few sell sex or have more than one sexual partner; and (6) most IDUs reside in urban areas and their spouses are generally well informed about common HIV prevention methods (abstinence and condom use).

Conclusion
The results suggest factors that may limit spread of HIV infection from high risk groups like the IDUs to their spouses and other females in Pakistan. Notably, bridging from IDUs to women or to men who have sex with men may be comparatively low in Pakistan.

Key words
Pakistani women, protecting factors, HIV