As Pakistan braces for another intense monsoon season, people living with HIV fear a repeat of last year’s devastating floods that cut off access to life-saving medicines, putting thousands at risk of severe health complications, reports Dawn.For Khalid (name changed), a daily wage worker from Buner in north-western Pakistan, saving his family’s HIV medication became more important than rescuing any valuables when floodwaters engulfed their home during the 2025 monsoon.As contaminated floodwater rushed into their house, Khalid and his wife first helped their three children reach safety before wading through neck-deep water to retrieve their antiretroviral (ART) medicines.”The waist-deep mud left behind by floodwaters had cut off our village for more than eight days. Thankfully, my wife and I still had our HIV medication with us,” Khalid recalled.The floods, which claimed more than 1,000 lives, displaced nearly three million people, and damaged around 230,000 homes, created an additional crisis for HIV patients who rely on uninterrupted treatment.According to Asma Nasim, head of the Department of Infectious Diseases at the Sindh Institute for Urology and Transplantation, many HIV-positive patients fell ill after being cut off from antiretroviral therapy centres.”During last year’s floods, many people with HIV got sick because they were cut off from antiretroviral therapy centres and couldn’t access drugs,” she said.Pakistan provides free HIV treatment through dedicated ART centres. However, experts warn that even short interruptions can have serious consequences.”Gaps in treatment have severe health consequences, including viral rebound, immune system damage and progression to AIDS,” said Asghar Ilyas Satti, National Coordinator of the Association of People Living with HIV-Pakistan.”For HIV patients, who are already navigating stigma and fragile health systems, climate disasters are not only destroying their homes and livelihoods, but also endangering access to essential medication.”Stigma adds to the crisisWaheed (name changed), a schoolteacher from Swat district, said stigma forced him to hide his HIV status even from his wife.”Due to the stigma associated with the disease, I have kept my illness a secret from everyone, even from my spouse,” he said.As floodwaters rose, Waheed secretly returned to his submerged home to recover his medicines.”I had only nine tablets left and was worried about facing a gap in treatment due to loss of access to the antiretroviral centre,” he recalled.Pakistan records sharp rise in HIV casesThe health crisis comes as Pakistan witnesses an alarming rise in HIV infections.According to the World Health Organization (WHO), new HIV infections in the country have increased by 200 per cent over the past 15 years, rising from 16,000 cases in 2010 to 48,000 in 2024.Doctors are also reporting a worrying increase in infections among children.”During the last three months, I have seen more children who are HIV positive than I have seen in the last ten years. It isn’t just that more people are being tested. It is that there are more people being infected,” Nasim said.Health experts have linked several outbreaks to unsafe medical practices, including the reuse of syringes and non-sterile medical equipment. A recent investigation found that 331 children tested HIV-positive in Punjab’s Taunsa between November 2024 and October 2025, allegedly after receiving injections with reused syringes.Monsoon threat looms againPakistan’s National Disaster Management Authority (NDMA) has warned that the 2026 monsoon could bring 22-26 per cent more rainfall than last year, raising fears of fresh flooding.Prime Minister Shehbaz Sharif has directed authorities to strengthen flood preparedness and ensure comprehensive HIV and hepatitis screening in public hospitals.Meanwhile, nearly 20,000 HIV patients who had started treatment at ART centres were reported missing from follow-up records as of May 2026, raising concerns over treatment continuity.Health workers say restoring contact with patients after floods is extremely challenging, especially when communication networks collapse and entire communities remain isolated for weeks..