HIV/AIDS in Afghanistan is prevalent. However, reliable data on HIV/AIDS in Afghanistan is scarce due to a lack of reporting cases and common failure to seek medical treatment. The World Bank recognizes unsafe paid sex and injecting drug users as the most likely cause of the epidemics spread. Many know Afghanistan as dangerous considering its consistent involvement in devastating wars; however, less known is the massive struggle Afghanistan faces in combating drug usage. In accordance with this, HIV/AIDS is predominantly among those who inject drugs, prisoners, female sex workers and men who have sex with men.

About HIV/AIDS

HIV, also known as AIDS, is a human immunodeficiency virus that people can transmit through bodily fluid. HIV/AIDS first emerged through human interaction with a certain type of chimpanzee located in Central Africa. HIV then spread from Africa to other parts of the world and became prevalent in the United States around 1975. HIV/AIDS can cause flu-like symptoms a few weeks post contraction before remaining dormant until progressing to AIDS. AIDS severely weakens a person’s immune system causing an increase in the likelihood of a person getting a severe illness. There is no cure for HIV/AIDS but there are medications that can help infected people live healthier longer lives. The CDC has written about the severity of HIV/AIDS stating that “without treatment, people with AIDS typically survive about three years.” Here are some of the most common ways people can contract HIV/AIDS.

1. Engaging in sexual intercourse without the use of a condom.
2. Mother-to-child transmission.
3. Sharing injecting equipment (most commonly, needles during drug usage).
4. Contaminated blood transfusions and organ transplants.

Doing the Math

These affected populations rarely have the means necessary to seek treatment. In fact, the World Health Organization (WHO) has stated that “In 2017, the number of people living with HIV (PLHIV) in Afghanistan was estimated to be 5900…by December of 2017, 800 PLHIVs were enrolled for treatment.” This means that of the people in Afghanistan who have tested positive for HIV/AIDS, only 13.5% of them have received treatment. Furthermore, from this, one can conclude that the 5,100 people who have tested positive but have not received treatment could die within the next three years.

Disproportionate Effects on the Poor

The disproportionate effects of HIV/AIDS in Afghanistan on the poor are clear as female sex workers, prisoners and those who use injectable drugs are often living on or below the poverty line. An Open Society Foundations article explored the connection between poverty and sex work as it highlights, “The vast majority of sex workers choose to do sex work because it is the best option they have. Many sex workers struggle with poverty and destitution and have few other options for work.” This need for money to support their basic life needs drives women into prostitution putting them at greater risk for HIV/AIDS. Furthermore, refugees make up another category of impoverished individuals who end up at greater risk of contracting HIV. According to WHO, refugees are “stuck in limbo with nothing to do, under great pressure and with drugs abundantly available, many of these refugees have become addicted to drugs.”

Not only does poverty enable greater exposure to HIV/AIDS in Afghanistan, but it also prevents Afghans from affording potential treatments. Estimates for HIV/AIDS treatments run from $1,800 USD to $4,500 USD per month during a person’s lifetime. The average salary for someone living in Afghanistan converts to $18,505 USD per year, making it impossible for even middle-class citizens to pay for treatments, let alone those facing poverty.

The Good News

Afghanistan developed a National Strategic Plan to investigate and respond to the HIV/AIDS epidemic. The World Health Organization (WHO) outlined that this National Strategic Plan took effect in 2016 and reached its full effect in 2020. It includes five priority areas:

1. Greater accessibility to and effectiveness of HIV prevention tools.
2. Increase accessibility to treatment/support.
3. Provide documentation and information to allow patients to make informed decisions on medication and treatment paths.
4. Enable an environment that will allow the national response to HIV/AIDS to be both effective and sustainable.
5. Strengthen and manage government programs at national and provincial levels.

Looking Ahead

The continued implementation of this plan and increased foreign aid, are helping curtail the devastating effects of the HIV/AIDS epidemic over time. However, the COVID-19 pandemic and the Taliban’s takeover of Afghanistan have thrown progress off track. A New York Times article explains the health care situation in Afghanistan stating that “The country’s health care has been propped up by aid from international donors. But after the Taliban seized power, the World Bank and other organizations froze $600 million in health care aid.” Major strides have occurred in Afghanistan with regards to female health and epidemics however this progress is now at risk of reversing as organizations withdrawal their aid from Afghanistan amidst the Taliban’s reign.

– Lily Vassalo
Photo: Flickr