Pakistani migrant workers at risk of HIV in GULF States

Pakistani HIV

Pakistan has a long history of emigration for work, particularly to the Gulf States. Due to a lack of knowledge about sexually transmitted diseases, Pakistan is facing an HIV epidemic. Young male migrant workers have been identified as a significant risk group.

Emigration trends in Pakistan

The partition of India after World War II led to religious conflict, triggering migration between India and Pakistan. Over the years, Pakistan has witnessed significant emigration, driven by geopolitical issues, inflation, rising unemployment, and economic instability, impeding the country’s economic development. [1] To address these challenges, The Pakistani government encourages labour emigration through institutions like the Bureau of Emigration and Overseas Employment (BE&OE).

Between 1971 and 2020, nearly 97% of Pakistani workers migrated to the Gulf Cooperation Council (GCC) countries, primarily Saudi Arabia and the United Arab Emirates (UAE), as shown in Figure 1. [2] These migrants, predominantly single males, endured challenging living conditions in overcrowded labour camps with unsanitary environments, exacerbated by the COVID-19 pandemic. The government has established organizations such as the Ministry of Overseas Pakistan and Human Development (MOPHRD) and the Overseas Pakistanis Foundation (OPF) to manage and regulate migration.

Despite poor living and working conditions, Pakistani migrant workers seek opportunities abroad to support their families.  Loneliness and harsh working conditions sometimes lead some migrant workers to seek comfort from sex workers, exposing them to sexually transmitted diseases, including HIV. A 2015 government report identified people who inject drugs (PWID) and sex workers (i.e. Hijra, male and female sex workers) as high-risk groups for HIV infections as shown in Figure 2 below. [3]

HIV among Pakistani migrant workers

Young Pakistani male construction and agricultural migrant workers who engage in unprotected sex constitute a significant risk group for contracting HIV. Another transmission route is through unsafe and unregulated drug use, with migrant workers exposed to such practices. HIV can then continue to spread within Pakistani communities upon the workers’ return.

HIV has been one of the leading causes of death worldwide since the first discovery of the disease in 1983. However, the death rate of HIV decreased significantly due to the advances in technology, but many countries, including Pakistan, continue to grapple with the disease.  A 2019 study reported a rise in HIV prevalence in a Pakistani village from 1% in 2018 to 13%, attributing the epidemic factors such as literacy rates, insanitary conditions, and unsafe syringes usage. [4]

Challenges in HIV Prevention in Pakistan

Social stigma and lack of privacy rights serve as deterrents to individuals to seek HIV testing. The Pakistani government, along with support from various NGOs, is making efforts to assist HIV-infected returned migrants and to educate communities on the dangers of unprotected sex and needles-sharing. Despite this effort, a significant percentage (83%) of HIV cases in 2015 had not received any pre-departure HIV information on protective measures. [3]

To combat the prevalence of HIV and enhance the quality of life for infected individuals, efforts should focus on raising awareness, promoting safe sexual practices, combating social stigma, and supporting those affected. While the challenges persist, a comprehensive approach involving government initiatives and community engagement can help reduce the prevalence of HIV and contribute to a healthier future for Pakistani migrant workers and their communities.

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About the authors:  Daniel Lindgren is the Founder of Rapid Asia Co., Ltd., a management consultancy firm based in Bangkok that specializes in evaluations for programs, projects, social marketing campaigns and other social development initiatives. Techin Charoenchitrwattana, a co-author, works as a project assistant intern at Rapid Asia.

Photo by Jair Lázaro on Unsplash