FREQUENCY AND DETERMINANTS OF HIV INFECTION AMONG PATIENTS ATTENDING DISTRICT HEADQUARTERS HOSPITAL, KOHAT: A CROSS-SECTIONAL STUDY FROM KOHAT DIVISION, KHYBER PAKHTUNKHWA, PAKISTAN

Abstract

HIV infection is an emerging public health concern in Pakistan, driven by unsafe medical practices, blood transfusion, and high-risk behaviours. This study determined the frequency and demographic/behavioural determinants of HIV infection among patients attending DHQ Hospital Kohat and referred for HIV testing. Between September 2025 and April 2026, 750 individuals with clinical symptoms suggestive of HIV, referred by attending physicians, were screened using an Immunochromatographic (ICT) test kit; 72 (9.6%) tested positive. Prevalence was significantly higher in males (68.1%) than females (31.9%; χ²=9.39, df=1, p=0.002), and in rural (79.2%) versus urban residents (20.8%; χ²=24.50, df=1, p<0.001). The 21–40-year age group showed the highest prevalence (43.1%), followed by 41–60 years (27.8%), with a significant deviation from an even distribution across six age categories (χ²=58.17, df=5, p<0.001). Cases were distributed across Kohat (41.7%), Karak (30.6%), and Hangu (27.8%) districts, without significant inter-district variation (χ²=2.33, df=2, p=0.311).Structured interviews of the 72 positive cases (mean age 40 years) showed 80.6% were married (χ²=26.89, df=1, p<0.001) and 86.1% had no formal education (χ²=90.58, df=2, p<0.001). Heterosexual contact was the predominant transmission route (58.3%), significantly exceeding combined mother-to-child transmission, blood transfusion, and dental-procedure exposure (χ²=75.00, df=3, p<0.001); 23 of these cases involved contact with sex workers. No homosexual or transgender transmission was reported. Regarding addiction, oral snuff use was most common (31.9%), followed by smoking, hashish, and injection drug use, with significant variation across categories (χ²=55.64, df=4, p<0.001). These findings highlight a substantial, predominantly heterosexually and iatrogenically driven HIV burden in rural Kohat division, emphasizing the need for expanded community-based screening, safe injection practices, and targeted awareness programmes.