Prepared for Nai Zindagi Trust by Dr Jenny Iversen & Professor Lisa Maher | Kirby Institute, UNSW Sydney

Findings indicate that PWID living with HIV in Pakistan continue to face barriers to ART adherence with just over half (55%) of our sample of 5,482 MWID assessed as adherent.

HIV prevention and treatment services targeting MWID and their female spouses in Pakistan require scale up to prevent further HIV infections.

Evidence-based interventions, including opioid agonist therapy (OAT), are needed to increase ART adherence and improve clinical outcomes, health equity and survival among MWID.

More needs to be done to support early intervention to prevent HIV transmission to female partners of HIV positive MWID, including provision of HIV pre-exposure prophylaxis (PrEP) to female spouses at high risk of HIV transmission, particularly young women and women whose husbands are not receiving, or have difficulty adhering to, ART.