engaged in substance abuse and sexual behaviours that increase their risk of HIV transmission, and STD transmission and acquisition. Such patients were more likely to want to discuss their mental health concerns than those who did not engage in these behaviours. These findings underscore the importance of interventions to decrease risky sexual behaviour and to promote clinical assessment of mental health needs for this patient population. A mental health assessment can identify patients who

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... t need greater psychosocial support or referral for treatment of substance abuse and underlying mental illness. Background National AIDS control of Pakistan and its development partner Canadian Government CIDA is seeking for effective AIDS surveillance. However, prevailing illiteracy and conservative societal norms are challenging factors in preventing HIV spread. Factors which lead to behavioural changes among people if they have been told of their HIV positive status are complicated and directly related to self-esteem and personal liberation. Methods We evaluated this complex phenomenon with an aim to identify factors that prevent a person to disclose his/her HIV status to family members. Effort was also made to characterise determinants of prevailing stigma at society level for HIV positive and PLHA. Self structured questionnaire with binary and multiple response items was used for data collection. Multivariate logistic regression was used to identify significant predictors of stigma at family and societal level. Results A total of 412 subjects (178 females and 234 males) were included in the study. Family level anticipated stigma items that were significantly associated with HIV test refusal were family perception, life partner perception, family break-up and neglect by family. Social indicators for prevalent stigmatisation were losing job and livelihood, bad treatment by the healthcare worker and difficulty in finding marital partner of choice (Abstract P5-S1.03 table 1). Conclusions The study concludes that prevailing stigma is the major hindrance for running effective AIDS surveillance program. Clinical programs to prevent HIV infection must be integrated with psychiatric care service as a policy to improve awareness and peoples' willingness for HIV testing.