Delays and gaps in HIV programmes in Pakistan

Altaf, Arshad

doi:10.1016/s2352-3018(18)30252-2

Cited by 13 publications

(8 citation statements)

References 4 publications

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“…Pakistan has a high prevalence of HIV/hepatitis amongst hidden MSM [36]. Fortunately, there are increasing advocacy initiatives in Pakistan for HIV prevention, and MSM specific-interventions [37,38].…”

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Cailhol

Khan

2020

BMC Public Health

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Background Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. Methods The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants was selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. Results Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tools to preserve anonymity. Conclusions Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.

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Section: Discussionmentioning

confidence: 99%

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Cailhol

Khan

2020

BMC Public Health

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“…Pakistan has a high prevalence of HIV/hepatitis amongst hidden MSM (36). Fortunately, there are increasing advocacy initiatives in Pakistan for HIV prevention, and MSM speci c-interventions (37,38).…”

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Cailhol

Khan

2020

Preprint

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BackgroundSeine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention.MethodsThe study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis.ResultsThirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. ConclusionsOur findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.

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“…This can be because the person being examined is not as a whole, it can also be because it is still in the window period, so it is too late to be known. [11][12][13][14] Moreover, the practice of prostitution in Benjina which involves several fishermen from abroad (South East Asia) as the main customers, thus expanding the impact of the spread of infectious sexually transmitted diseases, and increasingly complicating efforts to control them. [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

How to control the sexually transmitted diseases in Benjina?: qualitative studies on the practice of prostitution

Laksono¹,

Dwiningsih

2019

hsji

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Latar Belakang: Prostitusi yang muncul bersamaan dengan industri besar menimbulkan masalah kesehatan, masalah sosial ekonomi, dan budaya. Artikel ini dimaksudkan untuk mengeksplorasi faktor-faktor yang berkaitan dengan praktik prostitusi di Benjina dan mengeksplorasi potensi untuk mengendalikan dampak penyakit penularan melalui hubungan seks. Metode: Penelitian kualitatif ini dilakukan dengan pendekatan etnografi. Wawancara mendalam dan observasi partisipatif dilakukan terhadap 30 informan yang terkait langsung dengan praktik prostitusi di Benjina. Hasil: Tidak ditemukan lokalisasi di Benjina. Praktik pelacuran ditemukan sebagai hal yang biasa di tempat yang disebut rumah karaoke yang menyediakan peralatan menyanyi sederhana, minuman keras, dan layanan seksual. Ada 46 pekerja seks perempuan yang bekerja di 12 rumah karaoke. Faktor ekonomi ditemukan sebagai faktor dominan yang mendorong para pelaku pelacuran, di samping balas dendam. Ada beberapa kendala dalam menggunakan kondom dalam praktik pelacuran ini. Di antara mereka adalah bentuk fisiologi penis yang mengalami modifikasi, dan hubungan pekerja seks khusus dengan kekasih mereka. Ada potensi Sasi yang dapat digunakan sebagai upaya untuk mengendalikan penyakit penularan melalui hubungan seks. Kesimpulan: Sasi sebagai hukum adat berpotensi menjadi hukum positif untuk menerapkan kondomisasi secara keseluruhan di Benjina. Kata kunci: Penyakit menular seksual, pelacuran, hukum adat, Sasi, adat istiadat. Abstract Background: Prostitution that appears together with massive industry raises health problems, socioeconomic problems, and culture. This article was intended to explore factors related to prostitution practices in Benjina and explore the potential for controlling the impact of sex transmission disease. Methods: This qualitative study was carried out with an ethnographic approach. In-depth interviews and participatory observation were carried out on 30 informants who were directly related to the practice of prostitution in Benjina. Results: No localization was found at Benjina. The practice of prostitution was found to be commonplace in a place called karaoke houses that provided simple singing equipment, liquor, and sexual services. There were 46 female sex workers who worked in 12 karaoke houses. Economic factors were found to be the dominant factor driving the perpetrators of prostitution, in addition to revenge. There are some obstacles to using condoms in this practice. Among them were the forms of penile physiology that experience modification, and the relationship of special sex workers with their lovers. There was a Sasi potential that can be used as an effort to control sex transmission disease. Conclusion: Sasi as a customary law has the potential to be a positive law to implement condomization as a whole in Benjina. Keywords: sexually transmitted disease, prostitution, customary law, Sasi, traditional customs.

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Delays and gaps in HIV programmes in Pakistan

Cited by 13 publications

References 4 publications

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

How to control the sexually transmitted diseases in Benjina?: qualitative studies on the practice of prostitution

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