Karachi: At least four children tested positive for HIV every day in Sindh during the first six months of 2026, with provincial authorities reporting an alarming 729 paediatric HIV cases, averaging 122 infections every month, official data showed.
The latest figures showed that June was the worst month, with 171 children, including 113 boys and 58 girls, diagnosed with HIV. It was the highest monthly total recorded during the first half of the year and almost double the 87 cases reported in March, when the province recorded its lowest monthly figure.
Official HIV registration data showed that 805 children were newly registered with HIV across Pakistan between January and June 2026, excluding Punjab, of whom 729, or 90.6 percent, belonged to Sindh. Among the infected children in Sindh, 447 were boys and 282 were girls.
Month-wise data showed that Sindh registered 125 child HIV cases in January, 117 in February, 87 in March, 121 in April, 108 in May and 171 in June, indicating sustained detection of paediatric HIV cases throughout the six-month period, with a sharp increase in June.
The surveillance data classify cases by age and sex but do not identify how the children acquired the infection. They do not distinguish whether infections resulted from mother-to-child transmission, unsafe injections, contaminated blood or blood products, healthcare-associated infections or any other route.
The latest figures come amid growing concern over repeated HIV outbreaks among children in Sindh since the Ratodero outbreak in 2019. More recently, another cluster of paediatric HIV cases emerged at Karachi’s Valika Hospital, raising renewed concerns over infection prevention and control practices in healthcare facilities.
Renowned infectious diseases specialist Dr Faisal Mahmood described the high number of infected children as “unusual”, saying the data appeared consistent with a paediatric HIV epidemic, although the timing of infection could not be determined from surveillance figures alone because children infected several years earlier could be diagnosed only now.
He said the age distribution of infected children strongly suggested that mother-to-child transmission alone could not explain the large number of cases.
“Children are usually infected at birth, but when such a large number of children of different ages are being diagnosed, this is clearly not just vertical transmission. Repeated investigations have consistently pointed to unsafe injection practices,” he said.
Dr Mahmood said further inquiries into the general causes of transmission might not be necessary because previous investigations had repeatedly highlighted unsafe injection practices. Instead, he called for stricter regulation of private and informal healthcare facilities, education of general practitioners on safe injection practices and ensuring that safe injection practices are financially sustainable.
He said merely banning healthcare providers or introducing temporary restrictions would have limited impact, suggesting that informal practitioners should instead be brought under a regulated framework with clearly defined responsibilities and penalties for unsafe practices.
The infectious diseases expert also called for expanding HIV screening among children admitted to hospitals across Sindh, saying this would be more effective than limiting screening mainly to pre-operative patients during periodic campaigns.
Eminent public health expert and Vice Chancellor of the Health Services Academy, Prof Shahzad Ali Khan, termed the figures extremely alarming and called for a comprehensive epidemiological investigation into every paediatric HIV cluster in Sindh.
He said even a single HIV infection in a child required serious investigation, while hundreds of infections represented a major public health crisis.
Prof Shahzad attributed most paediatric HIV infections to poor infection prevention and control practices, including the reuse of syringes, intravenous drip sets and cannulas, as well as inadequately screened blood transfusions. He warned that in many settings blood was only cross-matched before transfusion without proper screening for transfusion-transmitted infections.
He further observed that although HIV has traditionally been concentrated among key populations such as people who inject drugs, men who have sex with men, female sex workers and transgender persons, a bridging population was now facilitating transmission into the general community.
Calling the situation an epidemic in Sindh, Prof Shahzad urged authorities to launch mass HIV screening, promote self-testing, strengthen public awareness campaigns and undertake comprehensive epidemiological investigations and contact tracing similar to those carried out during the COVID-19 pandemic to identify hidden infections and link patients to treatment.
Despite repeated requests for comments, the Sindh Health Department and the Provincial HIV/AIDS Programme (CDC-I) did not respond to questions regarding the unusually high number of paediatric HIV cases or the measures being taken to investigate and prevent new infections.
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