Seven times as many men as women are living with HIV in Pakistan, but HIV stigma and taboos around sex make it difficult to successfully address the epidemic, The New York Times reports (, 7/22). The findings were published in medical journal The Lancet.

Safe-sex education and condom use are uncommon in the Muslim country, where at least 85,000 people are living with the virus according to UNAIDS. Because Islamic law prohibits extramarital sex, many Pakistanis do not believe that HIV/AIDS is a concern in Muslim countries.

In Pakistan, like many other countries, men who have sex with men exist—as do male sex workers—but they’re considered taboo in the conservative culture, further compounding HIV education, prevention and treatment efforts.