Informatics Publishing Limited

Rehana Khalil ¹, Zahid Naeem ¹, Atif Zaman ², Saadia Gul ³, Jayram Das ³

Affiliations
1 Family & Community Medicine Dept, Unaizah College of Medicine, Qassim University, SA
2 Dept. of Medicine, Fauji Foundation Hospital, Rawalpindi, PK
3 Baqai Institute of Health Sciences, Baqai Medical University, Karachi, PK

Abstract

Stigma and discrimination have always accompanied the HIV/AIDS epidemic, resulting in prejudice against those living with HIV/AIDS, as well as the groups that are considered 'high- risk'. Healthcare settings are the most significant context for stigma and discrimination as it greatly hampers HIV/AIDS testing, treatment and prevention. This study was done to assess the nature and prevalence of discriminatory practices and attitudes towards People Living with HIV/AIDS (PLHA) in the health sector in Karachi, Pakistan.

A descriptive cross sectional study was conducted in Karachi, Pakistan. Trained interviewers used a semi-structured questionnaire to interview 102 HIV-positive adults to collect information on socio-demographic characteristics, HIV testing, reactions upon receiving a positive test result, and their experiences accessing the healthcare services The data were analyzed using SPSS version 18.

Majority (67%) of the participants were aged between 21 and 40 years. More than one-third (35%) were illiterate and 65% reported a household income between Rs1000 and Rs5000 per month (USD12 and USD54).

Average time since diagnosis was 2 years. 42% of the participants were tested without their knowledge. Post-test counseling was provided to 75% individuals.

35% participants reported discrimination at the hands of the healthcare providers. This included rudeness, blaming and denial of treatment.

This study reveals the existence of stigma and discrimination at health care facilities against PLHA in Karachi. In addition to HIV/AIDS related education and training, the healthcare providers also need to be targeted in HIV/AIDS intervention programs.

Keywords

PLHA, HIV/AIDS, Stigma, Discrimination, Healthcare Facilities.

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Rehana Khalil ¹

Affiliations
1 Department of Family and Community Medicine, Unaizah College of Medicine, Qassim University, SA

Abstract

Substance abuse in college campuses is not a hidden practice and is well received by the students to escalate it very fast. Illicit drug addiction may be one of the most dangerous types of addictions. In general, illicit drugs are those that are illegal to make, sell, or use and include a long list of items which are psychoactive, highly addictive and pose serious health risks, even when taken in small doses. The aim of this study was to explore the illicit use of psychoactive substances among college students between ages 15 to 25 years studying in Karachi, Pakistan and add to our understanding of other associated factors with illicit use of these substances. A descriptive cross sectional study was conducted in Karachi, Pakistan in the year 2015. Using educational framework, the scope of the frequency of drug use among teens and youth was studied. A standardized multiple-choice and open-ended questionnaire was completed by 600 students from different institutes. The questionnaire was focused on frequency, accessibility and type of substance use, age at which the abuse started, monthly expenditure, dependence upon drug, and if the individual is aware of the toxic dose illicit substance use. The data were analysed using IBM SPSS Statistics version 22 and Microsoft excel. The prevalence of illicit drug use among students was found to be 54%. The frequency of consumption of the drugs by these students was weekly (31%), daily (27%), monthly (22%) and 20% consumed it only once a year. Most of them started drug consumption at age between 15-19 years. Most frequently used substances among university students were Marijuana (34%), alcohol (23%), cocaine (14%), heroin (12%), ecstasy (11%) and solvent (6%). More than one drug was used by 35% of the respondents. Students admitted easy accessibility of their substances of choice through friends (47%), dealers (36%), and over the counter (17%). They spent Rs.500 to Rs.3000 per month on drugs. The awareness about lethal dose among students was found to be very high (89%). Consumption of illicit psychoactive substances is widely prevalent affecting more than half of the students of age 15-25 studying in different educational institutes of Karachi. Most common substances consumed were marijuana and alcohol. Most of the students get drugs through their friends. There is a need to educate and create awareness about illicit drug use among the students and the community at large.

Keywords

Psychoactive Substances, Recreational Consumption, Illicit Substances, Substance Use among Students.

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Ghulam Sarwar Soomro ¹, Nazia Jameel ¹, Rehana Khalil ², Afrina Raza ², Tahira Gul ³

Affiliations
1 Department of Community Medicine, Baqai Medical University, Karachi, PK
2 Department of Family and Community Medicine, Unaizah College of Medicine, Qassim University, SA
3 Bridge Consultants’ Foundation, PK

Abstract

Tuberculosis is endemic and is a major public health challenge in Pakistan. Illicit drug users continue to be a group at high risk for tuberculosis (TB). Drug users and injection drug users in particular, have driven TB epidemics in a number of countries including Pakistan. The successful identification and treatment of TB among illicit drug users remain important components of a comprehensive TB strategy, but illicit drug users present a unique set of challenges for TB diagnosis and control due to their exposure to risk factors like HIV Infection, homelessness, health disparities and other negative socio-economic factors poverty among them. In this study we aimed to determine the prevalence of Tuberculosis among injecting Drug Users (IDUs) in Karachi, Pakistan. A descriptive cross sectional study was conducted, in the year 2015 in two towns of Karachi (Kimari and Saddar), Pakistan. Trained investigators used a standardized multiple-choice and open-ended questionnaire to collect the data regarding demographic profile of the respondents, injecting practices and other related information to identify Tuberculosis suspects. Written informed Consent was obtained and questionnaire was completed by 155 injection drug user (IDUs) selected through proportionate stratified sampling. The sputum samples were collected as per guidelines of National TB Control Program from identified TB suspects. The data were analysed using IBM SPSS Statistics version 20.0 and Microsoft excel. There were 151 men (97%), 3 female (2%) and 1 (1%) transgender among participants. In our study prevalence of TB among IDUs was 12% and most (72%) of them were living on street and 46 (30.9%) were married, therefore making their spouses and family members a high risk group for TB. The prevalence of Tuberculosis among injecting illicit drug users is 12%. Future research needs to be directed toward this sensitive issue and social support programs with treatment services should be ensured for TB positive IDUs living on streets to reduce the disparities in provision of health services for this vulnerable stratum of our society.

Keywords

Pulmonary Tuberculosis, Illicit drug Users, Injecting drug users, Prevalence of Tuberculosis.

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