The epidemic is almost certainly the fault of more than one doctor, health officials said. Lax safety rules and reuse of syringes or needles apply to city registered doctors and unregistered charlatans.
Medical waste is not disposed of safely and syringes are even recycled in the bazaar and re-sold. Unsterilized dentist's instruments, barber razors and poorly regulated blood transfusions increase the risk of spreading blood-borne diseases.
The number of new infections has now been reduced to one or two a day, but as panic disappears, health officials are wondering how to stop the spread of infection and treat those who have it.
Pakistan's AIDS program doctors admit to being overwhelmed at first. There was not enough medicine or staff to deal with the crisis. The parents complain that they do not receive medication and have to travel 20 miles from Ratodero to Larkana to get drugs.
Health officials are now denying the shortage and claiming that a clinical service for treating patients is set up from scratch. More than half of the patients receive antiretrovirals and the rest will be treated as soon as they are treated for other infections such as tuberculosis.
Yet, despite the assurances given, about 25 HIV-positive children have already died since diagnosis, in a region already affected by malnutrition and high infant mortality. AIDS treatment is at best fragmented in Pakistan, and the UN estimates that 6,400 people died from the disease last year.
Dr. Sikander Ali Memon, director of Sindh's AIDS program, said: "Not all patients have benefited from all the treatments, some people already having an infection, such as tuberculosis. When they are cured, they will begin treatment for HIV. Up to now, 600 people are taking antiretroviral drugs.
He added that a public information campaign would be conducted to try to eliminate some of the stigma associated with the infection, which many still associate with sex or drugs.