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In a video spread on social media and filmed by Shah himself, Mufti Azizur Rehman — a religious leader belonging to the conservative Jamiat Ulema-e-Islam-Fazl JUI-F party, who confessed to his crime — could be seen involved in inappropriate acts with the victim, his student at the seminary.

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School frightens him now. Earlier this year, a cleric at the religious school he faithfully attended in the southern Punjab town of Pakpattan took him into a washroom and tried to rape him.

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Reproductive Health volume Pakistan for sexArticle : 22 Cite this article. Metrics details. In Pakistan, sexual practices outside marriage are proscribed by law. We aimed to assess the range and magnitude of non-marital sexual behaviours of urban men, focusing on men having sex with men. In this cross sectional survey undertaken in six cities of Pakistan, we interviewed men aged 16—45 years selected through a multistage systematic sampling de.

Sexual behaviours were assessed through a structured questionnaire. Multivariable analysis was used to identify association between various individual level characteristics Pakistan for sex probability of engaging in sexual activities involving men.

Nearly one-third 29 percent reported having had non-marital sex in their lifetime. Of these men 16 percent reported premarital sex, while 11 percent reported engaging in both pre- and extramarital sex. Only two percent reported exclusive extramarital sex. In total respondents, 9 percent reported ever having had sexual relations with men. While 62 respondents, 2. Factors that were ificantly associated with MSM behaviours were being less than 27 years adjusted OR 5.

Factors ificantly associated with exclusive homosexual behaviour were having sexual debut at a younger age i. Through public-private partnership stigmatised groups should be reached through established community networks and provided with information on accessing voluntary counseling and treatment centres. Peer Review reports.

Pakistan is currently the sixth most populous country in the world, with an estimated population of million [ 1 ]. HIV prevalence in the general population remains under 0. Although, Pakistan has been identified as a low HIV prevalence country, available evidence shows that the country is already experiencing a concentrated epidemic in the high-risk groups such as the injecting drugs user IDUsfemale and male sex workers [ 45 ].

The infection has therefore, the potential to spread from these groups to the general population. Recognizing the Pakistan for sex threat of a generalized HIV epidemic that might occur through men who engage in risky sexual practices, the National Aids Control Program of Pakistan NACP commissioned a pioneering behavioural and biological study of urban men funded by DFID and implemented by the Population Council in The study was commissioned with the primary objective to measure the prevalence of five selected sexually transmitted infections that included syphilis, gonorrhoea, chlamydia, HSV-2 and HIV [ 9 ].

The secondary objective was to measure sexual behaviours in urban men who could act as a bridge for spreading STIs from the high to low risk groups. A cross-sectional household survey of men was carried out in six major cities of Pakistan Lahore, Karachi, Peshawar, Quetta, Rawalpindi and Faisalabad in In each city men aged 16—45 years were selected through multistage sampling techniques.

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The sample size was based on a power calculation to deduct a ificant decrease Pakistan for sex sexually transmitted infection STI prevalence in five years Pakistan for sex in terms of its power to detect behavioural change with statistical confidence [ 10 ]. Initially in each city 10 blocks, households in each block, demarcated by the Population Census Organisation were selected based on probability proportionate to socio-economic status using female literacy as a proxy indicator for economic status. Within each block, 40 men were selected who had been resident in the selected households households comprised houses, hostels and apartments on the night prior to enumeration through systematic random sampling.

Informed consent was obtained, twice for administering a behavioural questionnaire and obtaining biological specimens. The study population included both married and unmarried men from different occupations including those working in the informal sector as well as those who were students or unemployed. It represented most linguistic groups since migration to cities is likely to originate from almost all parts of the country. The quantitative data were obtained by a study team that comprised two male social scientists. The information collected on sexual behaviours included history of sexual debut including age and type of partner, sexual partners in the last 12 months and last three months, type of sex including anal, oral and vaginal sex, condom use ever and last time, and personal hygiene.

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For data collection in each city two teams were hired locally. All teams were assembled in Islamabad and provided extensive training. Field work was carried out and completed in approximately 40 days from July 1 to August 10, Informed consent was obtained from all study participants who were provided comprehensive information about the study.

Participants were given four options to confirm their informed consent: consent by ature; consent by fingerprint; oral consent with a witness; or oral consent recorded by audiotape. In case of respondents aged 16 and 17 years, informed consent was obtained from their parents and guardians. Data entry was carried out using CSPro version 3.

Statistical analysis included descriptive statistics, bivariate analysis using chi-square test and multivariable analysis using logistic regression models, with 95 percent confidence intervals. This paper reports that reflect the non-marital sexual behaviours of men in major urban centers of Pakistan, with a special emphasis on male to male sexual activity. The refusal rate was 37 percent which is well within the range of similar studies [ 1314 ].

