PUBLISHED
December 21, 2025
Inmates serving their sentences look forward to the day when they will finally escape their life of containment. Unfortunately, as an HIV-AIDS epidemic finds its way inside prisons across the country, inmates trapped inside cells of sickness never know whether they will live to see the light of freedom.
According to a UNAIDS estimate, as of 2023, there are approximately 297,052 people living with HIV-AIDS in Pakistan, with Khyber-Pakhtunkhwa reporting the highest prevalence rate of 20 cases per 100,000 population followed by Sindh with 6 cases, Punjab with 5 cases and Balochistan with 3 cases in the same sample size.
Punjab, the largest province of Pakistan, has an expansive network of prisons holding the highest number of prisoners. There are currently 43 jails in the province with more than 61,000 inmates, even though the actual capacity of these prisons is only about 37,000. These statistics are a clear proof that overcrowding in prisons is a persistent problem, not only causing dangerous diseases but also overburdening the facilities in the event of an HIV epidemic.
According to sources, 645 prisoners have been diagnosed with HIV-AIDS so far during screening across various jails of Punjab. Although this number appears to be low in terms of the total number of inmates, it is an extremely alarming reality in the context of the limited resources of prisons and the inadequate health facilities. Rawalpindi’s Adiala Jail is the worst affected jail with 148 patients registered. As many as 83 patients have been found to be infected with HIV in Lahore Camp Jail, 37 in Faisalabad Central Jail, 27 in Kot Lakhpat Lahore and 27 in Gujranwala Central Jail.
While officials from Sindh refused to share data on the number of HIV-AIDS cases in jails, Nawaz Gill, in-charge of the DRC Central Jail Peshawar, revealed that currently 18 drug addicts with HIV were under treatment at the centre. “We report to the Provincial AIDS Programme, various donors, and NGOs. There are a total of 3,000 prisoners in the Central Jail Peshawar. There are 38 jails in K-P, holding 13,000 prisoners. Major jails are monitoring and treating inmates suffering from HIV-AIDS to some extent,” claimed Gill.
As per figures obtained by UNAIDS, common transmission routes for HIV by percentage are as follows: 52.55 per cent of cases occur due to blood contamination, 23 per cent are acquired through needle sharing among drug users, 18 per cent cases are reported among men having sex with men, 3 per cent occur due to the activities of transgender sex workers, while 1 per cent are caused by relations with female sex workers.
Sources have revealed that although many inmates carry the virus before entering prison, some acquire it during their time behind bars through drug syringe sharing, the collective use of shaving blades, unsterile use of medical equipment and even unprotected sex.
Addictions and infections
Committing crime leads to jail. Yet there are some crimes, which lure in a deadly disease alongside a jail conviction. For nearly 17 million youth battling drug addiction across the country, HIV-AIDS is often their hidden companion behind prison bars, which unknowingly harbour the deadly duo of addictions and infections.
Farmanullah, a 28-year-old from Peshawar who worked as a scrap collector, got addicted to various drugs after finding them in a pile of garbage four years ago. “Initially my friends started taking drugs through shared syringes, but then one day I too tried the substances. After developing an addiction, I started exploring various drugs including ice. One day, I was caught stealing an expensive drug and was arrested by the police,” recalled Farman, who met the correspondent at the drug rehabilitation centre of Central Jail Peshawar.
Unfortunately, following his bloodwork, Farman was diagnosed with HIV-AIDS, due to which his treatment now not only focuses on drug rehabilitation but also on AIDS management. “It is a pity that there are not enough facilities for HIV positive inmates in prisons,” laments Farhan, who had no knowledge of the fatal disease he had acquired due to his drug addiction. However, despite his unawareness, Farhan expressed his hopes of one day leaving the prison and living in society as a healthy, respectable citizen.
Muhammad Ali Sarang, an activist working with various local and international NGOs on the spread of HIV-AIDS in Sindh, confirmed that blood contamination was the main reason contributing to the spread of the disease in the province. Regarding the spread of HIV-AIDS in jails, sources have confirmed on the condition of the anonymity that drug addicts who were kept in jails often continued their illegal activities due to covert drug supply networks operating within jails hence allowing the virus to spread among other inmates through syringe sharing.
Unfortunately, however, since these networks often operate with the complicity of the local police and state officials, they are nearly impossible to catch. Yet despite the secret nature of these activities, specific cases provide a mere glimpse into the kind of reproachable dealings happening within the fortresses of morality. In 2023, one case of drug smuggling within prison facilities came to the fore when government employees were caught supplying various narcotics to inmates inside the Camp Jail Lahore.
