Islamabad: The HIV caseload in Pakistan’s federal territories, especially the Islamabad has climbed close to 4,800 by the end of 2025, after an additional 300 infections were added during the last six month, with health authorities warning that a large pool of untreated patients is quietly driving the spread of the virus into the wider population, particularly in Islamabad.
Officials in the Ministry of National Health Services, Regulation and Coordination told this correspondent that Islamabad Capital Territory continues to account for the overwhelming majority of HIV cases reported from the federal region, including patients linked to services in Azad Jammu and Kashmir and Gilgit Baltistan.
They said an average of around 50 new HIV cases are being reported each month across Islamabad, AJK and GB, with more than 80 percent of these originating from Islamabad alone. “What is especially concerning is the age profile in the capital. A significant proportion of newly detected patients are young people, and around 60 percent of the recent cases involve youngsters,” a senior official said.
According to consolidated ICT Federal HIV registration data updated to December 31, 2025, a total of 4,756 people living with HIV are now registered in the federal system. This includes the additional 300 cases recorded during the year.
The breakdown of registered cases shows 3,432 adult males, 805 adult females, 422 transgender persons, 67 male children and 30 female children, taking the total caseload in the federal territories to 4,756.
Health officials cautioned that these figures only represent individuals who have entered the health system and do not reflect the true scale of infections, as a large number of people remain undiagnosed due to low screening uptake and stigma.
“These are people who voluntarily came forward for testing or were diagnosed when they approached health facilities for other reasons. The majority of people still do not get themselves screened,” an official said, adding that efforts to expand testing among high risk populations remain contentious. “There are groups that oppose mandatory screening of high risk populations on human rights grounds, which makes early detection and timely linkage to treatment more difficult.”
The data also highlights a serious treatment gap as only 2,257 people living with HIV in the ICT Federal system are currently receiving antiretroviral therapy (ART). Based on the total registered caseload of 4,756 by the end of 2025, this means only about 47.5 percent of known patients are on treatment, leaving more than half without lifesaving medication.
Among those on ART, adult males form the largest group with 1,492 patients, followed by 495 adult females and 194 transgender persons. Children on treatment include 50 boys and 26 girls.
Health officials warned that untreated patients pose a serious public health risk beyond their own health outcomes. “People who are not on treatment have higher viral loads and are far more likely to transmit HIV. When large numbers remain outside the treatment net, the infection does not stay confined to any one group and gradually spills into the general population,” an official said.
Explaining the drivers of Islamabad’s rising caseload, officials said transmission is highest among men who have sex with men (MSM), followed by infections linked to unsafe medical practices. Poor infection prevention and control in healthcare settings, reuse of syringes, and unsafe procedures at informal clinics run by unqualified practitioners were identified as major contributors.
Officials also pointed to risky sexual behaviour associated with substance use in the capital. “Sexual activity under the influence of drugs, commonly referred to as chemsex, is emerging as a significant factor in Islamabad. It lowers inhibitions, increases unprotected sex, and often involves multiple partners,” a ministry official said.
While Islamabad reports higher numbers than other regions, officials said this also reflects better access to testing and diagnostic services, and should not be mistaken for a complete picture. “Even here, stigma remains a major barrier. Many people delay testing, hide their risk history, and only come when they fall seriously ill. We are still detecting the epidemic late,” the official said.
The ministry said expanding confidential testing services, improving linkage to ART, enforcing infection control standards in both public and private healthcare facilities, and cracking down on unsafe quack clinics were essential to slowing the spread in the federal capital. Officials also called for a more evidence based debate on screening high risk populations, warning that delaying detection in the name of sensitivity ultimately harms both vulnerable communities and the wider public.
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