We anticipated relatively high rates of non-response due to the sensitive nature of the subject matter of the questionnaire, the biological testing requirement, and the known difficulty in locating men in urban settings [ 13 ]. To reach the sample size, in total, households had to be approached. Table 1 provides the socio-demographic characteristics of the study respondents. Among the total sample of 2, men, 31 percent reported never experiencing Pakistan for sex or non-marital sexual relation i. Only 3 respondents, 0. The mean and median age at the time of marital sexual debut was 24 years Standard Deviation 4.

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The mean and median ages at the time of sexual debut for pre-marital sexual relation were 19 and 18 years, respectively. In order to determine the extent to which the study population engages in premarital or extramarital sexual activity, all respondents were asked to recall their non-marital sexual relation over their lifetime, within the last twelve and three months. Of thesemen16 percent reported premarital sex, while 11 percent reported engaging in both pre- and extramarital sex.

In total, 13 percent of men reported Pakistan for sex in extramarital sexual activity. Figure 1 shows non-marital sexual behaviour over different time periods lifetime, last 12 months, and last 3 months with 95 percent confidence intervals. The next most frequent category was female sex workers 41 percent overall. The third most frequent non-marital sexual liaison was reported with males who were not sex workers 23 percent while 8 percent reported sex with a male sex worker.

Sex with hijra sex worker was about 6 percent in all six cities. Multiple responses were Pakistan for sex as respondents could have more than one partner.

Our show that overall 44 percent of those who reported non-marital sex said they had three or more non-marital partners in their lives while Pakistan for sex percent reported two and 39 percent had one partner only. Looking at the distribution of high-risk partners within the married and unmarried of Figure 3 the suggest that unmarried men had higher rates of sexual activity with male sex workers, males other than sex workers, and hijras as compared to married men. Most unmarried men were in the younger age category. Among these 26 percent were married. Out of these 62 respondents 2.

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As shown in Figure 4 nearly half of the MSM men reported having had three or more sexual partners in the last 12 months. Pakistan for sex analysis was carried out to identify the association between various individual level characteristics and the probability of engaging in sexual activities involving men. Two models Tables 2 and 3 were constructed for the purpose. The first identifies the contribution of covariates to being sexually active for MSM while the second model explores the contribution of covariates to the probability of men having sex exclusively with men.

The outcome variables in the first and second models were respectively based on MSM included bisexual men as well 62 men having exclusive sex with men and 62 exclusively homosexual men. As the first step, univariable analysis was carried out for each logistic regression model.

The purpose was to determine individual association of each independent variable with the respective outcome Pakistan for sex. The likelihood ratio test was used for testing the ificance of the coefficients. Independent variables with p-value of less than 0.

Next, multivariable analysis was performed to look for the association of independent variables with the two outcome variables Pakistan for sex two separate models while adjusting for the confounding effect of the other variables. In addition to the independent variables selected at univariable analysis, biologically plausible variables were also selected at this step. ificance of each independent variable in the multivariate analysis was assessed by its confidence interval and Wald statistic.

Variables, which were not ificant at a p-value of 0. The overall ificance of the variables in the model was assessed by the G statistic. Factors that had a ificant association with men engaging in MSM behaviours were being less than 27 years the median age of all respondents in the samplehaving education less than 10 years adjusted OR 2.

In Table 3the factors ificantly associated with exclusive homosexual behaviour were having sexual debut at a younger age i. In Pakistan, sex outside marriage is completely proscribed by law a. Our studyon the other hand, show that a sizeable minority of Pakistani men are indulging in sexual practices outside of marriage that are Pakistan for sex at a young age and include sexual practices that have not been ly documented.

The multivariate analysis has helped in identifying some of the factors associated with this practice. The ificance level at 0. This study provides empirical evidence to describe the range and magnitude of non-marital sexual practices prevalent in Pakistani society. Our are supported by other studies from South Asia that found relatively high rates of both extramarital and premarital sexual activity. Faisel and Cleland, infound that 55 percent of the unmarried men in their study of migrant men in Lahore reported being sexually experienced [ 17 ].

Another important finding from the study is that it reveals exclusive male sexual activity with Pakistan for sex 2.

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Our conform to the range reported in some other Islamic Pakistan for sex. We do acknowledge that our estimates of males having sex exclusively with males are possibly an underestimate. Most studies are believed to underestimate the prevalence of male-to-male sex [ 20 ].

The issue of male-to-male sex in most societies is associated with stigma making it difficult for people to discuss the issue candidly. For this reason we trained out interviewers to build rapport and establishing trust with the respondents in order to obtain information of a sensitive nature and assuring the confidentiality and maintaining privacy while conducting the interview.


The findings of our study however have important implications for preventing and Pakistan for sex the future spread of the HIV epidemic in Pakistan. At least 5 percent to 10 percent of all HIV infections in the world are transmitted through unprotected sex between men [ 20 ]. Our show that sex with males is more likely to occur at younger ages 16—20 years and declines with age. At younger ages men often begin sexual activity, and their choice of sexual partner at this age is often based on availability and affordability and not necessarily on sexual orientation or preference.

This may explain why male sexual partners are reported comparatively higher in the lower age groups than in the older ones.