A new wave of the Larkana HIV outbreak has hit Sindh province, with at least 78 children infected at a government hospital in what officials say may be linked to reused syringes. The outbreak has reignited concern over HIV in Pakistan, a crisis that has repeatedly centered on unsafe medical practices in the same district since 2019.

Background

Sindh has a long, troubling history with pediatric HIV outbreaks. The first major incident struck Larkana in April 2019, when hundreds of children were diagnosed with HIV within a few months, most linked to unsafe injections at local clinics.

That outbreak was investigated by the World Health Organization, which found that unsafe healthcare practices, including reused syringes and poor infection control, were the most likely cause. Despite that investigation and years of promised reform, similar outbreaks have kept surfacing across Sindh, including in Jacobabad, Shikarpur, Mirpur Khas, and Naushahro Feroze.

HIV cases in Sindh 2025 data show the scale of the renewed crisis. Admissions at the Sindh Infectious Diseases Hospital and Research Centre rose sharply, climbing from just 10 HIV-positive children in 2024 to 70 in 2025. A further 30 children have already been admitted this year, most of them previously treated at the hospital now at the center of the investigation.

Details

Provincial labour minister Saeed Ghani confirmed that at least 78 children contracted HIV at Kulsoom Bai Valika Hospital in Sindh, with an investigation now underway into allegations that contaminated syringes were reused on patients. The outbreak was first reported last November but has only recently drawn wider national attention.

Sindh’s health ministry data shows 894 HIV cases were registered across the province between January and March this year alone, of which 329 involved children. That number reflects just how much HIV cases in Pakistan 2025 have accelerated in this province compared to previous years.

The broader picture of HIV in Pakistan 2024 already showed troubling growth. The National AIDS Control Program had registered 74,619 HIV cases nationally by December 2024, with 51,821 people enrolled in antiretroviral therapy across 94 ART centers. By December 2025, that number had grown to 84,421 registered cases, with 60,785 people on treatment.

Karachi remains one of the country’s highest-burden cities. Studies point to population movement and dense, underserved neighborhoods as major drivers behind elevated HIV cases in Karachi, particularly among people who inject drugs and other high-risk groups.

Islamabad has also seen a steady rise outside Sindh’s outbreaks. Reports on HIV cases in Islamabad 2024 pointed to hundreds of new diagnoses concentrated among specific risk groups, reflecting a national pattern where the epidemic is no longer confined to a handful of rural districts.

Quotes

Saeed Ghani addressed the affected families directly, saying the Sindh government would not abandon them. He stated that authorities would “ensure their complete medical treatment and provide every possible support,” while adding that “there must have been negligence on someone’s part.”

The Pakistan Medical Association issued a warning earlier this year, cautioning that rising pediatric HIV cases in Sindh reflected deeper systemic failures rather than isolated incidents. The association called for stronger enforcement of infection control standards across both public and private healthcare facilities.

The 2024 WHO-led review of Pakistan’s outbreak response noted a persistent gap in follow-through, stating that past outbreaks were “not followed by systematic infection prevention and control interventions that could have led to improved national IPC practices.”

Impact

The renewed Larkana HIV outbreak carries consequences well beyond the immediate infections. Families in the affected communities now face lifelong medical care for their children, along with the social stigma that still surrounds HIV in many parts of Pakistan.

Nationally, UNAIDS estimates the real number of people living with HIV in Pakistan exceeds 210,000, far higher than the roughly 84,000 officially registered cases. That gap is where the epidemic keeps growing quietly, since undiagnosed people can’t access treatment and often don’t know they’re passing the virus on.

Public health experts warn that repeated outbreaks in the same district signal a failure to fix root causes rather than a series of unrelated incidents. Unsafe injection practices by unqualified or poorly regulated practitioners remain the most commonly cited driver behind Pakistan’s pediatric HIV cases.

International partners, including WHO, UNICEF, and UNAIDS, have previously sent rapid response teams to Sindh, but funding gaps for infection prevention and control programs remain a concern for sustaining long-term reform.

Conclusion

Investigations into the Kulsoom Bai Valika Hospital outbreak are ongoing, with officials promising accountability for anyone found responsible. It’s not yet clear whether this will lead to lasting reform or just another short-term response followed by the next outbreak, a pattern Sindh’s health system has repeated before.

For now, health authorities are expanding testing and treatment access in the affected areas, while calls grow louder for stricter, better-enforced infection control standards across Pakistan’s healthcare facilities, both public and private.

Frequently Asked Questions

Can HIV positive marry HIV negative?

Yes, marriages between an HIV-positive partner and an HIV-negative partner, sometimes called serodiscordant couples, are medically possible and increasingly common worldwide. With consistent antiretroviral therapy, the HIV-positive partner can often reduce their viral load to undetectable levels, which significantly lowers the risk of transmission. Additional precautions, such as pre-exposure prophylaxis (PrEP) for the HIV-negative partner and regular medical monitoring, can further reduce risk. Couples in this situation are strongly encouraged to consult an infectious disease specialist for personalized guidance on treatment, prevention, and family planning.

Which city in Pakistan has the most HIV cases?

Karachi and the wider Sindh province consistently report the highest concentration of HIV cases in Pakistan, driven by a combination of dense population movement, underserved communities, and high-risk behaviors among certain groups, including people who inject drugs. Larkana, a smaller city within Sindh, has become particularly notorious due to repeated large-scale pediatric outbreaks traced back to unsafe medical practices since 2019. While Punjab and Khyber Pakhtunkhwa have also seen rising case numbers in recent years, Sindh remains the epicenter of the country’s HIV crisis.

How do HIV rashes look like?

An HIV-related skin rash typically appears during the acute stage of infection, usually within two to four weeks of exposure, and often presents as small, reddish or pink flat or slightly raised spots that can appear on the chest, back, face, and other parts of the body. The rash is frequently accompanied by other flu-like symptoms, including fever, fatigue, sore throat, and swollen lymph nodes, making it easy to mistake for a common viral illness. Because these symptoms overlap with many other conditions, a rash alone cannot confirm HIV status. Anyone experiencing these symptoms after a potential exposure should seek HIV testing rather than relying on visual symptoms alone.