Former DIG Prisons Muhammad Hassan Sehto, confirmed that most of the victims of HIV-AIDS in Karachi’s jails were in fact drug addicts. When contacted by The Express Tribune, District Jail Malir Superintendent Shahabuddin Siddiqui revealed that the total number of drug addicts currently in his jail was 203, out of which 114 were suffering from HIV/AIDS. “Usually, the new inmates in the jail are screened for HIV and tested for hepatitis. HIV-positive patients are kept isolated so that other prisoners are protected from the disease,” noted Sehto.
Behind closed bars
Violence against gender minorities is often downplayed by society, especially when it occurs behind closed doors. Unsurprisingly, this sexist palliation can be found in state structures as well, where sexual violence within prisons is a devastatingly under acknowledged reality plaguing the safety of female and transgender inmates.
According to a report published by the Human Rights Watch (HRW), women inmates are at a pronounced risk of sexual violence by male prison guards, who often pressurise them into having sex in exchange for food or favours. Quoting an Islamabad-based lawyer, the report further revealed that sex workers were a particularly vulnerable group.
For instance, Kiran, a 24-year-old dancer interviewed for the HRW report, shared her horrifying experience of dealing with prison guards after she was arrested in Sahiwal for a dance “solicitation”. “I was fair game for the guards, who hurled lewd comments at me, and touched me inappropriately. Women prisoners are often treated like this since people feel they are of “loose character”. I felt like a piece of meat on display at a butcher shop,” recounts Kiran.
Although actual cases of sexual violence inside prisons might never surface on the media, anonymous sources privy to the matter have confirmed that unprotected sex, whether consensual or as a result of coercion, was a mode of transmission of HIV inside jails.
According to Dr Uzma Ashiq Khan, Assistant Professor of Gender Studies at the Lahore College for Women University, the reports of sexual assault targeting vulnerable populations like sex workers and transgender inmates within jail facilities were a clear manifestation of a lack of gender sensitisation and accountability among jail staff.
“The mistreatment or abuse of vulnerable groups boils down to societal stigma and a lack of gender sensitive education. At schools, children should be taught respectful behaviour towards all people since they will one day grow up to take roles in law enforcement. The duty of law enforcement is to ensure justice therefore jails should be a safe environment. Unfortunately, however, many a times this is not the case,” noted Dr Khan.
A report published by the United Nations Development Programme (UNDP) on HIV Gender Assessment in Pakistan, confirmed that vulnerable populations like female and male sex workers, and transgender persons were at a specific risk of sexual violence and coercion from the police. One transgender person revealed that she been gang raped by multiple police officials, who threatened to file a false case on drug possession in case she did not comply. Such hidden vices partly explain the spread of the disease within prisons.
Race against time
According to national statistics, the number of HIV-AIDS patients registered in Pakistan is 72,515 as of September 2024. These statistics show that AIDS is a growing problem in Pakistan and more stringent measures are needed to control it.
Officials associated with the Sindh government’s HIV programme claimed that a non-governmental organization (NGO) provided financial support for the rehabilitation of HIV-AIDS patients in the province’s jails. Dr Kanwal Mustafa, Additional Director of Communicable Disease Control, told The Express Tribune that he had recently screened prisoners for HIV-AIDS in all jails of Sindh but could not give the results as they were confidential.
On the other hand, IG Punjab Farooq Nazir revealed that all prisoners were screened upon entry and were offered treatment. “After their release, the information of the patient is shared with the health department,” claims Nazir. “This initiative has been taken for the first time across all jails of Punjab and for this the patients are kept in isolation in the jail.”
Reportedly, the Punjab AIDS Control Programme has devised a system of regular screening in jails in view of the seriousness of this problem. Blood tests are conducted every six months to detect new cases. In addition, the AIDS Treatment Centres (ART Centers) set up in different cities of the province have been directed to visit jails every fortnight, register patients and provide them with anti-retroviral drugs for three months.
KP’s Director of the HIV Control Programme Dr Tariq Hayat informed that 13 treatment centres were available across the province. “The prison health facilities refer the patients to the respective treatment centres where screening, counselling and free treatment are provided,” he says. “Doctors, health staff and jail authorities refer patients to us based on their health condition.”
As state authorities promise timely treatment for HIV-AIDS patients, experts believe there is a need to reduce overcrowding in prisons in order to improve the efficacy of the offered healthcare facilities. Secondly, awareness programmes on HIV should be initiated within prisons to encourage inmates to avoid unsafe activities. Thirdly, rehab centres should be set up inside prisons where drug addicts can be treated.
With Additional Reporting by Mahnoor Tahir
All facts and information are the sole responsibility of the writers
