Emerging Infectious Diseases (Apr 2021)

Systematic Review of Reported HIV Outbreaks, Pakistan, 2000–2019

  • Elizabeth M. Rabold,
  • Hammad Ali,
  • Danielle Fernandez,
  • Martha Knuth,
  • Karl Schenkel,
  • Rana Jawad Asghar,
  • Mirza Amir Baig,
  • Saqib Shaikh,
  • Oliver Morgan

DOI
https://doi.org/10.3201/eid2704.204205
Journal volume & issue
Vol. 27, no. 4
pp. 1039 – 1047

Abstract

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Unsafe injection practices and injection drug use have been linked to multiple HIV outbreaks in Pakistan since 2003; however, few studies have systematically analyzed the causes of these outbreaks. We conducted a systematic review of published English-language literature indexed in bibliographic databases and search engines and a focused gray literature review to collate and analyze all reported HIV outbreaks in Pakistan during 2000–2019. Of 774 unique publications reviewed, we identified 25 eligible publications describing 7 outbreaks. More than half occurred during 2016–2019. The primary sources of transmission were iatrogenic transmission, affecting children, persons with chronic medical conditions, and the general population (4 outbreaks); injection drug use (2 outbreaks); and a combination of both (1 outbreak). In the absence of robust HIV testing and surveillance in Pakistan, timely and detailed outbreak reporting is important to understand the epidemiology of HIV in the country.

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