The theme for World AIDS Day will remain ‘Getting to Zero’ until 2015. The theme aims to achieve ‘zero new infections, zero discrimination, and zero AIDS related deaths’. On the global front there seems to be great progress in trying to achieve the ‘zero’ figure benchmark as indicated by the recent annual report on the state of the global pandemic by UNAIDS launched in November this year. In its report UNAIDS stressed that 25 low- and middle-income countries had managed to at least halve their rate of new HIV infections, more than half of those countries were in Africa, the region affected the most by HIV. Globally, the overall number of newly infected cases fell to 2.5 million from 2.6 million in 2010. The number of newly infected HIV children has also dramatically reduced. The number of AIDS related deaths also fell to 1.7 million people, which is a 24% drop rate from the peak recorded in 2005. 
However, this global progress and achievements in the arena of HIV sadly do not apply to the state of HIV in Pakistan. Pakistan is the second largest country in South Asia that stands only a few steps behind India and Nepal in terms of HIV epidemic. Rather than making progress in the fight against HIV unfortunately Pakistan has taken a few steps back. Until recently Pakistan was classified as a ‘low prevalence high risk’ country but now Pakistan is in a ‘concentrated phase’ of the epidemic with HIV prevalence of more than 5% among injecting drug users (IDUs) in at least eight major cities. Optimists at the National AIDS Control Program tend to look at the brighter side of the picture and insist that Pakistan still has a window of opportunity as the current estimates, using the various latest prevalence estimation models, indicate that the HIV prevalence among general adult population is still below 0.1%. According to the latest national HIV estimates there are approximately 97,400 cases of HIV in Pakistan.
There are several social factors that make tackling the issue of HIV in Pakistan more complicated. One of the biggest factors is ‘denial.’ Denial, in the fact that pre or extra marital sex does not exist in our society is one of the main reasons why a lot of people choose not to talk about HIV awareness as they feel this does not concern our society. In the patriarchal dominated society of Pakistan, women are much more vulnerable to HIV as they have little or no control over the risky behavior of their husbands and cannot even question them. Sexual/reproductive decision making is the sole responsibility of the husband and wives cannot question it. In Pakistan so many wives are infected with HIV, infections their husbands brought along with them when they were living and working overseas, especially in the Middle East countries. This is the situation for thousands of women across Pakistan, who are at high risk of contracting sexually transmitted diseases, including HIV, because of their lack of knowledge, awareness, and a low social status that denies them their basic human rights.
Unless the core issues of denial, injecting drug users, and women empowerment are addressed, Pakistan will find it extremely difficult to contribute towards the global ‘zero.’