P140 The rising HIV epidemic among key populations: an urgent need for a focused targeted prevention response in pakistan

Background HIV Surveillance data has been used extensively to guide HIV prevention program in Pakistan since 2004. The 5th round of surveillance was conducted in 23 cities to determine the progression of the HIV epidemic, profile risk behaviors and program coverage among key populations to inform HIV prevention programs in Pakistan Methods A total number of 5,660 FSWs, 6,773 MSM, 5,191 Transgenders and 4,062 PWIDs participated in the study using diverse sampling techniques to draw representative samples. Behavioral data were collected using structured questionnaires while blood samples were tested using two rapid HIV tests following WHO protocol. Informed consent was obtained and all participants were linked with HIV programs. Moreover, all positive subjects were linked to HIV treatment care and support. International ethical guidelines were followed and ethical approval for the study was obtained from PMRC ethics review board in Pakistan. Results Overall, weighted prevalence of HIV among PWID was 38.4% (95% CI; 37.9, 38.9), 7.1% (95% CI; 6.8, 7.4) among TGs, 5.4% (95% CI: 5.2, 5.6) among MSM and 2.2% (95% CI: 2.1, 2.3) among FSWs. Among key HIV risk behaviors condom use at last sex was 27.7% in TGs, 50% in FSWs, 24% in MSM and 15.8% in PWID, who also shared syringes extensively (31%). Approximately 5% of TG, 16.9% of FSW and 4.0% of MSM reported having sex with a PWID in past year. Only 24.6% PWID, 15% TGs, 8.3% FSWs and 13.3% MSM utilized HIV prevention programs in the past year, which explains the escalating trends of HIV among these populations. Conclusion The HIV epidemic in Pakistan is growing rapidly and is following a rapidly propagating Asian HIV epidemic pattern. Pakistan needs to quickly scale-up services for key populations to contain the epidemic and to prevent a further spread to other KP members and into general population. Disclosure No significant relationships.